I'm hearing worrying rhetoric from scientists suggesting that children don't suffer from 'severe illness' so may not need vaccination. Let's look at the evidence around this. How severe in SARS-CoV-2 in children, and what are the impacts of transmission occurring among children?
We've heard repeatedly, even from scientists that children are less susceptible to infection or transmission- a narrative that seems to suggest children are less likely to get infected. We know now that this is simply not the case.
Indeed, as this point in time, young children have highest positivity rates in England & Scotland (shown below), with rises having occurred soon after school re-openings in both regions. We also know that infection rates were highest in primary & secondary age groups in December.
What is the impact of high levels of infection among children?
Children, unfortunately, are also susceptible to long COVID. Between 10-13% of children have symptoms for 5 wks or more, & 7-8% for 12 wks or more. The long term impacts of this disease on children is not understood.
The ONS estimates that there are currently 43,000 children in the UK living with long COVID. Because the impact of this disease, and causes are so poorly understood, many are struggling to get appropriate care for this, despite the debilitating impact on their lives.
Transmission within schools also leads to disruption of education, with children & staff off sick, or isolating. Last November, attendance was as low as 60% in some regions due to high levels of transmission. 114,000 educational staff estimated to have long COVID.
Here are some current statistics on this. We are clearly still seeing outbreaks across England & Scotland that are disrupting education.

Of course, if transmission is allowed to get out of hand, as we saw in December, this ultimately leads to school closures, which also impacts children, and their families. It also amplifies existing inequities, by disproportionately impacting households in more deprived areas.
What about impact on parents?
We know that parents of both primary & secondary school children are at higher risk of infection- studies across the globe confirm this - in the US, Denmark, Sweden. Lack of mitigations have sadly led to many CV parents having to de-register children
I'm not sure if anyone is counting deaths among parents & grandparents in the UK, but the impact of this on a global scale has been huge. The impact of such loss early in life cannot be overstated.

What about hospitalisation?

5,421 children admitted to hospital with COVID-19 since the start of the pandemic. While these numbers are much smaller than adult hospitalisations, they're still somewhat more than hospitalisations with flu during winter.

And while death is very rare in children with SARS-CoV-2, this is also the case with flu (shown above)- but this hasn't stopped us vaccinating children for influenza - despite influenza not being associated so frequently with the other long-term impacts & risks discussed here.
There are also other reasons to vaccinate children. It's very unlikely we will be able to reach any sort of herd immunity threshold unless we vaccinate a large proportion of our populations- particularly the groups that have the most contacts & contribute most to transmission.
It's very clear that children play a big role in driving community transmission when schools are open, and robust mitigations are not in place. Vaccination of children - if found to be safe, and effective in reducing transmission- could play an important role in pandemic control.
This is all the more important with the variants of concern circulating across the globe. Evidence suggests that when the new Kent variant was increasing in frequency, they were more dominant in school age children compared to the old variant.

The reasons are unclear but children can be an important reservoir for transmission if not vaccinated, which can provide opportunities for virus adaptation, which is crucial to prevent, given the risks this entails.
Of course, all of this assumes safe & effective vaccinations for children- we know that trials are being undertaken now & we have to wait for the results of these trials. The purpose of this discussion is to address the myth that transmission among children is without consequence
We need to stop measuring the cost of SARS-CoV-2 just in terms of deaths- rather than the very real impact of transmission on children - in terms of long COVID, educational disruption, bereavement & parental illness.
Children are part of our communities- the sooner we treat them as such, rather than separate entities that are somehow immune to the impact of the pandemic we're living in, the better we'll do protecting them, supporting them and our communities.
For all these reasons it's important to prevent them being exposed to a virus we don't even understand the consequences of yet - this means putting strict mitigations in place in schools now, as well as vaccination, if/when safe & effective vaccines become available for children.

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More from @dgurdasani1

1 Apr
ONS survey data out today- looking at the pandemic by age paints a heterogenous picture. We appear to be having two different pandemics- one accelerating among young children since schools re-opened, alongside declines in older age groups possibly due to vaccination/lockdown 🧵
Infection prevalence appears to have decreased slightly in England, level in Wales, with increases in Northern Ireland, and slight decrease in Scotland after increases the last few weeks.
Infection rates appear highest, and rising among primary school children, followed by secondary school children & 35-49 yr olds. While this is a general population, survey data, it seems consistent with what we're seeing in symptom-based case data from PHE as well (discuss later)
Read 13 tweets
1 Apr
Very concerning piece by @NafeezAhmed at @BylineTimes suggesting that @educationgovuk review of face-covering policies in schools is “skewing evidence” to justify “dumping face-covering requirements and mitigations rather than strengthening them”.

This is truly bizarre given current DfE policy is well behind evidence on aerosol transmission, and behind most European, and other countries, where mask use is recommended in primaries & secondaries irrespective of distancing.
Also shocking, given data from the ONS today showing increases in infection among primary and secondary school children across England & Scotland after school re-opening, with infection rates being highest currently among primaries compared to all other age groups.
Read 4 tweets
1 Apr
Data from the ONS on long COVID just out- this is one of the most comprehensive studies on long COVID across the globe- based on a survey across England.

What does it show?
Based on self-reported long COVID (given many weren't tested early in the pandemic), an estimated 1.1 million people were living with long COVID in March 2021. Of these, ~478,000 report some impact on day to day life, and ~196,000 reported a lot of impact on daily functioning.
~700K have had symptoms for over 12 weeks, with ~473K having symptoms lasting more than 6 months.

43,000 children estimated to be living with long COVID. Illness appears to predominate in young adults, and women.
Read 17 tweets
31 Mar
Not only has UFT, a lobbying group with non-transparent funding & connections to the CRG & tory govt had a hugely damaging impact on school policy, they're actively working to strip back even the woefully inadequate protections we have in schools. We should be v. worried.🧵
The @educationgovuk is currently carrying out on review on masking policy in schools. Currently masks are recommended for secondaries when distancing cannot be maintained. Even this is completely inadequate, but the review may mean even these basic protections are stripped back.
What is this review considering? Nothing has been made public yet. It appears that unions have been asked to respond to questions about adherence, tolerance, harms & benefits. But how does the review consider the key benefit of mask use- reduction in transmission?
Read 10 tweets
28 Mar
Wow. It's astonishing to see the extent to which scientists who have repeatedly promoted narratives that have turned out to be false & damaging to COVID pandemic control will go to try and salvage their reputations, by targeting academics who have challenged false claims.
The paper concludes an IFR of 0.15% for SARS-CoV-2. So essentially a 100 million people would have needed to be infected in the UK to have deaths of ~150,000, as we do now. Bizarre, given the UK population is 67 million... How did this get past peer review?
Read 4 tweets
26 Mar
ONS data just out- as expected, clear rises in SARS-CoV-2 prevalence in Scotland. Levelling off in all other regions, and rises in several regions in England. Positivity highest among primary & secondary school children across all age groups & trending upwards. Thread.
Rises in overall infection prevalence in Scotland earlier than other regions are in line with earlier openings of primaries, and rises in confirmed cases in the 0-14 yr age group, as discussed earlier on this thread.

This means R has crept above 1 in Scotland, is likely at 1 in other regions, as declines are no longer being seen. In fact, we're seeing increases in some parts of England as well.
Read 13 tweets

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