Back in the classroom: the Russian roulette for our children

Retour en classe: la roulette russe pour nos enfants

Annabelle Blais

Quebec is preparing to reopen schools and day care centers without knowing exactly at what point the children can transmit the COVID-19, and without having consulted the Association of pediatricians.

“There are many questions about the risk of catching the infection and their role in the transmission. This is a group for which one is in a situation very unusual, ” said Dr. Gaston De Serres, epidemiologist at national Institute of public health of Quebec.

If the children are usually the major transmitters of influenza, it is less clear for the COVID-19. Even the experts do not agree among themselves. Several studies contradictory, have been published over the last few weeks (see below).

The problem is that the majority of the countries that have been affected by the COVID-19 have closed their schools. In the few countries that have reopened, such as France, the debate rages on the risk for the spread of the virus.

However, it is known that symptoms are less important in children. In Quebec, only seven children had to be hospitalized since the beginning of the pandemic, or 0.4 % of all hospitalizations. The vast majority gets away with a slight cough, a little fever, or even without symptoms.

For the doctor intensivist Michel de Marchie, it is the transmission from children to adults that should be monitored. “We do not know yet the transmission of the child to the adult, we don’t know,” he says.

The intensive care unit at the jewish general Hospital where he treats patients with the COVID-19, several of whom are between the ages of 40 to 60 years.

The pediatricians ignored

In the United States, the american Association of pediatrics has a list of criteria to guide the authorities in the decision to reopen or not the schools. The association indicates among other things that one must have data on the transmission between children.

It is also said to focus on a partial reopening and to measure the impact on the contamination. When questioned on these criteria, the quebec Association of pediatrics has not wanted to comment saying that she had not been consulted before the government gives the green light to the reopening.

The increase in the cases of an inflammatory disease, sows the seeds of turmoil

The increase in cases of inflammatory disease that cause fever, heart problems, or digestive in children has caused quite a stir for a week.

Cases were detected in children who tested positive to the COVID-19, the United States and Europe.

At the centre hospitalier Sainte-Justine, we have also seen a few cases similar to the syndrome of Kawasaki, but they were negative and responded well to treatment.

“There is no evidence that this is the COVID-19 [the cause is] “, however, indicates Dr. Elie Haddad. To have the heart net, we will do serological tests in the framework of a clinical study.

Arguments for

Children are not the primary source of propagation

“Unlike the flu, the data to date suggest that children are not the main drivers of the spread of the COVID-19 in schools or in the community “, one can read in an australian study of the National Centre for Immunisation Research and Surveillance (NCIRS) published on 22 April.

The study is interested in the case of 9 adults and 9 children infected with the COVID-19 in 15 schools. These people have been in contact with 735 other students and 128 teachers. The investigation found no evidence of children allegedly infected teachers.

The case of a child who is infected person

A study led by a researcher of the French public health published on 11 April by the Clinical infectious Disease has focused on the case of an outbreak in a chalet in the French Alps.

Some 75 % of the occupants have caught the virus, including a boy of 9 years, who had visited three schools then that he had minor symptoms. He had been in contact with 172 people, including 112 students.

Gold nobody has been contaminated. The child also had the flu and passed it to his siblings, but these have not had the COVID-19.

Less serious symptoms

A study in china published in the Journal of the american Academy of pediatrics shows that in China, on 2135-infected children, 90 % had symptoms of mild, moderate, or no symptoms.

In Canada, children represent only 1 % of the total hospitalizations.

Arguments against

The children have the same viral loads

In a German study, published April 29, on the viral load in 3712 infected patients, virologists have found no change in viral load according to the age of the patients including children.

“On the basis of these results, we need to guard against a re-opening unlimited schools and day care facilities in the current situation. Children can be as contagious as adults, ” can we read.

Few studies

The way in which the children act as a vector of transmission is not yet clear. As pointed out by the German scientists, the study to understand the role of children in transmission are complex due to the confinement.

As they are not in class, it is unlikely that they are the source of contamination of a family that would be infected. This observation could falsely suggest that children are less infectious.

There are children in the hospital

Even though children represent only a small percentage of hospitalizations in connection with the COVID-19, it does not mean that there is not.

In a report by the US Center for disease control and prevention, one can read that in the United States, among the 149 082 cases reported, 2572 were minors, or 1.7 % of the cases. In all, 745 of them, or 5.7 %, had to be hospitalized, including 15 in intensive care.

The report mentions three deaths of children without giving more details, since the analyses were still in progress.

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