Oy. Schools. This is really tough. As we debate risk/benefit, understanding whether schools are a major source of transmission to the community (and high risk people) is the billion dollar question. Thread: the science to date.
Tons of data showing kids (especially younger) disproportionately not diagnosed with #COVID19. BUT, that’s not definitive – maybe they get infected as often but don’t get symptoms. Asymptomatic disease would actually make school openings harder.
Let& #39;s stipulate for now that kids are genuinely less likely to be infected. Do those that are infected still spread it, though? There’s a lot of bad/inconclusive data out there. Following, some of the better evidence AGAINST spread by/among kids.
In 15 Australian schools, 9 students/9 teachers were positive; of their 863 contacts, 0 teachers and 2 kids subsequently tested positive (1 primary school, 1 high school). But, school attendance was dropping through the period as #COVID19 fears rose. http://ncirs.org.au/sites/default/files/2020-04/NCIRS%20NSW%20Schools%20COVID_Summary_FINAL%20public_26%20April%202020.pdf">https://ncirs.org.au/sites/def...
In Ireland, 3 kids and 3 teachers were positive. Only two subsequent cases were detected among 1,155 of their contacts (both non-school adults who caught it from infected teachers). https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.21.2000903">https://www.eurosurveillance.org/content/1...
In an early outbreak in France, one positive child attended school while symptomatic; of 84 high/moderate risk contacts only 1 subsequently tested positive (the schools were closed for two weeks once initial diagnosis made). https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa424/5819060">https://academic.oup.com/cid/artic...
So, there is some evidence that (younger) kids tend to catch the disease from adults rather than the reverse, and better evidence that they don’t tend to spread it a lot among other kids or contacts once infected.
But there is also evidence FOR spread by/among kids within schools; here we leave the realm of published data and move to news reports. Note that the risks here are mostly high school level.
So bottom line: kids don& #39;t catch COVID19 as much, don& #39;t get as sick, and don& #39;t seem to spread as much. But they CAN spread to others; and the older the kids we are talking about, the more risk there is. Elementary school likely much safer than high school.
Another good paper, this from Singapore, h/t @laxswamy: 1 12 year old, 1 preschooler, 1 teacher positive in 3 schools: no spread among 119 exposed children, but 16 staff and 11 of their household members infected by the positive teacher. https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa794/5862649">https://academic.oup.com/cid/artic...
More evidence that older children are more like adults in their ability to transmit to others; younger children continue to seem less likely to transmit. https://wwwnc.cdc.gov/eid/article/26/10/20-1315_article?referringSource=articleShare">https://wwwnc.cdc.gov/eid/artic...
Adding periodically to this thread. Here is a new report from @CDCgov about outbreak at a sleepover camp. Different than in-school transmission, but relevant to pediatric transmission. First identified case was a teenage staffer. https://twitter.com/amymaxmen/status/1289241881537392640?s=21">https://twitter.com/amymaxmen... https://twitter.com/amymaxmen/status/1289241881537392640">https://twitter.com/amymaxmen...
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