August 2, 2020

and what about school?

I haven’t really talked much about kids or school yet, in relation to the pandemic. Partly because what we know about COVID-19 is still so fluid, especially when it comes to children. Partly because I don’t really know the answer. I never had children of my own, but I did used to be a teacher, long ago, and I have cared for many families and children over the years as their family doctor.

I do know that shutting schools in the spring saved lives. We also know a little more about children and COVID-19. Unlike when children are super-spreaders of influenza and other viruses, they don’t seem to spread SARS-CoV-2 as much as adults do. They might not even get infected as often. Most children that do get COVID-19 have milder symptoms, with only rare severe cases or complications. Also infections seem to be age related- with children younger than 10 having many less infections than 16-18 year olds. As I mentioned, the data is fluid. There are some thoughts about why they don’t seem to get sick, but remember the virus is still less than a year old, so these thoughts can change.

We hear stories about specific outbreaks related to camps or church. You all may have heard about the summer camp in Georgia that had to close after an outbreak of COVID-19 infected 76% of 366 campers and staff. Most infections were in the 6-10 year old age group. All children and staff were tested prior to coming, but as we know, testing for the virus is limited by being just one point in time. The CDC reported that masks were not required and they participated in indoor and outdoor activities that involved singing and yelling, common camp activities.

In some countries, schools have reopened and infections are holding steady, but those countries have controlled the virus better than the US has. We have no consensus on re-opening schools. Many entities, such as the American Academy of Pediatrics and the New England Journal of Medicine, have come out with recommendations, especially regarding primary schools, since presumably those younger children are less at risk.

Teachers and vulnerable family members are not so sure of the safety. If we could make re-opening schools a national priority and lower the national infection rate, it might be possible to do it safely. But we are not there yet. The country’s epidemic still has not peaked. Sadly, without a concerted effort in all parts of our country to follow guidelines on mask wearing and physical distancing, we will not be ready anytime soon. Leadership to guide us has been lacking, media has given contradictory information, disinformation is interfering with perception, and we need the CDC and NIH and the healthcare industry to make this a priority for the kids. If we thought this was a priority as a country, we could make it happen.

Wash your hands, cover your nose, stay safe six, and think about how to help the kids. I wish I knew.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.nytimes.com/2020/07/29/magazine/schools-reopening-covid.html

https://www.seattletimes.com/nation-world/what-we-know-about-children-and-covid-19/

https://www.nytimes.com/2020/07/20/parenting/coronavirus-children-spread-covid-19.html

https://www.statnews.com/2020/07/29/school-reopening-covid19-cases/

https://www.nejm.org/doi/full/10.1056/NEJMms2024920

https://www.nejm.org/doi/full/10.1056/NEJMp2026045

https://www.washingtonpost.com/nation/2020/08/01/schools-reopening-coronavirus-arizona-superintendent/

https://www.nytimes.com/2020/07/31/health/coronavirus-children-camp.html

https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm?s_cid=mm6931e1_w

https://www.nytimes.com/2020/07/29/magazine/schools-reopening-covid.html