By Kevin Roche
I will be very upfront about this. One thing that drives me really nuts is the way children are being treated in this epidemic. Despite all the evidence that they rarely have serious illnesses and aren’t a significant source of transmission, schools have been closed, they have been restricted from normal social and extracurricular activities, and they must be very frightened and confused by what is happening. This has the potential to be a lifelong source of trauma for these children, and completely unnecessarily. I am sorry to be suspicious, but as we approach normal school-opening time, suddenly we see research on children and schools, generally poor quality, or certainly with the results mis-stated by some people, in an attempt to scare parents and school boards. There is clearly a coordinated effort to use the epidemic for political purposes and putting children in the middle of that is despicable.
Here is one of the pieces of new research which is being misused. (Medrxiv Paper) This is a contact tracing study from a region in Italy in March and April. Seems like a fine study. The results, however, in regard to children have been mis-stated. 2,812 cases, only 70% of which had been confirmed by testing, were traced and 6,690 contacts identified, of whom 890 developed symptoms, or about 13%. Only 485 of this group actually had infection confirmed by a test. 56% of all contacts lived in the same household. Out of the 2,812 index cases only 14, or less than 1/2 of one percent, were among children, a huge under-representation compared to their percentage of the population. Among those 14 cases, the tracers believed that 8 caused infections in 11 out of 49 contacts. The researchers noted that this was the highest risk of transmission among age groups. But look at how small the number of cases is. And note that this is an R, or transmission rate, under 1. Furthermore, if you look at the age of the contacts, those under age 14 had the lowest rate of infection from an index case, only 8.4%. So the conclusion should be that children are very under-represented as an index case and children are very under-represented in getting an infection from an index case. And as the authors note, having children at home rather than at school may increase the likelihood that they get infected and/or pass the infection on. This is consistent with what other studies have suggested.
On the other hand, the American Academy of Pediatrics journal has an article clearly stating that children have a minor role in the epidemic and should be in school. (Ped. Article) The article references a recent Swiss contact tracing study again finding a very limited role of children in the epidemic. It gets repetitious. The editorial concludes that given the enormous harms to children from being out of school, they need to be allowed to attend with few limitations.