Compared with adults, children and adolescents are at lower risk of getting and spreading COVID-19. But low risk is not no risk.
That’s why the issue of reopening schools has become the latest heated argument in the U.S. pandemic response.
“There’s nothing in the data that suggests that kids being in school is in any way dangerous,” U.S. Education Secretary Betsy DeVos told Fox News Sunday as she championed President Donald Trump’s demand to fully reopen schools in the fall for in-person instruction.
To which U.S. Rep. Ayanna Pressley, D-Mass., tweeted at DeVos: “I wouldn’t trust you to care for a house plant let alone my child.”
Scott Gottlieb, former Food and Drug Administration commissioner under Trump, strove for a dispassionate tone in a Wall Street Journal commentary published Sunday: “Schools should open in the fall. It’s critical for meeting the educational and social needs of children. But local officials should have the discretion to take tailored actions to help keep children safe. ... Reopening schools will draw more controversy if people believe their school district was forced into opening.”
From the beginning of the pandemic in March, it has been apparent that children are largely spared. In the U.S., Germany, and Italy, fewer than 10% of confirmed COVID-19 cases have been in people under age 18, according to health authorities.
Why? No one knows. One theory is that youngsters have fewer of the cell receptors that the virus uses to invade the respiratory system.
As mysterious as it is, researchers have found evidence supporting this pediatric protective effect. Some studies have also found that children are not big “vectors,” or spreaders of infection.
In a commentary this month in the journal Pediatrics, two pediatricians with infectious disease specialties at the University of Vermont summarized recent data on COVID-19 transmission and children:
In France, a study found that a boy with COVID-19 exposed at least 80 classmates at three schools, yet none developed an infection.
In Switzerland, a study of the households of 39 children diagnosed with COVID-19 revealed that, even though the virus sickened 85% of adults in those households, a child was the suspected initial case only in three households (8%).
Two recent studies in China also traced pediatric infections to their adult household contacts.
In New South Wales, Australia, a study of transmission in schools found that 9 infected students and 9 infected staff exposed 735 students and 128 staff to the virus. Only two infections resulted, and only one was transmitted by a child.
“These data all suggest that children are not significant drivers of the COVID-19 pandemic,” wrote the Vermont researchers, Benjamin Lee and William V. Raszka. “Therefore, serious consideration should be paid toward strategies that allow schools to remain open, even during periods of COVID-19 spread.”
The dilemma is that some children do get very sick, and deaths have occurred. An ultra-rare but potentially life-threatening pediatric inflammatory syndrome also has been linked to the coronavirus.
Adding to the conundrum, there is conflicting data. As Gottlieb noted, some studies have found that children are just as susceptible to infection as adults.
“The evidence is still emerging, and credible studies can be marshaled to support both more and less caution” in reopening schools, the former FDA commissioner wrote in his commentary.
The U.S. Centers for Disease Control and Prevention — as well as other medical, public health and education groups — have tried to find a middle ground.
“Whereas most COVID-19 cases in children are not severe, serious COVID-19 illness resulting in hospitalization still occurs in this age group. Social distancing and everyday preventive behaviors remain important for all age groups as patients with less serious illness and those without symptoms likely play an important role in disease transmission,” the CDC says on its website.