Read on Twitter
I’m seeing tweets from anxious parents about kids in Auckland returning to school tomorrow.
As a Mum, paediatrician and big fan of scientific literature, I just want to share again why I’m feeling relaxed about my boys being back at school and daycare: (Refs at the end) /1
As a Mum, paediatrician and big fan of scientific literature, I just want to share again why I’m feeling relaxed about my boys being back at school and daycare: (Refs at the end) /1
From the start of the pandemic, it’s been noted that children make up only a small proportion of COVID-19 cases. This continues to be the case - w children usually accounting for 1-5% of total cases. These may be underestimates as some regions only test those who are unwell /2
But this is reassuring as it means that children make up a minority of infections, and even if there are slightly more children w infections than are counted, they are likely to be mild, or asymptomatic, and not needing hospitalisation nearly as much as older age groups /3
The literature also continues to support that when children do get infected with COVID-19 that they are not nearly as unwell as older adults. Critical illness is rare (~1%); older adolescents can be affected more like adults, but deaths amongst children is extremely rare /4
The area of uncertainty is the extent to which children may transmit the virus when they are infected. Work here is ongoing, but in general studies of family clusters show that children are less likely to be the index case in a household /5
A meta-analysis study (in preprint) by Viner et al concluded: “There is preliminary evidence that children and young people have lower susceptibility to SARS-CoV-2, with a 43% lower odds of being an infected contact.” https://www.medrxiv.org/content/10.1101/2020.05.20.20108126v2 /6
And same study (Viner et al) also found: “Three school contact tracing studies found minimal transmission by child or teacher index cases.” /7
This recent modelling paper published in the Lancet of school reopenings in the UK, concluded: “To prevent a second COVID-19 wave, relaxation of physical distancing, including reopening of schools, in the UK must be accompanied by large-scale,...” /8
“... population-wide testing of symptomatic individuals and effective tracing of their contacts, followed by isolation of diagnosed individuals.”
In other words - exactly what NZ IS doing now and has built capacity for. /9 https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30250-9/fulltext
In other words - exactly what NZ IS doing now and has built capacity for. /9 https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30250-9/fulltext
The UK reopened schools on 1st June with >20,000 schools and >1 million students AND MUCH higher levels of cases and transmission than children - this paper reports on ensuing outbreaks. A total of 67 single confirmed cases, 30 outbreaks during June - and - this is VIP.../ 10
There was a “strong correlation between number of outbreaks and regional COVID-19 incidence...Overall, SARS-CoV-2 infections and outbreaks were uncommon across all educational settings.”
In Auckland we are Level 2.5 but regional incidence is still very low - encouraging /11
In Auckland we are Level 2.5 but regional incidence is still very low - encouraging /11
The reference is https://www.medrxiv.org/content/10.1101/2020.08.21.20178574v1
So - what’s the conclusion?
/12
So - what’s the conclusion?
/12
With low regional case numbers overall (esp compared to the UK), a robust contact tracing, testing regime - we can be confident that our schools will do well, and that the majority of students (and households) will do well. /13
What about children w comorbidities? Difficult to speak to every situation but the Paediatric literature review team I follow say: “The rates of complications from SARS-CoV-2 infection do not appear disproportionate to those from other respiratory viruses from early data.” /14
We need to weigh this against the knowledge that schools not just educate our children, but provide friendships, care and safety for many. I’m looking forwards to saying bye to my boys in the morning /15
Finally - I am NOT some sort of literature review goddess - I follow the @DFTBubbles of Paediatric COVID-19 literature reviewers, who have systematically reviewed >500 papers related to COVID-19 and children. The executive summary is here https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/ /16
And the @DFTBubbles team include very reliable tweeters: @apsmunro @AlisonBoast @gracie_leo @sunilbhop and others. Peace everyone, sleep well (oh and please get a test if you need one)
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