The Guardian (Charlottetown)
There will be transmission
It’s not clear if children truly acquire virus less often than adults
It’s hardly a comfort to parents that a prominent voice in medical ethics believes reopening schools come fall will amount to one of the biggest human experiments in living memory.
“An oft-made argument holds that COVID-19 infections in children are ‘benign’ and that students don’t infect teachers (or vice versa),” Arthur Caplan, founding director of the division of ethics at New York University Langone Medical Center and physician-epidemiologist David Lilienfeld write in Newsday.
“But we don’t really know that because the available data are simply too sparse to be informative.”
In fact, both child-to-child and child-to-adult transmission has occurred. Just this week, South Korean researchers who traced an astonishing 59,000 contacts of 5,706 “index” cases — the first identified case in a cluster — reported that household transmission of the SARS-CoV-2 virus was high if the “index” person was aged 10 to 19. Kids under age 10 were least likely to spread the virus, though the researchers caution young children may show higher attack rates when schools reopen.
“There will be transmission,” University of Minnesota infectious diseases expert Dr. Michael Osterholm told the New York Times. “What we have to do is accept that now and include that in our plans.”
Others point to data suggesting school-aged children aren’t significant drivers of the pandemic, and relatively few children get severely ill from COVID-19. School reopenings in countries with low community transmission hasn’t resulted in significant or sudden surges in the growth rate of COVID-19 cases and school-based transmission could be an entirely “manageable problem,” according to a commentary published this week in the journal Pediatrics. Schools should remain open, the authors suggested, “even during periods of COVID-19 spread.”
Canada’s child specialists are also urging a safe return to classrooms and daycares, by September, arguing the months of isolation are affecting the mental, emotional and developmental health of children, particularly the ones most vulnerable even before the pandemic hit.
Among epidemiologists, however, the mood is decidedly uneasy. “Proposal: ‘I am a paediatrician and my friends are paediatricians and we are fine with kids going to school’ is the same level of evidence as: ‘Nine out of 10 doctors surveyed smoke Chesterfields. Discuss,” tweeted University of Toronto professor of epidemiology David Fisman.
Fisman says the per-test positivity in children is no different in Ontario, per capita, than in the 20-to-40 age group. “So the idea that there is something magic about kids that makes them uninfectable, we don’t seem to see that in Ontario at all,” he says.
As the experts debate how to open schools safely, parents are struggling with their own agonizing dilemma: Do I send my child back? How do you make an informed decision when the evidence keeps shifting beneath your feet?
From the very first days of the pandemic, from the early dispatches from China, children appeared relatively resistant to the virus that causes COVID-19. Seven months out, researchers are still trying to unpack why transmissibility by kids might be different, why younger children seem to acquire COVID-19 less frequently than adults — a biological advantage or undertesting? — and why kids get less sick than adults even though they have similar viral loads.