Is it safe for children to return to school while the coronavirus is on the loose?
This depends on what is likely to happen if a student becomes infected. Will the virus bounce on your classmates, who will be able to fuel its spread through the student body? Will he find his way to the professor and hitch a ride to the break room, jeopardizing college on campus?
Scientists don’t have definitive answers to questions like these – and they probably won’t for a long time.
Schools are dealing with this uncertainty in different ways. In Southern California, the state’s two largest districts – Los Angeles Unified and San Diego Unified – said they would start the new school year with full-time distance learning. Among them is Orange County, where the Board of Education voted to allow students to reach campus without requiring masks or social distance.
A report released Wednesday by the National Academies of Science, Engineering and Medicine recognizes that compulsory schools are in.
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“There is not enough evidence to determine how easily children and young people contract the virus and how contagious they are once,” says the report. This knowledge gap “makes it extremely difficult for decision makers to assess the health risks of opening schools physically and creating plans to operate them in ways that reduce the transmission of the virus.”
But decisions must be made anyway. Here is a more detailed analysis of what scientists know about children and COVID-19 – and what that suggests about the risks of sending them back to school.
Do children have any type of natural protection against the coronavirus?
They do seems to be less susceptible to the virus, and this is especially true for younger children.
Data from the US Centers for Disease Control and Prevention shows that, by May 30, the incidence of COVID-19 was 51.1 cases per 100,000 children under 10 years old and 117.3 cases per 100,000 children and young adults among 10 and 19 years. these numbers were well below the national number of 403.6 cases per 100,000 Americans.
Scientists are not sure what explains this phenomenon. One theory is that children’s cells have fewer ACE2 receptors that the coronavirus needs to bind to initiate an infection. The researchers analyzed the level of expression of the ACE2 gene in 305 people between the ages of 4 and 60 and found that it steadily increased with age.
“Lower expression of ACE2 in children compared to adults may help to explain why COVID-19 is less prevalent in children,” the researchers reported in the Journal of American Medical Assn.
But that does not mean that children cannot get sick. In fact, a small number of pediatric patients have developed a serious disease called multisystem inflammatory syndrome, or MIS-C, in children.
“Although the balance of data shows that children are less susceptible to infection and less likely to transmit them, less susceptible does not mean that they are not susceptible” Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration, said this week on Face the Nation.
If children are less likely to be infected, doesn’t that mean they are less likely to spread it?
Most likely. After all, you can’t spread a virus if you don’t have it in the first place.
Some health experts suspect that one of the reasons why infection rates have been lower in children than in adults is that they are relatively isolated at home while their parents leave home to work, shop or socialize. When children return to school, they can begin to update themselves.
Even so, there is evidence that children simply do not have the same coronavirus spreading power as adults. Studies that tracked how infections spread to homes in the U.S., Switzerland and several Asian countries showed that adults are much more likely than children to carry the virus home, they said. Dr. Naomi Bardach, pediatrician and policy researcher at UC San Francisco.
“Most of the time, the adult in the house was the one who was originally infected,” he added. Dr. Ibukun Christine Akinboyo, medical director of pediatric infection prevention at Duke University Medical Center. “If it were the child, there seemed to be less than a 15% risk that the child would spread throughout the house.”
Should we think of kindergarten students in the same way as high school students?
No. On the one hand, infection rates are lower for school-age children than for adolescents.
Another consideration is that high school students can do more to protect themselves than young children. For example, they should be able to wear a mask all the time on campus, something that kindergarten students are probably unable to cope with. Older students must also have a better social distance.
And when they get home, high school students can operate more independently than elementary school children. This could help mitigate the risk of a teenager, if infected, transmitting the virus to family members at home, he said. Dr. Charlene Wong, a pediatrician who also studies health behaviors at Duke University.
Is it safe for children to be on campus if they are too young to keep a mask on their faces?
Pediatricians recognize that younger children may not wear masks all the time, stay away from peers or keep their hands away from their faces. But because they are less vulnerable to infection, this is probably a good thing, they said.
This country allows children over 12 to approach children and adults without having to worry about social distance, he said. Even teenagers aged 13 to 17 can be in close contact. But since adults are responsible for most of the viral spread, they need to stay at least six feet when possible.
What happened in other countries when students returned to school?
Generally speaking, not much. For example:
• A report by Australia’s National Immunization Surveillance and Research Center examined 15 schools in New South Wales that reported cases of COVID-19 in March and April. Nine students confirmed coronavirus infections during that period and they may have spread for a grand total of two colleagues out of 735 considered “close contacts”. Nine adults from these schools also caught the coronavirus, but did not spread it to any of their 128 “close contacts” between teachers and staff, health officials concluded.
• The first known patient in Ireland with COVID-19 was a child who visited northern Italy in early March, just as the coronavirus crisis in that country was beginning to take off. Schools in Ireland were closed soon after, on March 12; so far, health officials had identified a total of three infected students – one in primary school and two in secondary school – along with a teacher and two other adult instructors. None of the 924 children’s classmates caught the virus school, nor 101 school contacts of the three infected adults. Even outside of school, the six infected people did not spread the virus to any of the 1,001 children who were among their closest contacts, according to a report from Eurosurveillance magazine.
• A study published in the journal Clinical Infectious Diseases found what happened after an English tourist who caught the coronavirus in Singapore visited a ski chalet in France. He spread the virus to 11 others, including a child who later visited three schools and a ski class. None of this child’s contacts was infected.
• In the Netherlands, schools and day care centers began to reopen on May 11 and, on June 8, students had returned to campus full time. The country’s National Institute of Public Health and Environment said it had received “some reports” of infections among school officials since it resumed normal operations, but none of them got it from kids on campus. In addition, the average number of people who contract the virus from a single infected person has remained below one since March.
Although no significant outbreaks of coronavirus have been found in schools, that does not mean that it cannot happen in the future, Akinboyo said, especially since the virus is more widespread in the community now than in the early days of the pandemic.
We should also keep in mind that the US population is more diverse than in most other countries, so their experiences may not reflect what is likely to happen here, he said. Lisa Gennetian, Duke economist who studies childhood poverty.
The closure of schools and the move to distance learning were extremely disturbing. Did it really help to delay the pandemic?
It seems that the answer should be yes, but it could have helped less than you think.
Several studies have attempted to quantify the benefits of measures designed to slow the spread of coronavirus, including quarantines, orders to stay at home, close schools and policies of social detachment. Together, these policies seemed prevent the transmission of the virus, although as far as it is not clear.
A preliminary study focused on Hong Kong found that measures to keep people separated may have reduced the spread of the community by up to 44%, but the authors did not estimate how much of this benefit could be attributed to school closings.
AN Review in Lancet magazine …