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Covid-19 in schoolchildren – A comparison between Finland and Sweden [pdf]
- all_blue_chucks 6y agoCase counts in children is irrelevant. For an infection to become a case it has to be diagnosed, and that typically only happens with symptoms. But we know young people rarely have symptoms, so obviously they rarely count as cases. INFECTIONS, however, matter a LOT. If you're infected you can pass a virus on without ever being counted as a "case." And we have zero reason to think children can't be infected. Hell, tigers and mink can be infected. Of course children can be infected. This thing is crazy infectious. Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases."
- dragonwriter 6y ago> But we know young people rarely have symptoms And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent. The fact that children tend not to be diagnosed because they tend much more strongly than adults to be asymptomatic when infected is not irrelevant to their propensity to spread the disease.
- enraged_camel 6y ago>>And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent. Our knowledge is not that precise yet. What we do know, based on models, is that "silent" transmission accounts for about 50% of covid-19 infections. https://abcnews.go.com/Health/asymptomatic-presymptomatic-people-transmit-covid-19-infections-study/story?id=71647268 https://abcnews.go.com/Health/asymptomatic-presymptomatic-pe...
- salmon30salmon 6y agoWe don't know this. We would need full contact tracing and much faster testing to know this. Plus, we now know antibodies may _not_ be the biggest contributor to the immune response. It seems T-Cells are in some cases able to fight the disease without ever mounting an antibody response Thus no antibodies. But the ol' maxim applies here: absence of evidence is not evidence of absence
- notacoward 6y ago> absence of evidence is not evidence of absence That applies to infection/transmission via schools in general. Precisely because we don't have decent testing and tracing, we have a large number of cases whose origin is unknown. Schools have to be considered as one possibility, especially considering the several cases where reopening schools has been strongly correlated with spikes in infections. The precise mechanism doesn't matter. It's a red herring. Whether it's kid to kid, parent to teacher, cafeteria workers, whatever, it seems to happen some of the time. Until we've clearly ruled out a cause for those unknowns, we have to consider it still operative.
- all_blue_chucks 6y agoAsymptomatic spread nonexistent? "Our results indicate that silent disease transmission during the presymptomatic and asymptomatic stages are responsible for more than 50% of the overall attack rate in COVID-19 outbreaks." https://www.pnas.org/content/early/2020/07/02/2008373117 https://www.pnas.org/content/early/2020/07/02/2008373117
- dragonwriter 6y agoSure, if you add presymptomatic and asymptomatic spread you get a large number (because the most infectious period is the presymptomatic period right before symptoms develop.) That doesn't even begin to contradict asymptomatic spread, distinguished from presymptomatic spread, being rare to nonexistent. Usually, this makes little difference because you can individually distinguish the two only in retrospect, but when you have a population (like children) that demonstrably has a much lower propensity to develop disease symptoms when infected and a much higher propensity to remain asymptomatic, it makes a big difference.
- all_blue_chucks 6y agoYou should publish your findings showing it is "rare to nonexistant" so that these researchers no longer waste time studying asymptomatic spread...
- zamfi 6y ago> Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases." Actually this is exactly the big question right now -- ignoring "cases", are children as infectious as adults? We don't know, signs point to "not as infectious, but probably nonzero".
- amiga_500 6y agoSo in a classroom with 15 kids breathing in and out, talking etc, for hours, with an airborne virus, seems the teachers will catch it.
- zamfi 6y agoWe don't know this either. May be age-dependent.
- amiga_500 6y agoEver caught a cold from your kid, who didn't have it bad? I have. It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception.
- zamfi 6y ago> Ever caught a cold from your kid, who didn't have it bad? I have. Of course, and so has every parent -- what, exactly, are you implying, that the people studying this haven't had this experience? And are therefore not considering that kids can have mild symptoms but still be contagious? If so, that's an awful lot of ignorance that you are ascribing to everyone studying this with an opinion that doesn't match your lived experience with other viruses. If not, please enlighten me. > It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception. Yes. You are literally commenting in a thread about a paper that is trying to provide evidence ("burden of proof") by looking at differential rates of illness, and not simply drawing inferences from general facts about viruses -- which is what you are doing here.
- patjoh 6y agoThe report mentions this and for Sweden there was a study that found that school staff had no increased risk of exposure. In that report (see reference 6) for example taxi drivers had 4 times the increased risk of exposure compared to teachers of primary school.
- notacoward 6y agoAnd yet, in other cases (e.g. Israel) infections have spiked after school reopenings. The evidence is highly mixed, so it's very important not to cherry-pick cases that only support one's hoped-for policy outcome.
- pugworthy 6y agoThe second bullet point of the conclusion states... | Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted. I feel like that is probably the next most important question to answer.
- vvanders 6y agoOr we could take a look at Israel where they opened up schools and saw a significant spike[1]. [1] https://www.npr.org/sections/coronavirus-live-updates/2020/06/03/868507524/israel-orders-schools-to-close-when-covid-19-cases-are-discovered https://www.npr.org/sections/coronavirus-live-updates/2020/0...
- GhostVII 6y agoThey opened up schools, as well as pretty much everything else. So it is not really clear whether the schools were the biggest contributor to the spread.
- SpicyLemonZest 6y agoI don't see why it's an "or". If data from Finland and Sweden suggests school has no impact, and data from Israel suggests it could, that's all the more reason transmission studies are needed.
- deleted 6y ago[deleted]
- BadCookie 6y agoOr South Africa where they tried to open up schools for only two grades (7th and 12th). "Since the first phase of the schools reopening last month, 968 schools have had to close due to outbreaks and 2,400 teachers and 1,260 learners have tested positive for COVID-19." Source: https://medicalxpress.com/news/2020-07-south-africa-phase-reopening-schools.html https://medicalxpress.com/news/2020-07-south-africa-phase-re... Or the Georgia summer camp that had an outbreak involving 85 campers and staff: https://www.wftv.com/news/trending/85-campers-staff-test-positive-covid-19-ymca-summer-camp/OPSPVDSXRFCLZOD7SEMLCYN2OA/ https://www.wftv.com/news/trending/85-campers-staff-test-pos... Or the Missouri summer camp that had an outbreak involving 82 kids and staff: https://www.foxnews.com/us/missouri-summer-camp-closes-after-82-kids-staffers-infected-with-coronavirus-reports https://www.foxnews.com/us/missouri-summer-camp-closes-after... A lot of this is anecdotal, sure, but I find it hard to believe that kids don't spread the virus if we're seeing large outbreaks like these already.
- salmon30salmon 6y agoHere is a big problem. The children need to go somewhere. Parents need to work, bills need to be paid and tax incomes need to continue to flow. So what to do with the kids? Right now, the options are either send them to school, where there are (in the US) government employees making sure they are safe. The workers are well represented by a strong union, have good healthcare and reasonable wages. The other option is to send them to private day care, where private citizens with no oversight, very low pay and no worker protections are being asked to shoulder the risk. It seems like we have no problem hoisting even more responsibility upon the poor and least represented in society. Teaches are essential workers, much like firefighters, DMV workers or court clerks. We expect a girl making minimum wage at Kroger to accept that she is an essential worker. Why do we not expect the same from school staff? Disclosure: I have siblings and other close relatives that work for and in school in the US. I am not externalizing the risk.
- bpodgursky 6y agoThe teachers don't expect the same, because they are still getting paid. I'm not saying they don't have legitimate questions about how schools will reopen safely, but to be frank, it's really easy to argue that it's "just not safe enough", when you're still pulling a paycheck sitting at home and the closing of schools is felt by working parents who are SOL -- not by yourself.
- cheez 6y agoDing ding ding. I heard of teachers outright disappearing, claiming "technical issues" during this time.
- kilroy_jones 6y agoOf course there will be people like this. Do you think they are anywhere close to the majority?
- cheez 6y agoNo but it's unacceptable.
- jonahbenton 6y agoFrustratingly unhelpful paper, for those looking for useful, applicable measures and measurements. No details around: * distancing measures * space utilization * travel arrangements * coplay arrangements
- SpicyLemonZest 6y agoThe reason the comparison is interesting is that Sweden didn't really implement such measures. Schools there have been operating pretty much as normal.
- jonahbenton 6y agoI understand and appreciate the Swedish strategy...and its failings for its adult population. With respect to what may be claimed "success" in its juvenile population, because of potential applicability (or not) to other communities, details of "normal" are essential. Those are entirely absent from this report. More directly- as a parent in NYC, I am unhappily looking forward to people citing this unhelpful paper and "the Swedish model" claiming return to school will be safe. No and no is what I say to them. Cheers.
- TravelPiglet 6y agoI guess this is the closest to what you are looking for. Google translate is usually pretty good. https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utbrott/aktuella-utbrott/covid-19/verksamheter/information-till-skola-och-forskola-om-den-nya-sjukdomen-covid-19/forebyggande-atgarder-i-for--och-grundskola/ https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utb...
- nkurz 6y agoIf you haven't read it yet, this short report seems to conclude that for reasons that are not yet well understood, children are not very likely to contract the disease, and if they do contract it, are not that likely to spread it to others. As a result, school closings (or the lack thereof) do not seem to have a major effect on the spread of the disease. Pulling some key quotes: "Outbreak investigations in Finland has not shown children to be contributing much in terms of transmission and in Sweden a report comparing risk of covid-19 in different professions, showed no increased risk for teachers." "In conclusion, closure or not of schools had no measurable direct impact on the number of laboratory confirmed cases in school-aged children in Finland or Sweden" "In the contact tracings in primary schools in Finland, there has been hardly any evidence of children infecting other persons. The Swedish comparison of number of reported cases among staff in day care and primary school to number of cases in other professions does not show any increased risk for teachers. This also indicates that the role of children in propagating this infection is likely to be small. Various papers on contact tracing have also found that children rarely are the first case in family clusters (4, 12, 13)." "Closing of schools had no measurable effect on the number of cases of covid- 19 among children." "Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted." Intriguing. This Mercury News article from a couple days ago tells the same general story, and offers some theories on how things might work biologically: Coronavirus: Why kids aren’t the germbags, and grownups are. As school districts sweat over reopening plans, a growing body of research suggests young children are unlikely to transmit COVID-19 virus. They get it from us. https://www.mercurynews.com/2020/07/10/coronavirus-why-kids-arent-the-germbags-and-grownups-are/ https://www.mercurynews.com/2020/07/10/coronavirus-why-kids-...
- IG_Semmelweiss 6y agoWhy is no one mandating open windows and good air flow? If this thing is an aerosol and kids are going to school, seems to me we could do class outdoor until further notice.
- mnm1 6y agoI don't see any data for adult infections. That's what we're concerned about mostly when opening schools. That the kids will infect the adults who will infect each other. I can't believe they have the audacity to publish this paper and its conclusions which clearly cannot be drawn from the data presented. This is pure and utter garbage, garbage that will be used by idiots to make policy decisions that will kill people unnecessarily. The paper should be retracted and peer reviewers should rip it up. What idiocy.
- nikolay 6y ago6% of infected people in Orange County, California are children 0-17 - this is after many restrictions. Even if the percentage stays at 6% after schools reopen, we're talking about a huge ripple effect on the whole population. Unlike adults, kids really can't follow strict measures - America is no Finland, no Sweden, no Asia!
- tmellon 6y agoCan anyone comment if this document 'Covid-19 in school children - A comparison between Sweden & Finland' is an official report ? I'm unable to find it by browsing or searching for it on the website.
- TravelPiglet 6y agohttps://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/c/covid-19-hos-forskole-och-skolbarn/ https://www.folkhalsomyndigheten.se/publicerat-material/publ... It can be found at https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utbrott/aktuella-utbrott/covid-19/statistik-och-analyser/analys-och-prognoser/ https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utb...