How much of this is simply because vaccine development is so much faster than it was in the past? By the time a measles vaccine was developed, we’d had a long time to study measles and prove those things. But we won’t have had all that time to study this specific virus, so sure, we won’t be able to prove that to the same degree of certainty.
But there is every reason to believe that it’s likely the case. COVID spreads like a cold. And kids spread colds very efficiently! We have lots of data on that. Or, watch any sick kid for five minutes as they cough into the air and wipe their mucus all over things.
The fear of public health impact is, in some districts with certain rates, too great to open despite the guidance of the best bodies, while in some districts with much poorer metrics are opening all levels, rushing in where those bodies would say not enough is yet known to be sure enough it is safe to do, and for which they’d advise that abundance of caution.
Next, let us accept as a given that a vaccine for kids won’t be approved and recommended until after it has been out for adults for sometime and then tested in large numbers of kids to prove its safety and efficacy in them. IF a vaccine is safe and effective THEN transmission among adults should be down substantially by then, and by those standards school could open safely. It would be question of how much vaccinating children would add to further marginally decreasing significant disease caseloads.
Lastly, if you know that SARS-CoV-19 spreads like the common cold causing human covids then you know MUCH more than the scientific community knows. In fact if you have access to what R naught and/or secondary infection rates for those viruses are, since you say we have so much data on it, please share. I don’t know the numbers myself. Given that they cause a small fraction of common colds I’d WAG not as high as you think and way less than influenza.
No, you shouldn’t assume that. There’s a vast difference between someone posting anonymously on the Internet and a specialist publishing a study under their real name in a peer-reviewed journal or speaking as a recognized authority in their field. Their education and areas of specialization are known, and their medical views are subjected to public and professional scrutiny.
Many, probably most, physicians have integrity and form conclusions on medical issues based on studies, clinical trials, and research, supplemented by their own experiences when relevant. But as anonymous posters on a medical topic that has become politicized, one or two may start with their political beliefs and cherry-pick the data that supports their views.
Can you maybe rephrase this, because it sounds to me like your second paragraph basically agrees with my statement. I’m going to echo back in my own words and you can point out what I’m missing:
“In some school districts, public health authorities have advised against opening because it’s unsafe to do so. In other districts which are doing even worse, they’re opening anyway, despite public health authorities saying they’re not sure, but they probably shouldn’t because it might not be safe”
That sounds a lot like “it’s not safe to open schools” to me.
I take your second point about the fact that by the time a vaccine is approved for children the general public health outlook may have changed and it won’t be necessary.
This reads as sophistry to me. Like, I’m sure there’s some hair you can split that shows that every cold virus is a unique snowflake but from my perspective: colds spread when you breath and cough and sneeze on people, and touch things and mucus membranes in a variety of orders. All things that children are quite good at because they have terrible hygiene practices.
That is what I mean when I say that COVID spreads like a cold. Everything I’ve seen from the scientific community so far has generally reinforced that understand, one that could generally be derived from knowing only two things (1) virus (2) that makes you cough.
Do you think that’s wrong, or are you possibly focusing on some unreasonable standard of proof?
The issues with schools opening is not just safety for the kids, or even for the general community. I’ve been hearing reports of school districts that planned to open in-person or with some sort of hybrid, and have had to change their plans last-minute because too many teachers quit or retired.
Even if kids don’t spread the virus as efficiently as adults, teachers are going to be at very high risk for a while. And a vaccine would significantly reduce their risk. And as most other vaccine, it works best if “the herd” is vaccinated, and not just the teacher, since no vaccine works perfectly or for everyone.
I don’t think we need to require kids to be vaccinated, but I think we probably will need to require them to be vaccinated if they will be going to school.
I’m not sure how to rephrase. Fear does not equal reality any more than lack fear equals reality. We have a complete other thread on this so I’ll try to keep it brief here. It is hard as for many hard absolute positions one direction or the other have become statements of political faith, and disagreement with those faith statements prima facie evidence of being of the opposing political team.
Well established that opening schools in the context of fairly low community rates can be done safely. Lots of places across the world have done so. In America places like that are afraid to do despite expert guidance otherwise. A vaccine in wide distribution to adults that did not result in community rates that low would be a pretty poor vaccine.
Not established one way or the other what is of what degree of risk in the context of higher background transmission rates. Established that younger and special need students are harmed more by lack of in person school than are older students and fairly well established that they present less risk than older students. Given those unknowns and knowns expert bodies have advised that some communities should open cautiously prioritizing in person for elementary and special need students, and some to shut down schools along with much else. Many of those districts are instead opening widely.
Almost all have by action declared that bars, restaurants, hair and nail care, and in person retail therapy come first, despite their large risk to safety.
It is not sophistry to state that there is little reason to assume that SARS-CoV-2 spreads by the same mechanisms as the any other human coronavirus, be it one that causes a common cold, or SARS or MERS. A snowflake it ain’t but unique it is. It is not influenza, not SARS, and it is not OC47 or any other common cold causing hCoV.
The evidence that kids spread SARS-CoV-2 efficiently by snot wiped on surfaces, that such is a major mode of transmission in any age group, is completely non-existent, even though such happens with many other germs. Respiratory droplets and aerosolized ones to debated relative degrees of importance are what is accepted as the prime transmission mode, with 10% of those infected likely responsible for 80% of the spread and 70% of those infected not spreading it at all.
That was enough. You’re saying it might be safe enough, but we’re possibly unreasonably afraid of it. Ok.
This seems to be an argument against a point I didn’t make. I didn’t claim that snot wiped on surfaces was a major mode of COVID transmission, or that it was a major mode of cold transmission. I listed it among behaviors that make kids better spreaders of viruses in general.
It’s not? Colds and influenza don’t spread by droplets or aerosols?
Superspreaders are not anywhere near of the same role in those diseases. Nonzero but not the same degree.
Fomite transmission (that’s things like snot spread that kids do so well, I state having served my time as the convenient shirt to wipe a nose on) plays a major role in the transmission of almost all common cold viruses (especially the most common rhinovirus ones that spread among kids and their families very well) and a significant (albeit not main) role for influenza as well. Even more for the enteric viruses. SARS-CoV-2 apparently less so.
Can you provide a cite for this? It’s not that I can claim otherwise. I’m having trouble finding any quantitative claims for how common colds are transmitted.
So far what I’ve found on the flu is consistent with COVID transmission: Primarily droplet/aerosols, with other methods as well.
That said, I think this might be a mostly-irrelevant digression. Kids are also good spreaders of things that involve coughing and breathing on you for the same reason that they’re good spreaders of fomites: they’re bad at basic hygiene. I don’t know about others, but my kids spend a lot of time shouting, too.
This. I see that happening frequently in SDMB. Most often the cherry-picking happens and the poster denies that their political stance has any effect on their expertise.
Gee, I dunno - maybe because no Democrat has suggested injecting bleach to treat covid? Maybe because no Democrat has been mindlessly repeating that it will “just disappear”. Would you like me to keep going?
And it is what I’ve been lectured to by many an Infectious Disease professor … but looking for original research that backs it up I’m coming up more about how difficult the question is to answer definitively.
Even for influenza, very extensively studied for years, searching shows that actual evidence for how significant each transmission mode is “in the wild” is open for heavy debate and still unresolved.
Still SARS-CoV-2 is further in the superspreader end of the spectrum than most, and assuming that every respiratory germ is spread by kids similarly would be a very silly thing to assume.
Not so irrelevant. Much modeling has been very off based on accepting that this germ would behave like an influenza bug, even when the bug declared by its real world behavior that it is different than influenza (and different that other hCoVs) in many ways.
Trying to tie back to the op of this thread, IF one would propose a mandated vaccine program based on the belief that such would have a major impact on wider spread community spread, then one is obligated to back that up with more than just belief, assumptions, or the position that it is not 100% proven it wouldn’t.
Fear matters if you can’t hire enough teachers. But also, it is rational to be more afraid of new, unknown risks than of established, well-understood ones. The “distribution of unknown risk” is heavily skewed – the odds that there’s something we don’t know about covid that makes it a lot less dangerous than we think are much smaller than the odds that there’s something we don’t know that will make it a lot more dangerous.
If we knew that the current infection rate, etc., for kids was the only risk… if we knew that people don’t get sicker if they catch it a second time, if we weren’t worried about potential long-term damage to the lungs and kidneys and hearts of people with a “mild case”, if we didn’t worry that kids with their apparently higher viral load might prove to be super-spreaders, if we knew there wasn’t something else lurking there that we don’t know about yet… Then yeah, it probably wouldn’t be worth immunizing kids. Just like it may not be worth immunizing them for chicken pox, another disease that rarely kills children.
Can you give some examples of who has safely opened schools? Because I keep reading about placing like Israel running into trouble doing it.
Also, the places that I’ve read about that seem to be doing a good job at it, like Denmark, are giving the kids a LOT more space than anything I’ve heard about in the US, and seem to be taking other precautions that I haven’t heard in most of the re-opening situations.
Right now, with no vaccine, I personally favor opening day care with small groups and extra space and ventilation, along with nursery schools and probably K-3, again, with a lot more space, more ventilation, masks, and small, fixed groups. I agree that both that what data we have suggests that younger children are safer, and ALSO that they have a greater need for in-person instruction. Also, they need full-time supervision and most of them have parents who need to work.
By the time we have a vaccine, we’ll have more data as to how risky that proves to be for those children and their families and teachers.
Well that’s just dumb. Bars should be the very last thing to open. Like, we should be able to open the high schools before we open the bars. I’m not seeing communities doing that (opening bars but keeping the schools closed) but I can’t say I’ve been looking for it, either.
I have also gone looking for evidence of how diseases are transmitted, and I have to say, there’s surprising little data on it. I don’t understand why there aren’t graduate students putting running wheels in a cage of infected hamsters and then moving them to a cage of uninfected hamsters to see what happens, for instance. Yeah, it’s not perfect. But you can’t do those sorts of experiments with people, and most “natural” situations where people touch fomites they also breath each other’s air. And you could do experiments with animals eating food laced with virus, playing on running wheels that were exposed, walking around in litter that had been in a cage with infected animals… and none of those would be terribly expensive to do. I really don’t understand why I’m not seeing that research. Maybe you can shed some light on that?
I’m not sure how, knowing there’s evidence that children get infected with Covid-19 as easily as adults and carry similar viral loads, one can assume that kids don’t spread Covid-19 effectively. I’ve seen one article speculating that small kids “may have weaker coughs and therefore would release fewer infectious particles into their environment”, but that sounds like sophistry to anyone who’s been out in public around small children coughing and sneezing vigorously (and, one notes, usually without attempting to cover their mouths and noses).
One recent study from South Korea found that while young children seem less able to spread the disease compared to adults, children 10 to 19 years old spread the virus at least as well as the adults do.
It’s also been postulated that the shutdown of schools early in the outbreak in the U.S. limited the opportunity for children to transmit infection to the general population, but that could well change as schools reopen.
As with other aspects of Covid-19 transmission and treatment, there is much that we either don’t know or have only limited data on in regards to the role of kids in the pandemic. It would seem prudent however not to offhandedly dismiss the scenario of children playing a significant role in transmission. It would also be wise in considering school reopening not to ignore concerns about increased vulnerabilities of those with pre-existing conditions (children or adults) or to scoff about fears of teachers and other school employees who for many hours each day will be in a classroom full of kids.
"…the national conversation turned towards the reopening of schools. The president and his education secretary made bold and sweeping statements that despite the rising numbers of COVID-19 cases across the country, and our inability to flatten and maintain a flattened curve, schools must reopen. Children must go back to schools. And teachers, many of whom are considered part of the vulnerable population because of age, underlying conditions, and immunodeficiencies, must return to the classroom. Never mind that it might be a matter of life and death…
…I know teachers want to be in classrooms.
But we cannot—we should not—ask them to forgo their own health and safety, and that of their children, grandchildren, elderly parents, and all the other people that teachers support outside of the classroom as well.
You know we have a whole thread on this subject running since May 21? Not sure how much is appropriate to hijack this thread with.
Countries that have re-opened or never closed include Denmark, Netherlands, Norway, Sweden, Switzerland, Finland, Germany, France, Austria, Switzerland, Japan, Singapore, Uruguay, Australia, South Korea …
Of course there have been cases in schools in some of those countries. But even when that has occurred they have been contained and few at all in elementary or preschools. Spread from kids in elementary school settings, to adults or other children is not being seen. In districts in which there have been cases spreading in a High School the elementary school positives have tracked to family members (that one in France).
Interesting but not surprising that what you keep reading about is “Israel running into trouble” … which had most cases out of one High School and associated to it, which was in the context of crowded classrooms, reported poor compliance by a sick teacher and students alike with mask wearing rules, and a broad opening of the country including crowded bars (yes DUMB). There was some small spread into Middle Schoolers and only scattered cases in elementary students without much documented spread between them. From there they’ve had zero tolerance: any single case shuts down a whole school.
Animal studies just don’t translate across species so well. You need people data to say what happens in people, and specific age groups even. Biology, physiology, and behaviors vary by age.
Just for fomites - Finding virus detectable on surfaces isn’t enough; it could be dead. Finding some that can be cultured isn’t enough. You need to prove that there is enough viable virus there and that it can fairly easily get to where it needs to be to cause an infection. And that it happens in the real world. Just as difficult for aerosols and droplets.
No one assumes it. One observes it, and fails to observe clear effective spread from kids.
A vaccine mandate certainly needs more than an assumption that they do spread effectively when it has not been seen.
And please let’s continue any more about this to the other thread. For this thread leave at there is, to date, no evidence consistent with kids, especially elementary students, playing a major role in driving community spread, and that neither is the hypothesis that such could occur yet completely falsified. A vaccine mandate would require more than that contention not being completely falsified. Lots more.
What it mostly requires is enough people worried about the long-term effects of covid on kids. Or enough trouble hiring teachers. I expect that several states will mandate vaccines for schools.
The New York City pubic schools system requires an array of vaccinations for all children, including DTaP, poliovirus, MMR, varicella and hepatitis B and influenza.
Those are the baseline, for entry into the system at any age. Boosters are required at appropriate ages.
Families can obtain a medical exemption, if warranted, for their children. There are no religious exemptions.
I do not know what the law is when it comes to private schools, or New York’s extensive Catholic school system. I hope the law applies to those schools, and I hope it’s enforced.
I have one child in the system, one entering soon, and an infant.
I am 100% behind mandatory vaccinations. When there is a tested, approved, safe vaccine available, my children will have it (at the appropriate age), and I certainly hope the schools system makes it mandatory, and denies admission to children who haven’t been vaccinated.
FWIW I completely agree that deference to claimed expertise on a MB is unjustified. Me for example? For all you know I’m really a shoeshine boy. Accepting for the sake of argument that I am indeed a general pediatrician, who perhaps you know the name of, that should earn nothing. Whether or not my contributions have value should be judged on their contents only. Exception to that only for things based on personal experience - when it comes to dealing with the vaccine hesitant and getting or not getting compliance with recommendations few here likely have as much experience with that as I do, nor do academic virologists or such.
I am also open to the possibility that my radical center left incrementalist political perspective biases my interpretations. No human is free from bias and most of the time we are unaware of them.
You are very mistaken though to give a bias pass because someone is an academic.
Appreciate the update on problems with the cited South Korean study. That does not however eliminate children as a Covid-19 vector. For those desiring to “keep up”:
"Based on a growing body of anecdotal evidence, children don’t seem to have any problem spreading the virus to one another.
The Centers for Disease Control and Prevention…reported a large outbreak at a sleepaway camp in Georgia. Within a week of the camp’s orientation, one counselor went home, and the camp shut down a few days later. But by then, nearly half of the roughly 600 campers and counselors had already been infected.
Staff were required to wear cloth masks, but campers weren’t.
“The study affirms that group settings can lead to large outbreaks, even when they are primarily attended by children,” Johns Hopkins’ Caitlin Rivers told the NYT.
Piling on to the bad news, a recent study found that infected children carry at least as much — if not more — of the coronavirus in their noses and throats as adults.
The study, published in JAMA Pediatrics, found that children under 5 may host as much as 100 times the amount of the virus that adults do.
“Young children can potentially be important drivers of SARS-CoV-2 spread in the general population,” the authors write.
Yes, but: Although viral load is generally an indicator of infectiousness, the study didn’t establish that.
Between the lines: We’re also slowly learning more about the biggest outstanding question: how likely children are to transmit the virus to adults.
A recent study from South Korea found that, within their households, children between 10 and 19 transmitted the virus at least as well as adults, while those younger than 10 were significantly less likely than adults to spread the disease.
Given how many schools are attempting to open for in-person learning in areas experiencing significant community spread, we’re probably not going to have to wait long for more evidence.
The bottom line: “We’ve seen that kids can transmit it to adults. Whether they transmit it as efficiently as adults transmit, we still need to learn more,” said Johns Hopkins’ Anita Cicero.
“But I think we’re now beginning to scratch the surface and seeing that we can no longer presume that kids are not going to be a significant factor in transmission once schools open.”
Dogged refusal to face this issue, or the potential of harm to vulnerable populations (children and adults) once schools reopen on a wide scale and large numbers of unvaccinated kids cluster together, is not to resolve it.