The Guardian (Charlottetown)

There will be transmissi­on

It’s not clear if children truly acquire virus less often than adults

- SHARON KIRKEY

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.

 ?? REUTERS ?? Children sit on a bench in the playground at St John’s Primary School in Fulham, Britain.
REUTERS Children sit on a bench in the playground at St John’s Primary School in Fulham, Britain.

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