How does the virus infect children? And should they be in school?

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PARIS –
As parents and policymakers agonize over the school reopening date as closings are made easier, scientists are still struggling to find out how the new coronavirus affects children.

While young people may be infected with the new coronavirus, very few have died or contracted severe symptoms. But could they still spread the contagion?

Here’s what we know so far.

ARE CHILDREN AT RISK?

This is one of the few issues where there is broad consensus. Only a tiny proportion of children appear to have become seriously ill with COVID-19.

“There are three key questions: how much do children receive from COVID-19; how much does it affect them; and do they pass them on to others? Said Russell Viner, President of the Royal College of Paediatrics and Child Health in Great Britain.

“We only have good data on the second of them. “

Experts writing for the UK pediatric website Don’t Forget The Bubbles (DFTB) said in a recent review of international research that only about one percent of critical cases involved children, while “deaths remain extremely rare ”.

ARE THEY INFECTED?

The short answer is yes.

“Research indicates that children and adolescents are just as likely to be infected as any other age group and can spread the disease,” said the World Health Organization.

But that is not reflected in official global data on the virus, with many countries largely concentrating their COVID-19 tests on those who went to the hospital with severe symptoms.

The French health agency, which has merged data from a multitude of international studies, said that pediatric cases account for between one and five percent of all officially documented global infections.

He said this is due to the fact that children get the virus, but usually have only “mild” symptoms – or no symptoms – which means they are not counted.

But other experts believe that children, especially those under the age of 10, may not be as infected in the first place.

“It seems pretty convincing that children are much less likely to get the infection than adults,” said specialists Alasdair Munro and Damian Roland of the DFTB.

Their findings were based on several international contact tracing studies that examined how the disease spread and to whom.

They also assessed data from places that performed community-wide mass testing – South Korea, Iceland, and the Italian principality of Vo – all of whom found that the proportion of children infected was much lower than adults.

BUT ARE THEY SILENT VECTORS?

This is the most uncertain area.

The researchers originally thought they could spread the disease, making comparisons with other viruses like the flu where children help speed up infections.

But recent studies on the new coronavirus suggest that they are less likely to transmit the virus.

In one incident, a nine-year-old child was among 12 people infected during a super-spread event in a chalet in Haute-Savoie, France, after the return of a Briton from Singapore and a ski vacation.

A study of the incident – one of the first major infection groups in France – showed that the child, who presented only mild symptoms, came into contact with 172 people while he was sick.

None of them contracted COVID-19, not even the boy’s two siblings. However, the child transmitted other winter viruses, including the flu.

Children may be less contagious because they do not have as many symptoms and do not cough, said French expert Arnaud Fontanet at a parliamentary hearing last week.

But a German study conducted last month by virologist Christian Drosten, Angela Merkel’s advisor, found that children had a viral load comparable to that of adults.

They “could be as contagious,” he added.

Other scientists, including Munro, have challenged both the methodology of this study and its conclusion. Re-analyzing the data, they said it might even be possible to draw the opposite conclusion – that age and viral load are correlated.

Even so, we cannot say for sure that a higher viral load makes a person more contagious.

A NEW THREAT?

In the past few weeks, a series of cases of children with an inflammatory disease resembling a rare disease called Kawasaki disease have sounded the alarm.

Symptoms are high fever, abdominal pain, rash, and swollen glands. If left untreated, patients may suffer from heart failure, but those who receive medical care respond well.

A few dozen cases have been reported in New York, France, Great Britain, Italy and Spain and although no link has been officially established with the new coronavirus, scientists believe it could be connected .

In an article published this week in the medical journal The Lancet, British doctors describing eight cases seen in London said it could be “a new phenomenon” affecting children previously asymptomatic with coronavirus “manifesting as hyperinflammatory syndrome”.

The disease was reported when several European countries were considering reopening schools, raising fears among parents. But experts say the cases are too rare to affect political decisions.

SHOULD SCHOOLS OPEN?

On this point, there are many disagreements.

Italian authorities, who include the oldest teachers in OECD countries with almost 60 per cent of them over the age of 50, have expressed concern that reopening schools could infect staff and boost the epidemic.

But many other countries, including Germany, Denmark and France, have given priority to reopening schools as they unwind the foreclosure measures.

In France, scientific estimates that it would be better to close schools until September have been offset by concerns about other social problems, especially those faced by children from families in difficulty.

“School can be a haven of peace,” said Jean-François Delfraissy, who heads the scientific committee advising the government.

Other experts argue that the benefits of continuing education far outweigh the risks.

In a column published this week in the Archives of Disease in Childhood, Munro and British infectious disease specialist Saul Faust called on governments to allow children to return to school, regardless of underlying health conditions, and to conduct detailed surveillance to monitor security.

“Children are not COVID-19 super spreaders: it’s time to go back to school,” they said.

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