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THREAD: The way we talk about cases in child care programs & schools is continuing to inflate COVID fears and making it much harder than necessary to get our youngest students back in the classroom. Here's a really good example: https://www.sfchronicle.com/bayarea/article/Outbreak-in-Sonoma-County-virus-hits-13-child-15579074.php
That sounds bad! 13 child cares & schools (out of how many, we of course aren't told). But in this case the ignored denominator isn't even the sin, the scatter plot is. The Chronicle article tells us that 30(!) cases are linked to 1 preschool. Obviously, that's not good! But...
That only leaves 32 cases for the other 12 sites. As we learn from this KTLA article, there was a family child care home with 9 cases. Now we're down to 23 cases for the other 11 sites. You see where this is going? https://ktla.com/news/california/62-coronavirus-cases-traced-to-outbreaks-at-sonoma-county-preschools-childcare-centers/?fbclid=IwAR2dxbJavd-qKkisJtjr8sDwdi0V6a5M_lrbJFfm0JDzfLu1KriM7a4c5rg
Even if you distribute those 23 cases evenly, that's about 2 per site, which are awful hard to connect (there's a reason why many states don't start reporting an 'outbreak' until between 3 and 5 linked cases show up). So the actual headline is...
"Two outbreaks in Sonoma County, 11 other sites with cases." All of which continues to tell us only what we already know -- outbreaks can and will happen, most single cases don't lead to big outbreaks, and most programs have no cases at all. Sigh. Here's what frustrates me most:
We act as if we don't have a pretty solid grasp of the risk level posed by child cares & elementary schools. We do! European officials are so much more candid. Look at how they talk about Covid and kids in this article... https://www.washingtonpost.com/world/europe/coronavirus-outbreaks-schools-europe/2020/09/27/0dd19bf6-ff48-11ea-b0e4-350e4e60cc91_story.html?fbclid=IwAR3e8KudH1tt1WTWVUWvhgn78-O5lhx7RAJ-Dt3SbWIad-xZ26mRg9x62ns
"Children are not identified as the main driver of the pandemic." / “The schools are not driving this. The schools are a mirror of what’s going on in society.” / "If asymptomatic transmission was common, we should be seeing a lot more cases than [we are]." Now! Does this mean...
...the European experts are being blind or blunt-edged? No, they're clear-eyed: “It is clear that children can pass on the virus to each other. It’s not that this doesn’t exist." The recent JAMA piece by @apsmunro is similarly frank about the fact that transmission happens and...
...that community spread rates still matter enormously. Again, we know how this works in terms of defining the risk of young kids and covid! There's more to learn, but it's not a big huge giant mystery anymore. We need to stop treating it as such. SO... https://jamanetwork.com/journals/jamapediatrics/fullarticle/2771180?fbclid=IwAR3sG5AKGao5hsDrUA3UmauSpJoGjHMqNhj2yerM-PRzAQk0vVOmP0Xpvy0
I'd like to see every journalist covering kids & COVID commit to the following:
1) Always use denominators
2) Always cite community spread levels / compare to rates in general population
2) Be super-clear about defining cases vs. outbreaks
3) Acknowledge the larger evidence base
1) Always use denominators
2) Always cite community spread levels / compare to rates in general population
2) Be super-clear about defining cases vs. outbreaks
3) Acknowledge the larger evidence base
America is exceptional in one other way, and I'll conclude here: Our public is *way* more against returning to in-person school than most of Europe. As @ajlamesa has been chronicling, many Europeans protest at the very whiff of closures. I daresay that's partially because...
Americans have been given a false sense of risk when it comes to young kids and COVID. This isn't easy, particularly on deadline (and not just media: many of our elected & appointed leaders are also bad at communicating clearly). But there's real harm to risk distortion!...
And if this problematic narrative keeps up that kids are either super risky 'silent spreaders' or a giant who-can-say of a shrug emoji, it's going to continue to poison what could be otherwise reasonable reopening discussions. We can and must do better. /end
