Quick thread on latest @ONS infection survey data, which is very informative!

FYI: the survey involves mass random population testing for #COVID19 in England and Wales, so is not biased by symptoms/test seeking - so very useful indeed!

1/7
I can't go any further without pointing out the massive regional disparities between the north and south of England

Whilst not completely straight forward, this is likely in part due to socioeconomic differences which we know influence effects of disease transmission

2/7
But of course, I'm interested in the KIDS!

Schools open for nearly 6 weeks with fairly limited infection mitigation, and cases rising exponentially across the country

What's happening with primary school age kids?

Not much at all

Even I am surprised about that

3/7
Well we've heard a lot about young adults, what's going on there?

Oh crumbs

Turns out, what little kids are to flu, young adults are to #SARSCoV2

This is where all the action is

4/7
So what about secondary aged kids?

Not awful, but not going the right way. Big difference from primary age at least.

My contacts at @PHE_uk tell me most cases in schools are isolated and outbreaks only small, so I imagine a lot of this is due to community spread leaking in

5/7
What does this mean?

Primary schools look unlikely to be a bother (???could even relax isolation restrictions) - clear evidence young children less effected

Secondary school rise best combatted by reducing community spread. Need to get it down; young adult transmission key

6/7
FYI this is why you MUST be careful with age bins

People focussed about increasing cases in "10 - 19yo" miss that the vast majority of this is in the 16-19yo group, not schools

@ONS right to focus on grouping by policy implication

They are a national treasure 🏆

7/7

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More from @apsmunro

1 Oct
"If there's one thing we learn from history, it's that we don't learn from history"

A new study from India looks at #COVID19 contact tracing

And now reported, "[children] transmitted the virus at rates similar to the rest of the population"

🤔

latimes.com/world-nation/s…

1/10
There is SO much to dig in to here because these findings are complex - but we'll stick with the major issues for now

Child index cases were found to have a high proportion of positive contact of the same age

They must infect them easily, right?

science.sciencemag.org/content/early/…

2/10
The first caveat, is that to be defined as a index case, the child was almost certainly symptomatic

Symptomatic people seem to be much more infectious than asymptomatic

A large proportion of children seem asymptomatic (~50%) so findings are not generalisable

But wait...

3/10
Read 10 tweets
25 Sep
🔥Hot off the press🔥

New article in @JAMAPediatrics from me and @SaulFaust

"The education and well-being of the current generation of children and young people should be the highest priority in any national strategy to reopen society."

jamanetwork.com/journals/jamap…

1/8
Children have been spared the worst of disease from the pandemic, even considering the extremely rare post-COVID-19 hyperinflammatory syndrome

But school closures have been harming children, so the question regarding their role in transmission has loomed large

2/8
A new study from brings us a step closer to understanding

In a meta analysis of contact tracing studies, children acquire the infection less than adults. Looking at household transmission specifically, by less than half (OR 0.41, 95%CI 0.22 - 0.76)

jamanetwork.com/journals/jamap…

3/8
Read 8 tweets
21 Sep
Fascinating

2 groups of scientists with opposing viewpoints on handling the pandemic write open letters to the chief medical officers

Strangely I found them both compelling, and agree with the majority of both letters

Links in following tweets

1/4
First a group recommending more acknowledgment of non-COVID harms of interventions, and recognition of the age disparity in risk for future interventions



2/4
Next a group recommending strong virus suppression with sustainable measures, and arguing against age stratified intervention



3/4
Read 4 tweets
15 Sep
There has never been more confusion about the role of children in transmission of #SARSCoV2 , and tensions are running high over implications for #schoolsreopening

Time for some clarity

@Damian_Roland and I review ALL the evidence on @DFTBubbles

dontforgetthebubbles.com/the-missing-li…

1/13
When considering transmission risk we must consider 2 classes of factors;

Non-modifiable: The biology of the host and pathogen

Modifiable: Behavioural or environmental influence

Since we can change the latter via policy/guidance etc, we'll focus on the former

2/13
How easily to children catch the virus?

Household contact tracing studies suggest less easily than adults; by about half given the same exposure, based on 4 reviews of all the evidence (links in next tweet)

3/13 ImageImageImageImage
Read 13 tweets
14 Sep
I've almost given up on any balanced discourse about children, #COVID19 and schools, as everyone seems intent on either pretending children are not affected at all, or becoming borderline hysterical over the point

Case study: US daycares

1/6
This study from daycares in Utah has been amplified by high profile figures on twitter as a "big deal"

12 children infected (by staff) with 12 secondary cases, all in their homes, with no mention of transmission in the facility

A "big deal" 🤯

cdc.gov/mmwr/volumes/6…

2/6
That study is 3 days old and has an altmetric score of over 4000

That is insane

12 children with 12 secondary cases in over 3 months

How is this even newsworthy?

3/6
Read 6 tweets
11 Sep
A letter from myself, @mugecevik and @AshaBowen about #COVID19 in children and #schoolsreopening in reply to an opinion piece in @theMJA

We've been following the literature since the beginning

Careful and weighted review is vital to inform policy

osf.io/49q5a/

1/8
School closures were one of the first non-pharmaceutical closures around the world, leaving 1.6bil children out of education

en.unesco.org/covid19/educat…

Their reopening has been the source of intense debate

To suggest they are overlooked is erroneous

2/8
Interpreting the evidence means not bundling "children" together as one group

There is a clear difference between young children (<10y) as compare to older adolescents/young adults in regards to susceptibility and transmission

medrxiv.org/content/10.110…

3/8
Read 8 tweets

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