Schools should be largely safe from COVID: Research

Children under the age of 14 are only half (48%) as likely as adults to catch the SARS-CoV-2 virus that causes COVID-19, according to a JAMA Pediatrics meta-analysis of 32 studies.
 
Overall, children and adolescents together account for only 1–3% of all cases of COVID-19, according to the analysis.
 
Study co-author Professor Robert Booy, an infectious diseases paediatrician, told newsGP the results are ‘curious but not unforeseen.’
 
‘It is surprising [that children are not as susceptible]; however, a number of other viruses behave in similar ways,’ he said.
 
‘Even though we’re used to influenza and similar viruses that can cause major trouble in very young children, there are also viruses that cause outbreaks and pandemics that leave children alone [or] with mild disease.
 
‘It’s an evolutionary observation that these viruses are not dealt with severely by the immune system because that then allows the child to survive. The immune overreaction we see [in COVID-19] is a particular problem in people over 60.’
 
The analysis comes as new modelling from the Murdoch Children’s Research Institute (MCRI) found most coronavirus cases linked to schools and childcare are likely to have acquired the virus in community settings.
 
Professor Fiona Russell, who led the MCRI analysis, said her team’s research found ‘school and childcare COVID-19 outbreaks were far more likely in those areas that also had high community levels, suggesting community transmission drives COVID-19 spread in schools’.
 
Professor Russell told newsGP that shutting down schools quickly in the event of a positive case slashed the chance of an outbreak.
 
‘What we found is that if you shut down a school quickly, two-thirds of infections didn’t progress to an outbreak,’ she said.
 
‘Of the other third, 90% of those led to less than 10 cases. Of course, outbreaks did occur. But it was managed well.
 
‘I’m sure there are parents who are very concerned about this – I completely understand – but schools are not inherently dangerous places. Most onward transmission occurs in households, not schools.
 
‘What we found, and what all the international evidence suggests, is that most get it in households, and that the chance an infection in a young child leads to an outbreak is very uncommon.’
 
Professor Russell said the reason schools did not lead to major outbreaks – in contrast to workplaces such as meatworks – was likely due to younger children being less likely to transmit the virus. 
 
‘This is why primary schools are going back first in Victoria,’ she said.
 
‘But why do they transmit less? That’s the million-dollar question.
 
‘Schools are not inherently dangerous, but they mirror the community at large. When the second wave went berserk in July, that’s when school outbreaks went up as well.
 
‘What’s happening in the community will happen in schools if there is no mitigation. Now that we have very low transmission rates and the mitigation strategies we’ve recommended, if there is a case, it gets extinguished very quickly.’
 
Professor Russell said it will be vital for parents to keep children home if sick, and for school staff members to do the same if they are unwell.
 
‘The main risk is teacher–teacher, as adults transmit more,’ she said. ‘That’s the same as for any workplace.
 
‘It will be important that staffrooms have social distancing, and we recommend staff wear masks, with enhanced hygiene.’
 
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COVID-19 schools young people