If children were amplifiers, it seems we would have seen a lot more outbreaks traced to daycares. We really haven’t, or at least not put of proportion to other places.
It doesn’t follow that school is a good idea when COVID is screaming through an area, but there is a big leap from virus on a swab and actual contagiousness.
There have been outbreaks at day cares but I also thought they were uncommon. Now I’m wondering. In Texas, day cares opened in phase 2 right before memorial day. With so much opened and a holiday, I bet you it was simply too difficult to trace where these things originated. That’s especially true when children are asymptomatic or very mildly symptomatic. I would like to see a study on viral loads and kids. It’s mentioned in the article but I’d like to see more data.
Well, this is alarming:
White House blocks CDC from testifying on reopening schools next week.
The House Education and Labor committee wanted someone from the CDC to testify about reopening schools.
House Education and Labor Chairman Bobby Scott said the testimony from CDC officials is critical to understanding how scientists would manage the reopening of US schools.
The Trump administration refused: “We need our doctors to focus on the pandemic response.”
Gee, I kinda thought this was pandemic response. School districts, you’re on your own.
Yeah, and I thought that “science was on their side” /s
As noted before, science is only partially on their side, sure there will be less of an issue with kids, but they are only setting the parents and teachers to a higher risk that it is likely to not be compensated as it should be, and with very little support to increase funding for protective equipment.
?
You could start with the OP of the thread and articles discussed in several portions of this thread.
It is a very well established finding. Kids who are infected, including those under two, can have nasal viral loads as high, or sometimes even higher, than adults do.
It is part of why the consistent finding that they nevertheless transmit at best poorly has been so freakishly weird.
The silent spreader boogeyman (perhaps with kids literally being boogies) is raised again and again. It is simply without any evidence that it occurs. FWIW I am very sure that it does … to some non-zero number. What that small non-zero number is, is not pinned down. But the evidence is by now very very strong that at least in kids under 11 it occurs some small amount, nothing like influenza spread in the same populations, and nothing like SARS-CoV2 transmissibility by adults or even teens. No one really knows why. The population being amplifiers of spread, like they are for influenza, was the expected thing. Some are very anchored to the idea and will remain so.
I have been stating this for a long time now, but I remain of the mind that understanding why kids are both getting significantly sick with COVID-19 so rarely, and why they transmit so poorly when they are infected, are important to figure out.
In this case we agree. The science is not on the side of just open all grades with no mitigation measures and no support. The science is on the side that preschool to elementary grades are essential to open with students physically present and can be with even moderate mitigation (most especially focused on protecting the adults involved from each other). High Schools need more rigid mitigation and more support to pull it off. It can be done well but it can easily be done very poorly too if just rammed through. Middle Schools? In the middle …
The president of our university sent out an e-mail to faculty, students, and staff today saying that fall sports are being postponed indefinitely. Considering how sports have been connected to a few smallish outbreaks, I wonder if we’ll see this more soon, both at other colleges and universities and grades 6-12.
@DSeid, I like where your mind’s at. Apologies if you have mentioned this before, but do we even have a sense of what the most likely answers would be? Or, could be?
I disagree with this. New evidence of outbreaks at camps and schools, and of the virus’s ability to be transmitted through poor HVAC systems, means that there’s no consensus that it’s safe to open preK-6.
NC opens under a hybrid model, but our infection rates are high and rising. District after district are choosing online-only at least to open, and as of now, I think 19% of students will attend online-only districts.
Hybrid models present almost insurmountable childcare barriers for staff, in my district and others. A lot of educators are now talking about taking advantage of the FFCRA provisions for taking leave when your child’s school is closed, which has some irony to it but may be the best choice of some very bad choices for educator parents.
When thinking exclusively about the fact that children seem to get sick with COVID-19 so rarely the not mutually exclusive main contenders have been:
As we think about those possibilities let’s try to consider how any of them fit into two other observations:
I speculate that those fairly few who are capable of spreading very effectively have high viral loads lower down in their respiratory tracts in degrees that do not positively correlate well with nasal viral load, and that are impacted more by potentially aerosolizing activities that move large air volumes (speaking very loudly, yelling, singing). I speculate that children who are infected with SARS-CoV-2 have lower viral loads in those portions of the respiratory tract, which is then coupled with the simple mechanical fact that they move smaller volumes of air with less force.
I remain convinced that infected children highly probably can sometimes transmit but it is clear that they are much more commonly in the bucket of the 70% of all infected who never transmit to any other person, than in the 10% that are responsible for 80% of the spread.
I don’t disagree with anything you have said, but I think the logistics and sheer scale of schools have to be considered. Say that between being less likely to catch COVID and less likely to spread it, a student has only 10% the chance of developing into a super-spreader than a given adult. That’s great. But it’s counter-balanced by the fact that students in a school are crammed in much more tightly than the vast majority of adult interactions. “Loud, crowded, closed” is a pretty good description of a lot of schools. It may be possible to mitigate that, but not eliminate it. A school just has so many people in it, and they can’t be spread out much more than usual, unless you send half of them somewhere else. Lots of schools already hold classes in repurposed closets and portable buildings. So even if the odds of any one student being a super-spreader are very low, the cumulative chances of some one student being a super-spreader may be significantly higher than in many workplaces–and that superspreader may come into “sufficient” contact with a lot more people than if they walked through a grocery store or a restaurant at 50% capacity.
It also scales up radically as we get into high schools. Unless kids are cohorted (which schools really need a directive to implement: it’s not a thing you can do just on the campus level), each student shares at least one classroom with dozens, potentially nearly a hundred, kids each day. And the chances of a high school student being a super-spreader are much higher, both because they are closer to adults, in terms of contagiousness, and also because they are out in the world so much more: they have jobs. Cars. It adds a whole 'nother set of interactions.
And of course, all these components rest on the base level of spread in the community. One frustration I still have is that no one seems to be making that distinction, but to me it seems like it is everything. If there isn’t that much COVID in the community, school may be worth the risk. But if you are in a hot spot, the chances of at least one student being a super-spreader is much, much higher.
Which pretty much punted my school board’s decision last night right into the dumpster. They were going to go with a phased re-opening, but we are one of the Covid counties, so Distance-Learning it is. Personally, not too much of a hassle. I’ll be teaching a bunch of seniors I’ve never met and have no bond with, but what are ya gonna do? And the subject is American Government, so it’s not like I’m lacking in real-time research materials!
I was listening to an NPR story. I assume it was local, but I didn’t catch the beginning or the end of it (fun thing about radio in the car). Can’t find it online either.
Anyway, they were talking to someone from the school board, probably Cincinnati public schools, and they were talking about the vote that they took over whether or not to go back to in person classrooms.
Anyway, it came down to around 70% of parents wanted kids to go back, 48% of teachers.
However, it was also stated that a non-response was counted as a vote for in person, and they never said how many were non-responsive. That was the part that really bothered me.
So far across the world there are, to the best of my knowledge, zero documented episodes of an elementary school aged child being a super-spreader, or even a moderately efficient spreader. That sure seems like the chances of a younger student being a super-spreader is way less than 10% that of the one in ten of infected adults. While I am fairly confident that there will be some cases found of children transmitting to other kids and to adults (that number being a fraction as the number of influenza seems sure, but surely it won’t be zero), I am highly doubtful that one having the capacity to be a super-spreader will be anything other than extremely rare. Even with kids Horshack-like shouting “Ooooh! Oooh! Mr. Kotter!” constantly. If was anything other than that rare than even with low to moderate community rates we’d have seen it more by now.
Extremely rare is still non-zero. And the risk of a teacher bringing something in and being a super-spreader to staff and to the students, even if they then transmit it hardly at all, is likely larger. Organizing such that an infected teacher’s harms to others are limited is most key. Recognizing when a classroom or school has a flare and responding appropriately will be important, no matter how uncommonly it occurs.
But no, schools are not akin to bars in terms of crowded closed contact, which is how some are thinking.
Go back to the SIR model. What fraction of bodies in an elementary school are adults and what children? I’d WAG maybe 10% are adults? You’d know better. And let’s WAG that elementary students are 90% less likely to transmit than adults are. We’ll count 0% of adults as functioning like Resolveds and functionally 90% of the students (able to catch but not spreading significantly), or 81% of the building. That would be herd immunity by even most conservative estimates. Except of course that the bulk of the Susceptibles, the teachers, congregate. Stopping that is most key.
Agreed that level of spread in a community matters.
Texas exempts religious schools from local health regulations concerning reopening.
https://thehill.com/homenews/state-watch/507952-texas-exempts-religious-private-schools-from-reopening-guidelines?
10% is a pretty good number, I think, but only half are teachers, which I think is something missing from a lot of discussions. There are custodians, clerks, paraprofessionals. Most schools have at least one student who has an adult aid with them at all times, per their IEP. Most elementary schools have a teacher’s aid for every 3-5 classrooms. Lunch room workers. Many of those people work close together by definition.
Non-employee adults coming into the building is a whole separate group that I think will be critical. Right now, there are adults in and out of the building all day. Picking up sick kids. Dropping off lunches. Picking kids up for doctor’s appointments. Bringing up dry pants. Bringing in kids late from doctor’s
appointments. Volunteering to help with the library, with vision and hearing screenings, with book fair, clothing donations, hallway monitoring . . . Now, a lot of that can obviously just be cut out, but I think there’s still going to be enough of it that it can’t be ignored as trivial. You can’t tell parents they can’t come get their kids. As far as volunteering, some of that is stuff schools need to function. And some of it is $$$ they don’t know how to live without. None of this is impossible, but it’s another area that will be complicated, and if schools mess it up, it is another area of possible explosion.
Here in Texas they’ve walked back the “All schools must open for in-person instruction 5 days a week!” rigid requirement that was announced a couple of weeks ago. They were going to cut funding from any schools that delayed on-campus instruction for more than a few weeks. Now, they are being a little more sensible and giving districts more flexibility to make decisions based on local infection spread, and use remote learning for longer than three weeks if count health officials deem it necessary. Dallas County public health officials have already prohibited schools there from starting any on-campus instruction before Sept. 7. Next door in Tarrant County–where I teach, and which is much more politically conservative–there have been no announcements yet. As ‘hot’ as things are here right now, I would feel much better if we started with six weeks of remote learning, and reevaluate from there.
The thing is, as I mentioned earlier, the US is considering reopening with rates of infection 20 or more times higher than the other nations that reopened. Other folks didn’t try reopening while they were a worldwide hot-spot for COVID spread.
If only 0.1% of kids can be super-spreaders, and if 0.1% of children are infected, that’s real different from if 0.1% of kids can be super-spreaders, and 30% of children are infected.
The German study was led by Christian Drosten, a virologist who has ascended to something like celebrity status in recent months for his candid and clear commentary on the pandemic. Dr. Drosten leads a large virology lab in Berlin that has tested about 60,000 people for the coronavirus. Consistent with other studies, he and his colleagues found many more infected adults than children.
The team also analyzed a group of 47 infected children between ages 1 and 11. Fifteen of them had an underlying condition or were hospitalized, but the remaining were mostly free of symptoms. The children who were asymptomatic had viral loads that were just as high or higher than the symptomatic children or adults.
“In this cloud of children, there are these few children that have a virus concentration that is sky-high,” Dr. Drosten said.
He noted that there is a significant body of work suggesting that a person’s viral load tracks closely with their infectiousness. “So I’m a bit reluctant to happily recommend to politicians that we can now reopen day cares and schools.”
Yes, posted early, and the latest is that while that study was critizised, the authors stand by it, and they even revised it a few days back, In a revised version of the study the authors conclude that there is no evidence that children with regard to Sars-CoV-2 are not as contagious as adults. Point being that while a lot of the studies we are talking about are pre-prints, a lot of what I have seen is that schools that reopened in places around the world have shown that the success histories are coming from places with masks, social distancing lots of testing, contact tracing and reduced number of students in the classrooms. The failures like in Israel are IMHO more close to what the USA can get when there was little done about social distancing or number of students in the classroom.
In essence one can do estimations about how very young students are not so contagious, but the problem remains that preliminary studies do not lead one to be so confident that the numbers that could be low for young students elsewhere thanks to proper conditions can be applied for most schools in the USA.
So your answer to “no study has found children to be serious part of outbreaks” with a study that says “some have high viral loads. This suggests they might be contagious”?