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COVID-19 – research evidence summaries – Royal College of Paediatrics and Child Health

Are children as likely as adults to acquire COVID-19?

Emerging evidence suggests that children may be less likely to acquire the disease. This is supported in countries that have undertaken widespread community testing, where lower case numbers in children than adults have been found.4 14 44 45 Between 16 January and 3 May 2020, 35,200 children in England were swabbed for SARS-CoV-2 and 1408 (4%) were positive. Children under 16 years old accounted for only 1.1% of positive cases.

Can children transmit the virus?

The importance of children in transmitting the virus is difficult to establish, particularly because of the number of asymptomatic cases, but there is some evidence that their role in transmitting the virus is limited…

https://www.rcpch.ac.uk/resources/covid-19-research-evidence-summaries#transmission

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News

Primary schools ‘no greater risk than home’ for pupils and staff – BBC

Attending primary school puts children and staff at no greater risk of contracting coronavirus than staying at home, a study of 131 schools suggests…

…A separate sample of 2,100 staff and children, who were tested for antibodies, found 10.6% of pupils and 12.7% of staff had previously had coronavirus.

This could suggest that children are as likely as adults to be infected, rather than being less susceptible to the disease.

But because so few positive cases in children are detected, it confirms previous research that they are likely to experience mild symptoms, or none at all.

The study found children and staff who attended school more frequently were no more likely to test positive for antibodies than those who did not attend school, or went less often.

https://www.bbc.co.uk/news/health-54025708

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News Opinion

The Case Against Covid Tests for the Young and Healthy – Wall Street Journal

There is little purpose in using tests to check asymptomatic children to see if it is safe for them to come to school. When children are infected, most are asymptomatic, and the mortality risk is lower than for the flu. While adult-to-adult and adult-to-child transmission is common, child-to-adult transmission isn’t. Children thus pose minimal risk to their teachers. If a child has a cough, a runny nose or other respiratory symptoms, he should stay home. You don’t need a test for that.

Sweden was the only major Western country that kept schools open for kids 15 and younger throughout the pandemic, with no masks or mass testing. How did it turn out? Zero Covid-19 deaths among 1.8 million children attending day care or school. Teachers didn’t have an excess infection risk compared with the average of other professions.

https://www.wsj.com/articles/the-case-against-covid-tests-for-the-young-and-healthy-11599151722

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News Opinion

Children could spread COVID19 more if they wear masks – Professor Russell Viner, BBC Newsnight

According to professor Russell Viner, President of Royal College of Paediatrics and SAGE member:

  • There’s very little evidence for the use of masks in schools.
  • Children could potentially spread the virus more if they wear masks
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News

Pupils pose no risk of spreading Covid – Professor Russell Viner, The Sunday Times

One of the largest studies in the world on coronavirus in schools, carried out in 100 institutions in the UK, will confirm that “there is very little evidence that the virus is transmitted” there, according to a leading scientist.

Professor Russell Viner, president of the Royal College of Paediatrics and Child Health and a member of the government advisory group Sage, said: “A new study that has been done in UK schools confirms there is very little evidence that the virus is transmitted in schools.

“This is the some of the largest data you will find on schools anywhere. Britain has done very well in terms of thinking of collecting data in schools.”

https://www.thetimes.co.uk/article/pupils-pose-no-risk-of-spreading-covid-27q6zfd9l

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News

No known case of teacher catching coronavirus from pupils, says scientist – The Times

There has been no recorded case of a teacher catching the coronavirus from a pupil anywhere in the world, according to one of the government’s leading scientific advisers.

Mark Woolhouse, a leading epidemiologist and member of the government’s Sage committee, told The Times that it may have been a mistake to close schools in March given the limited role children play in spreading the virus.

https://www.thetimes.co.uk/edition/news/no-known-case-of-teacher-catching-coronavirus-from-pupils-says-scientist-3zk5g2x6z

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Opinion

Coronavirus: Why everyone was wrong – Dr. Beda Stadler

Professor Dr. Beda M Stadler is the former director of the Institute for Immunology at the University of Bern, a biologist and professor emeritus.

Novelty:

Sars-Cov-2 isn’t all that new, but merely a seasonal cold virus that mutated and disappears in summer, as all cold viri do — which is what we’re observing globally right now. Flu viri mutate significantly more, by the way, and nobody would ever claim that a new flu virus strain was completely novel.

Immunity:

In mid-April work was published by the group of Andreas Thiel at the Charité Berlin. A paper with 30 authors, amongst them the virologist Christian Drosten. It showed that in 34 % of people in Berlin who had never been in contact with the Sars-CoV-2 virus showed nonetheless T-cell immunity against it (T-cell immunity is a different kind of immune reaction, see below). This means that our T-cells, i.e. white blood cells, detect common structures appearing on Sars-CoV-2 and regular cold viri and therefore combat both of them.

…almost no children under ten years old got sick, everyone should have made the argument that children clearly have to be immune. For every other disease that doesn’t afflict a certain group of people, we would come to the conclusion that that group is immune. When people are sadly dying in a retirement home, but in the same place other pensioners with the same risk factors are left entirely unharmed, we should also conclude that they were presumably immune.

Modelling:

Epidemiologist also fell for the myth that there was no immunity in the population. They also didn’t want to believe that coronaviri were seasonal cold viri that would disappear in summer. Otherwise their curve models would have looked differently. When the initial worst case scenarios didn’t come true anywhere, some now still cling to models predicting a second wave.

Asymptomatic transmission:

The term “silent carriers” was conjured out of a hat and it was claimed that one could be sick without having symptoms.

The next joke that some virologists shared was the claim that those who were sick without symptoms could still spread the virus to other people…But for doctors and virologists to twist this into a story of “healthy” sick people, which stokes panic and was often given as a reason for stricter lockdown measures, just shows how bad the joke really is. At least the WHO didn’t accept the claim of asymptomatic infections and even challenges this claim on its website.

Testing:

So if we do a PCR corona test on an immune person, it is not a virus that is detected, but a small shattered part of the viral genome. The test comes back positive for as long as there are tiny shattered parts of the virus left. Correct: Even if the infectious viri are long dead, a corona test can come back positive, because the PCR method multiplies even a tiny fraction of the viral genetic material enough [to be detected]…The crux was that the virus debris registered with the overly sensitive test and therefore came back as “positive”. It is likely that a large number of the daily reported infection numbers are purely due to viral debris.

Kawasaki Syndrome:

If an infected person does not have enough antibodies, i.e. a weak immune response, the virus slowly spreads out across the entire body. Now that there are not enough antibodies, there is only the second, supporting leg of our immune response left: The T-cells beginn to attack the virus-infested cells all over the body. This can lead to an exaggerated immune response, basically to a massive slaughter; this is called a Cytokine Storm. Very rarely this can also happen in small children, in that case called Kawasaki Syndrome. This very rare occurrence in children was also used in our country to stoke panic. It’s interesting, however, that this syndrome is very easily cured. The [affected] children get antibodies from healthy blood donors, i.e. people who went through coronavirus colds.

Second Wave:

The virus is gone for now. It will probably come back in winter, but it won’t be a second wave, but just a cold.

Face masks:

Those young and healthy people who currently walk around with a mask on their faces would be better off wearing a helmet instead, because the risk of something falling on their head is greater than that of getting a serious case of Covid-19.

Lethality:

People below 65 years old make up only 0.6 to 2.6 % of all fatal Covid cases. To get on top of the pandemic, we need a strategy merely concentrating on the protection of at-risk people over 65.

https://medium.com/@vernunftundrichtigkeit/coronavirus-why-everyone-was-wrong-fce6db5ba809

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News

School Children Don’t Spread Coronavirus, French Study Shows – Bloomberg

Scientists at Institut Pasteur studied 1,340 people in Crepy-en-Valois, a town northeast of Paris that suffered an outbreak in February and March, including 510 students from six primary schools. They found three probable cases among kids that didn’t lead to more infections among other pupils or teachers.

The study confirms that children appear to show fewer telltale symptoms than adults and be less contagious, providing a justification for school reopenings in countries from Denmark to Switzerland. The researchers found that 61% of the parents of infected kids had the coronavirus, compared with about 7% of parents of healthy ones, suggesting it was the parents who had infected their offspring rather than the other way around.

https://www.bloomberg.com/news/articles/2020-06-23/school-children-don-t-spread-coronavirus-french-study-shows

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News

Coronavirus: Under-20s half as likely to catch COVID-19, according to study – Sky News

Researchers found school closures had little effect on preventing coronavirus transmission compared to that of the flu.

Under-20s are half as likely to catch COVID-19 as over-20s, making school closures less effective at stopping the spread of the virus, a new scientific study has found.

Researchers at the London School of Hygiene and Tropical Medicine found that susceptibility to the coronavirus was low for younger people, before increasing around the age of 20.

https://news.sky.com/story/coronavirus-under-20s-half-as-likely-to-catch-covid-19-says-study-12007936

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Opinion Videos

Professor Karol Sikora: fear is more deadly than the virus – UnHerd

  • Professor Karol Sikora says that COVID-19 behaves like pandemics in the past.
  • Society is scarred all over the world.
  • The virus will go but the fear will do the damage.

Note: YouTube has taken down the video. Please go directly to UnHerd’s site:

https://unherd.com/thepost/professor-karol-sikora-fear-is-more-dangerous-than-the-virus/

Professor Karol Sikora has become something of a celebrity in the UK over the past months for his expert commentary on the pandemic, and his unusual tendency for optimism rather than pessimism.

Virus ‘getting tired’
– In the past two weeks, the virus is showing signs of petering out
– It’s as though the virus is ‘getting tired’, almost ‘getting bored’
– It’s happening across the world at the same time

Existing herd immunity
– The serology results around the world (and forthcoming in Britain) don’t necessarily reveal the percentage of people who have had the disease
– He estimates 25-30% of the UK population has had Covid-19, and higher in the group that is most susceptible
– Pockets of herd immunity help *already* explain the downturn
– Sweden’s end result will not be different to ours – lockdown versus no lockdown

Fear more deadly than the virus
– When the history books are written, the fear will have killed many more people than the virus, including large numbers of cancer and cardiological patients not being treated
– We should have got the machinery of the NHS for non-corona patients back open earlier

Masks and schools
– Evidence on masks is just not there either way so it should be an ‘individual decision’
– We should move to 1m social distancing which means restaurants and bars could reopen
– More schools should reopen in June as ‘children are not the transmitters of this virus’
– We should be getting back to the ‘old normal’ not a ‘new normal’

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Publications

DFTB COVID-19 EVIDENCE REVIEW – Don’t Forget the Bubbles (pediatrics blog)

Don’t Forget The Bubbles — a blog for medical professionals specializing in pediatrics — partnered with the UK Royal College of Pediatrics and Child Health to track and review studies on COVID-19 in children, according to its website. Using research from 78 of those studies, it released a 45-page report on April 22 that extracts early findings on the epidemiology, transmission and symptoms of the coronavirus in children.

Conclusion:

The role of children in transmission is unclear, but it seems likely they do not play a significant role.

https://dontforgetthebubbles.com/wp-content/uploads/2020/04/COVID-data-top-10.pdf

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News Opinion

Matt Ridley We know everything – and nothing – about Covid – The Spectator

The horrible truth is that it now looks like in many of the early cases, the disease was probably caught in hospitals and doctors’ surgeries. That is where the virus kept returning, in the lungs of sick people, and that is where the next person often caught it, including plenty of healthcare workers. Many of these may not have realised they had it, or thought they had a mild cold. They then gave it to yet more elderly patients who were in hospital for other reasons, some of whom were sent back to care homes when the National Health Service made space on the wards for the expected wave of coronavirus patients.

Once the epidemic is under control in hospitals and care homes, the disease might die out anyway, even without lockdown. In sharp contrast to the pattern among the elderly, children do not transmit the virus much if at all. A recent review by paediatricians could not find a single case of a child passing the disease on and said the evidence ‘consistently demonstrates reduced infection and infectivity of children in the transmission chain’. One boy who caught it while skiing failed to give it to 170 contacts, but he also had both flu and a cold, which he donated to two siblings. Children appear to have ACE2 receptors, the cellular lock that the coronavirus picks, in their noses but not their lungs.

https://www.spectator.co.uk/article/we-know-everything-and-nothing-about-covid

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Publications

Children are not COVID-19 super spreaders: time to go back to school – BMJ

At the current time, children do not appear to be super spreaders. Sero-surveillance data will not be available to confirm or refute these findings prior to the urgent policy decisions that need to be taken in the next few weeks such as how and when to re-open schools. Policies for non-pharmacological interventions involving children are going to have to be made on a risk–benefit basis with current evidence available.

https://adc.bmj.com/content/early/2020/05/05/archdischild-2020-319474