Monday, July 22, 2024

Everything we now know about schools, children and Covid-19

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In April 2020, children under the age of 18 made up just 1.7% of reported coronavirus cases, according to CDC data. By August, that figure had risen to 7.3%. As of January 13, 2021, more than 2 million children had caught Covid-19 and children accounted for 10.8% of the country’s caseload. According to a report Released by the CDC on Wednesday, approximately 12,000 children were hospitalized with the disease between March 1 and December 12, 2020. During that time, 178 have died.

Childhood, however, is not a monolith. Newborns and infants are consistently most at risk, as well as children with underlying health problems. Then, as children transform into adolescents, their bodies look more like adults and their social networks develop, putting them more at risk than elementary and middle school students. A pivotal change seems to occur around the onset of puberty. Researchers from the COVID Monitor, a data monitoring group from more than 7,000 school districts in the United States, recently found that infection rates among secondary school students are three times higher than those among children of primary school age.

Age is not the only thing that matters. Black, Latin American and Native American children also suffer from severe Covid-19 disease and death at higher rates than white children, largely because of systemic racism this makes it harder for non-white Americans to access health care, housing, and the types of jobs that allow parents and older relatives to work from home. Black and Latino children have also suffered disproportionately from a constellation of severe heart, gastrointestinal and kidney complications after episodes of Covid-19. Known as multisystem inflammatory syndrome, or MIS-C, this still mysterious disease, although rare, has struck more than 1,600 children by the most recent CDC count.

When it comes to the debate on opening schools, the other crucial questions are not about gravity, but spread. How easily are children infected and how often do they pass the disease on to others?

One way the researchers have assessed this is by tracking infections in households where at least one person has tested positive. Of them early studies in China have found that children are less likely than adults in their households to contract the coronavirus. But scientists at the CDC had a hunch that something else was going on. The researchers conducting these studies wiped family members only if they started to feel sick. Anyone who had been infected but had no symptoms would be forgotten. In addition, schools in areas where families lived were mostly closed. The children stayed at home, reducing their risk of exposure to the virus.

“At the time, there was a ton of talk about how sensitive children really are,” says Melissa Rolfes, CDC epidemiologist on the agency’s Covid-19 response team. “We therefore sought to obtain very good data on all age groups, which would not be biased by things such as symptoms or seeking medical care.”

Rolfes teamed up with researchers from Marshfield, Wisconsin and Nashville, Tennessee, who had worked with the CDC in the past on influenza surveillance. They quickly set up a new study focused on finding the coronavirus in children. It worked like this: If a person tested positive for SARS-CoV-2 and lived with at least one other person who was not sick, scientists would try to recruit that whole household for 14 days of daily nasal swabbing and response to the questionnaire. . This allowed them to capture any viral spread within the household, regardless of who was showing symptoms.

What they found between April and October last was austere. People who had the virus passed it on to half of their household mates. (In previous studies in China, it looked more like 20-30%.) And it doesn’t matter if it was a child or an adult who brought SARS-CoV-2 home, they passed it on to their families. at the same rates. Within households, children are also infected as often as adults. But they tended to be less sick than adults, mostly avoiding fevers and coughs. “Maybe they would just have a stuffy nose, or maybe nothing, but when you dab them, you’ll find the virus,” Rolfes says. She realized that previous studies had overlooked many cases, especially in children, because they didn’t appear sick. “We were really surprised when we saw this data. A secondary infection rate of over 50% for household contacts was simply mind-boggling. “

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