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Lots of talk about schools and #COVID19 today, which is no surprise!
Time for a bumper thread on the evidence we have so far on schools, children, teachers, and #SARSCoV2 plus some additional thoughts/considerations
Lets go!
1/15
Time for a bumper thread on the evidence we have so far on schools, children, teachers, and #SARSCoV2 plus some additional thoughts/considerations
Lets go!
1/15
First, off to Australia 
Tracing of 18 confirmed cases in schools (9 kids, 9 teachers) found that of 863 contacts, only 2 (kids) were positive and not clear if they were infected in school or elsewhere
2/15
http://www.ncirs.org.au/covid-19-in-schools
Tracing of 18 confirmed cases in schools (9 kids, 9 teachers) found that of 863 contacts, only 2 (kids) were positive and not clear if they were infected in school or elsewhere
2/15
http://www.ncirs.org.au/covid-19-in-schools
Now a French highschool in a heavily affected area 
~40% of staff & pupils had positive serology
Note almost all kids >14y. Of those younger, 2.7% positive (not clear if pupil or sibling)
Lower rates in siblings/parents. Teens seem higher risk
3/15
https://doi.org/10.1101/2020.04.18.20071134
~40% of staff & pupils had positive serology
Note almost all kids >14y. Of those younger, 2.7% positive (not clear if pupil or sibling)
Lower rates in siblings/parents. Teens seem higher risk
3/15
https://doi.org/10.1101/2020.04.18.20071134
Same region in , but primary school
Here 8.8% pupils seropositive compared to 11.9% parents
3 kids in school whilst symptomatic, no evidence of transmission. Appears mainly infected at home.
Symptom onset/timings not affected by school closure
https://doi.org/10.1101/2020.06.25.20140178
4/15
, but primary schoolHere 8.8% pupils seropositive compared to 11.9% parents
3 kids in school whilst symptomatic, no evidence of transmission. Appears mainly infected at home.
Symptom onset/timings not affected by school closure
https://doi.org/10.1101/2020.06.25.20140178
4/15
Next, Ireland 
6 cases (3 kids, 3 teachers) with school contact tracing
Only 2 transmissions from >1000 contacts, both from a teacher to other adults outside of school
Asymptomatic contacts not tested, so possible undercounting
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.21.2000903#figuresntables
5/15
6 cases (3 kids, 3 teachers) with school contact tracing
Only 2 transmissions from >1000 contacts, both from a teacher to other adults outside of school
Asymptomatic contacts not tested, so possible undercounting
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.21.2000903#figuresntables
5/15
Finally Singapore 
3 +ve cases:
-12yo in secondary school. 8 classmates symptomatic, all tested negative
-5yo (sibling of
) in primary school. 34 classmates tested, all negative
-16 staff in pre-school cluster. 70% of kids tested, all negative
6/15 https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa794/5862649
3 +ve cases:
-12yo in secondary school. 8 classmates symptomatic, all tested negative
-5yo (sibling of
) in primary school. 34 classmates tested, all negative-16 staff in pre-school cluster. 70% of kids tested, all negative
6/15 https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa794/5862649
Small numbers, but some early lessons:
-Kids/teachers can catch #SARSCoV2 in school
-Transmission appears mostly rare
-Teenagers may be higher risk for transmitting (consistent with evidence of higher case loads, plus lots of close social mixing)
What else to consider?
7/15
-Kids/teachers can catch #SARSCoV2 in school
-Transmission appears mostly rare
-Teenagers may be higher risk for transmitting (consistent with evidence of higher case loads, plus lots of close social mixing)
What else to consider?
7/15
First, there is almost no controversy that children's safety is not the concern from being in school
Their risks of becoming infected and severely unwell are incredibly low (even accounting for the extremely rare hyperinflammatory syndrome)
8/15
https://medium.com/wintoncentre/what-have-been-the-fatal-risks-of-covid-particularly-to-children-and-younger-adults-a5cbf7060c49
Their risks of becoming infected and severely unwell are incredibly low (even accounting for the extremely rare hyperinflammatory syndrome)
8/15
https://medium.com/wintoncentre/what-have-been-the-fatal-risks-of-covid-particularly-to-children-and-younger-adults-a5cbf7060c49
Of course there are teachers in school too - however data from Sweden 
where schools have stayed open, shows that Teachers have not been any more likely to get infected than other professions (taxi drivers 5x risk)
c @ProfEmilyOster
9/15
https://www.folkhalsomyndigheten.se/contentassets/5e248b82cc284971a1c5fd922e7770f8/forekomst-covid-19-olika-yrkesgrupper.pdf
where schools have stayed open, shows that Teachers have not been any more likely to get infected than other professions (taxi drivers 5x risk)c @ProfEmilyOster
9/15
https://www.folkhalsomyndigheten.se/contentassets/5e248b82cc284971a1c5fd922e7770f8/forekomst-covid-19-olika-yrkesgrupper.pdf
The risk is primarily of increasing community transmission by spreading infection to each other, parents, grandparents etc who will in turn spread it on
Children seem less likely to transmit than adults, but they certainly can transmit
10/15 https://twitter.com/apsmunro/status/1272612343726440449?s=20
Children seem less likely to transmit than adults, but they certainly can transmit
10/15 https://twitter.com/apsmunro/status/1272612343726440449?s=20
Most people worry about kids transmitting similar to other resp viruses, like influenza
This does not appear to be the same for #COVID19 as nicely pictured in this modelling study
https://www.nature.com/articles/s41591-020-0962-9
So good news, but we shouldn't be complacent
11/15
This does not appear to be the same for #COVID19 as nicely pictured in this modelling study
https://www.nature.com/articles/s41591-020-0962-9
So good news, but we shouldn't be complacent
11/15
Israel has had some trouble with outbreaks in secondary schools in particular
Shows the importance of implementing infection mitigation measures and a responsive test, trace and isolate system, and extra vigilance for older children
https://www.timesofisrael.com/over-20-more-schools-closed-as-israel-sees-largest-daily-virus-rise-in-a-month/
12/15
Shows the importance of implementing infection mitigation measures and a responsive test, trace and isolate system, and extra vigilance for older children
https://www.timesofisrael.com/over-20-more-schools-closed-as-israel-sees-largest-daily-virus-rise-in-a-month/
12/15
Many other countries have schools up and running with most seeing few, if any issues so far (albeit with low community transmission)
Here are examples of creative solutions different places are using to keep it working safely
https://www.dailymail.co.uk/news/article-8406723/Secondary-schools-resume-Spain-Netherlands-South-Africa.html
13/15
Here are examples of creative solutions different places are using to keep it working safely
https://www.dailymail.co.uk/news/article-8406723/Secondary-schools-resume-Spain-Netherlands-South-Africa.html
13/15
A number of excellent articles this week emphasise the need to drive down community transmission, get and keep schools open and *prioritise them* over pubs, cinemas etc
14/15
https://www.nytimes.com/2020/07/01/opinion/coronavirus-schools.html
https://www.washingtonpost.com/outlook/2020/07/01/reopen-schools-close-bars/
https://slate.com/technology/2020/07/school-reopening-medical-case.html https://www.vox.com/future-perfect/2020/7/1/21306816/coronavirus-pandemic-reopen-schools-economy-social-distancing
14/15
https://www.nytimes.com/2020/07/01/opinion/coronavirus-schools.html
https://www.washingtonpost.com/outlook/2020/07/01/reopen-schools-close-bars/
https://slate.com/technology/2020/07/school-reopening-medical-case.html https://www.vox.com/future-perfect/2020/7/1/21306816/coronavirus-pandemic-reopen-schools-economy-social-distancing
Kids are suffering lifelong damage from lack of schooling. They are safer in school than out of it
There is always risk of increasing transmission, so we must prioritise schools over other social mixing
Lets make it happen, make it safe, and make it good!
End
15/15
There is always risk of increasing transmission, so we must prioritise schools over other social mixing
Lets make it happen, make it safe, and make it good!
End
15/15
