Those who believe schools are safe to reopen ahead of a vaccine typically cite the low transmission risk associated with young children. The data on this might be more nuanced than people know.
It’s true, toddlers rarely pass the SARS-CoV-2 virus responsible for COVID-19, however health officials aren’t convinced that there is a meaningful disparity separating older adults and those between the ages of 10 and 19 with respect to transmissibility.
“I fear that there has been this sense that kids just won’t get infected or don’t get infected in the same way as adults and that, therefore, they’re almost like a bubbled population,” Michael Osterholm, an infectious disease expert at the University of Minnesota told the New York Times. “There will be transmission,” Dr. Osterholm said. “What we have to do is accept that now and include that in our plans.”
As lawmakers try to litigate the end of immobility, virologists compile evidence on behalf of the contrary view.
Contact tracing program for evidence-based policy to mitigate the pandemic
“Effective contact tracing is critical to controlling the spread of coronavirus disease (COVID-19),” the authors of a new study published in the Emerging Infectious Disease Journal wrote. “We showed that household transmission of SARS-CoV-2 was high if the index patient was 10–19 years of age. In the current mitigation strategy that includes physical distancing, optimizing the likelihood of reducing individual, family, and community disease is important. Implementation of public health recommendations, including hand and respiratory hygiene, should be encouraged to reduce transmission of SARS-CoV-2 within affected households.”
The researchers analyzed 5,706 COVID-19 patients logged in South Korea between January 20 and March 27, 2020.
By pairing disease incidence with reports for 59,073 contacts via exhaustive databases–namely global positioning systems, credit card transactions, and closed-circuit television, the researchers make a compelling argument in favor of telelearning.
Many infectious disease experts have hailed the methods employed in the new paper as one of the most comprehensive contact-tracing programs to date- comprising traditional epidemiology and new-age techniques to track grouped index patients by age: 0–9, 10–19, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and >80 years.
The study posits that children under the age of 10 years old are roughly half as likely to transmit SARS-CoV-2 to their household. This figure is considerably higher among middle and high school-aged kids, though the mechanisms are not yet fully understood.
Experts who were not involved in the report have theorized that these might be halved between behavioral and biological factors.
The authors of the new report are confident that if schools re-open, coronavirus outbreaks will impact communities once again. This is an outcome that will undoubtedly be compounded by colder months ahead.
“The role of household transmission of SARS-CoV-2 amid reopening of schools and loosening of social distancing underscores the need for a time-sensitive epidemiologic study to guide public health policy,” the authors continued. “Contact tracing is especially important in light of upcoming future SARS-CoV-2 waves, for which social distancing and personal hygiene will remain the most viable options for prevention. Understanding the role of hygiene and infection control measures is critical to reducing household spread, and the role of masking within the home, especially if any family members are at high risk, needs to be studied.”
These findings by no means eliminate the potential to reopen schools before the development of a COVID-19 vaccine, but it does warrant a less ambiguous response than the ones currently on offer.
Improved ventilation, restricted attendance, and mask mandates have already been adopted by some institutions, to some success.
Above all else, more research needs to be conducted to determine the exact risk posed by school-age children.
“We also found the highest COVID-19 rate for household contacts of school-aged children and the lowest for household contacts of children 0–9 years in the middle of school closure. Despite closure of their schools, these children might have interacted with each other, although we do not have data to support that hypothesis. A contact survey in Wuhan and Shanghai, China, showed that school closure and social distancing significantly reduced the rate of COVID-19 among contacts of school-aged children. In the case of seasonal influenza epidemics, the highest secondary attack rate occurs among young children (9). Children who attend daycare or school also are at high risk for transmitting respiratory viruses to household members.”