Thread by @apsmunro

Lots of talk about schools and #COVID19 today, which is no surprise!

Time for a bumper thread on the evidence we have so far on schools, children, teachers, and #SARSCoV2 plus some additional thoughts/considerations

Lets go!

1/15

First, off to Australia 🦘🇦🇺

Tracing of 18 confirmed cases in schools (9 kids, 9 teachers) found that of 863 contacts, only 2 (kids) were positive and not clear if they were infected in school or elsewhere

2/15

ncirs.org.au/covid-19-in-sc…

Now a French highschool in a heavily affected area 🇫🇷

~40% of staff & pupils had positive serology

Note almost all kids >14y. Of those younger, 2.7% positive (not clear if pupil or sibling)

Lower rates in siblings/parents. Teens seem higher risk

3/15

doi.org/10.1101/2020.0…

Same region in 🇫🇷, but primary school

Here 8.8% pupils seropositive compared to 11.9% parents

3 kids in school whilst symptomatic, no evidence of transmission. Appears mainly infected at home.

Symptom onset/timings not affected by school closure

doi.org/10.1101/2020.0…

4/15

Next, Ireland 🇮🇪

6 cases (3 kids, 3 teachers) with school contact tracing

Only 2 transmissions from >1000 contacts, both from a teacher to other adults outside of school

Asymptomatic contacts not tested, so possible undercounting

eurosurveillance.org/content/10.280…

5/15

Finally Singapore 🇸🇬

3 +ve cases:
-12yo in secondary school. 8 classmates symptomatic, all tested negative
-5yo (sibling of ☝️) in primary school. 34 classmates tested, all negative
-16 staff in pre-school cluster. 70% of kids tested, all negative

6/15

academic.oup.com/cid/article/do…

Small numbers, but some early lessons:

-Kids/teachers can catch #SARSCoV2 in school
-Transmission appears mostly rare
-Teenagers may be higher risk for transmitting (consistent with evidence of higher case loads, plus lots of close social mixing)

What else to consider?

7/15

First, there is almost no controversy that children's safety is not the concern from being in school

Their risks of becoming infected and severely unwell are incredibly low (even accounting for the extremely rare hyperinflammatory syndrome)

8/15

medium.com/wintoncentre/w…

Of course there are teachers in school too - however data from Sweden 🇸🇪 where schools have stayed open, shows that Teachers have not been any more likely to get infected than other professions (taxi drivers 5x risk)

c @ProfEmilyOster

9/15

folkhalsomyndigheten.se/contentassets/…

The risk is primarily of increasing community transmission by spreading infection to each other, parents, grandparents etc who will in turn spread it on

Children seem less likely to transmit than adults, but they certainly can transmit

10/15

https://twitter.com/apsmunro/status/1272612343726440449?s=20

Most people worry about kids transmitting similar to other resp viruses, like influenza

This does not appear to be the same for #COVID19 as nicely pictured in this modelling study

nature.com/articles/s4159…

So good news, but we shouldn't be complacent

11/15

Israel has had some trouble with outbreaks in secondary schools in particular

Shows the importance of implementing infection mitigation measures and a responsive test, trace and isolate system, and extra vigilance for older children

timesofisrael.com/over-20-more-s…

12/15

Many other countries have schools up and running with most seeing few, if any issues so far (albeit with low community transmission)

Here are examples of creative solutions different places are using to keep it working safely

dailymail.co.uk/news/article-8…

13/15

A number of excellent articles this week emphasise the need to drive down community transmission, get and keep schools open and *prioritise them* over pubs, cinemas etc

14/15

nytimes.com/2020/07/01/opi…

washingtonpost.com/outlook/2020/0…

slate.com/technology/202…

vox.com/future-perfect…

Kids are suffering lifelong damage from lack of schooling. They are safer in school than out of it

There is always risk of increasing transmission, so we must prioritise schools over other social mixing

Lets make it happen, make it safe, and make it good!

End

15/15