Thread by @DrTomFrieden

Schools will open in weeks in the US with the Delta variant spreading rapidly. What does this mean for kids—especially those under 12 who aren’t eligible for vaccination? How can we keep them safe? These are important questions that require practical, thoughtful answers. 1/thread

The Delta variant is much more transmissible than the original virus and makes up at least 83% of sequenced cases in the US. Although most adults are now fully vaccinated, that’s not the case for adolescents, and kids under 12 can’t be vaccinated yet. 2/

Good news: Most kids who get Covid will have mild or no symptoms, and there’s no evidence that Covid caused by the Delta variant causes more severe illness among kids. 3/

Evidence from multiple contact tracing studies, household transmission studies, and population exposure studies suggests that children are less susceptible to Covid than adults. bit.ly/2TuWEuP 4/

As of July 22, 2021, CDC has reported 494 deaths among children under 18 in the US, a small fraction of the millions of reported cases among kids. 5/

But some kids who get Covid do get very ill. Though it is very rare, MIS-C is a serious complication of Covid in children. Available evidence suggests kids can get long Covid too, though possibly not as frequently as adults. We need better data on this. bit.ly/3kD9iD8 6/

The risk of death from Covid among kids is very low, but it isn’t zero. That’s why if your kid is 12 or above, it’s important they get vaccinated to protect themselves and people around them. Vaccination is proven safe and effective for adolescents. 7/

Vaccinated family members of unvaccinated kids may err on the side of caution, especially in areas with high rates of Covid: wear a mask in indoor public places, increase ventilation, practice physical distancing, and avoid large gatherings with many unmasked people. 8/

Safety measures work inside the house too: a new study shows kids can spread Covid to people in their households, but—importantly—that safety measures reduce this risk. Especially relevant to unvaccinated adults who spend a lot of time around kids. bit.ly/3rrd1oL 9/

The best way to keep all kids safe from Covid is to get as many people vaccinated as possible and to use multiple layers of protection. So what does this mean for schools? 10/

In person schooling is essential. Our kids have suffered enough from missing in-person learning over the past 18 months. It’s possible to open schools safely if we do it carefully, as guidance from @CDCgov, @AmerAcadPeds, and @ResolveTSL has indicated. bit.ly/3hX7JOH 11/

All of these safety measures should be implemented: Consistent and correct mask use, increased ventilation of indoor spaces, physical distancing of at least three feet, hand-washing, cleaning of school spaces, quick action to find and stop spread from cases in schools. 12/

For the small number of students and staff with very serious underlying health conditions that suppress immune response or increase vulnerability (e.g. organ transplantation, cystic fibrosis), reasonable accommodations would be...reasonable! 13/

When we know more about risk factors for breakthrough infection after vaccination, we can better target this type of reasonable accommodation. I hope we’ll learn a lot more about risk factors for serious and fatal breakthrough infections in the coming weeks. 14/

Horrifying to see some states block safety measures, such as masks requirements, in schools. Can’t we agree that we should work together to protect our kids? Masks in schools are a route to the new, safer normal as long as Covid is spreading widely. bit.ly/3zsSYsz 15/

Measures that protect students also protect teachers and staff. Data shows that teachers aren’t at greater risk of Covid than other essential workers. Getting vaccinated and having strong safety measures in place will keep risk low. 16/

It’s inevitable that cases will emerge. Schools must encourage students and staff to stay home when sick, ensure testing to promptly identify cases, clusters and outbreaks as they emerge, and conduct contact tracing in combination with isolation and quarantine as needed. 17/

Protecting our kids means expanding vaccination, opening schools carefully with layered protection measures for our kids and school staff, and reducing community spread of Covid as much as we can. 18/end of thread, but near beginning of school year