Covid-19 in schoolchildren – A comparison between Finland and Sweden [pdf](folkhalsomyndigheten.se)
folkhalsomyndigheten.se
Covid-19 in schoolchildren – A comparison between Finland and Sweden [pdf]
https://www.folkhalsomyndigheten.se/contentassets/c1b78bffbfde4a7899eb0d8ffdb57b09/covid-19-school-aged-children.pdf
90 comments
> The workers are well represented by a strong union, have good healthcare and reasonable wages.
My spouse and sister are both schoolteachers. Sister's situation: laid off from a private school where enrollment will drop significantly this year. Spouse's situation: works for a well-funded school in one of the most populous states in the U.S., where there is no strong union, the pay is below the poverty line after mandatory deductions, and the healthcare is so bad (no out-of-network benefits and in-network only applies within the county, basically) that most people have to expand their view of what "health insurance coverage" is in order to understand it. A number of the teachers in their network are considering teach 5 kids in a private daycare group (working 30 hours a week) instead of teaching 30+ kids working 50 hours a week under very constrained public school conditions. These are anecdotes, of course, but what we're seeing from over here is that teachers don't feel safe reopening schools, and aren't overly committed to their benefits since they're not particularly well taken care of by the standards of the average American worker. Just a different two cents.
My spouse and sister are both schoolteachers. Sister's situation: laid off from a private school where enrollment will drop significantly this year. Spouse's situation: works for a well-funded school in one of the most populous states in the U.S., where there is no strong union, the pay is below the poverty line after mandatory deductions, and the healthcare is so bad (no out-of-network benefits and in-network only applies within the county, basically) that most people have to expand their view of what "health insurance coverage" is in order to understand it. A number of the teachers in their network are considering teach 5 kids in a private daycare group (working 30 hours a week) instead of teaching 30+ kids working 50 hours a week under very constrained public school conditions. These are anecdotes, of course, but what we're seeing from over here is that teachers don't feel safe reopening schools, and aren't overly committed to their benefits since they're not particularly well taken care of by the standards of the average American worker. Just a different two cents.
I appreciate your perspective and I am sorry that that is the situation in your state. I admit I can only speak for my state, and as such should limit my opinions to that context.
Thank you!
Thank you!
Non-US tenured teacher here. I'd have to do something very, very, very wrong before I'd ever have a snowball's chance in hell of getting fired.
Most if not all of my colleagues and I have worked incredibly hard teaching remotely when that was the only option. We've been expected to use self purchased electronic equipment for that. When limited on-site teaching became possible again, we took the opportunity. Yes, older, overweight teachers most at risk also did.
We saw our bosses cared. We saw a fairly competent chain of command up to the prime minister, very much guided by the scientific approach. My guess is that made a large difference. At least with me it did.
Would we have done the same in the US? I don't think so. The scientific approach has been disregarded so badly, not to say ridiculed, at so many levels. Individual students, parents, school district leads, governors, the president. Don't expect me to voluntarily take the risk they've created.
Here are some of the important questions that need to be answered before I'd consider going back to teach on site:
- Will sufficient personal protective equipment be provided?
- Will elementary technical precautions like distancing, natural ventilation etcetera be taken?
- Will parents and students over 12 years old be required to use a facial mask in any physical proximity situation?
- Will my obese colleague with a heart condition be shielded from teaching in direct physical contact with students?
Also, it would be nice if government showed some appreciation for our hard remote work, by way of a budget for electronic equipment for remote teaching for example.
Most if not all of my colleagues and I have worked incredibly hard teaching remotely when that was the only option. We've been expected to use self purchased electronic equipment for that. When limited on-site teaching became possible again, we took the opportunity. Yes, older, overweight teachers most at risk also did.
We saw our bosses cared. We saw a fairly competent chain of command up to the prime minister, very much guided by the scientific approach. My guess is that made a large difference. At least with me it did.
Would we have done the same in the US? I don't think so. The scientific approach has been disregarded so badly, not to say ridiculed, at so many levels. Individual students, parents, school district leads, governors, the president. Don't expect me to voluntarily take the risk they've created.
Here are some of the important questions that need to be answered before I'd consider going back to teach on site:
- Will sufficient personal protective equipment be provided?
- Will elementary technical precautions like distancing, natural ventilation etcetera be taken?
- Will parents and students over 12 years old be required to use a facial mask in any physical proximity situation?
- Will my obese colleague with a heart condition be shielded from teaching in direct physical contact with students?
Also, it would be nice if government showed some appreciation for our hard remote work, by way of a budget for electronic equipment for remote teaching for example.
> there are (in the US) government employees making sure they are safe. The workers are well represented by a strong union, have good healthcare and reasonable wages.
What country do you live in? Most teachers are employees of the local school district, not directly of the government. (When I was a Title I teacher, I was a federal employee, but that's not very common). I was never in a union, because there weren't any in the Detroit charter schools I worked at. And I only made $27,000 a year. Does that sound well-paid to you? Even though we had decent health care, with student loans I couldn't afford the copay, so I forwent any health care unless it was an emergency.
What country do you live in? Most teachers are employees of the local school district, not directly of the government. (When I was a Title I teacher, I was a federal employee, but that's not very common). I was never in a union, because there weren't any in the Detroit charter schools I worked at. And I only made $27,000 a year. Does that sound well-paid to you? Even though we had decent health care, with student loans I couldn't afford the copay, so I forwent any health care unless it was an emergency.
The problem with this kind of framing is that it accepts the status quo as a sane premise in the face of a pandemic with largely unknown long term consequences.
Having public schools function as de facto daycares when there’s not a pandemic makes a certain amount of sense, but in the circumstances of the US, where we have uncontrolled spread and a dysfunctional healthcare system on many levels, it makes little.
The sane thing to do would be to implement some form of short term UBI that allows one parent or a designated caregiver to stay home and attend to children’s needs and do everything we can to get the situation under control (universal mask orders, regional lockdowns, replenish PPE, etc.)
Having public schools function as de facto daycares when there’s not a pandemic makes a certain amount of sense, but in the circumstances of the US, where we have uncontrolled spread and a dysfunctional healthcare system on many levels, it makes little.
The sane thing to do would be to implement some form of short term UBI that allows one parent or a designated caregiver to stay home and attend to children’s needs and do everything we can to get the situation under control (universal mask orders, regional lockdowns, replenish PPE, etc.)
Three questions:
1. What makes you think we _can_ get this under control without herd immunity or a vaccine? I am of the belief that there is a certain level of latent immunity via t-cells in a large portion of the population and thus effective herd immunity is around 25-30% infected. But for arguments sake, lets say it is around 70 based solely on Rt.
2. Who would pay for the UBI? My state is already running low on money. We are already having to cut programs. Raising taxes doesn't count, that would take a year to pass, a year to implement and collect and probably a few years in court litigating. So how do we pay for it?
3. How do you equitably select a parent to stay home? And how to do reimburse their employer for lost productivity? Do you guarantee their job upon the end of the pandemic?
1. What makes you think we _can_ get this under control without herd immunity or a vaccine? I am of the belief that there is a certain level of latent immunity via t-cells in a large portion of the population and thus effective herd immunity is around 25-30% infected. But for arguments sake, lets say it is around 70 based solely on Rt.
2. Who would pay for the UBI? My state is already running low on money. We are already having to cut programs. Raising taxes doesn't count, that would take a year to pass, a year to implement and collect and probably a few years in court litigating. So how do we pay for it?
3. How do you equitably select a parent to stay home? And how to do reimburse their employer for lost productivity? Do you guarantee their job upon the end of the pandemic?
Maybe the issue lies more in your first statement that children need to go somewhere. That's a fairly modern notion. If we've created a society where we rely on strangers to care for our kids, then maybe that's something that needs to be looked rather than creating additional covid hotspots?
While we're doing that, maybe a compromise with A/B school days to limit student numbers, with online participation for whichever group is at home. Schools also need to create strict rules as far as cafeterias, masks, etc... With clear consequences for violations.
The school I am at has dividers in the cafeteria and staggered lunches with no talking while eating. Masks at all times. Temperature checks at the doors and such. This is countrywide (not US) and there has been no spread in schools.
While we're doing that, maybe a compromise with A/B school days to limit student numbers, with online participation for whichever group is at home. Schools also need to create strict rules as far as cafeterias, masks, etc... With clear consequences for violations.
The school I am at has dividers in the cafeteria and staggered lunches with no talking while eating. Masks at all times. Temperature checks at the doors and such. This is countrywide (not US) and there has been no spread in schools.
Well the issue may well lie in my first statement. I am not disagreeing in principle with you. But we a day late and a dollar short to actually make large scale societal change in the time needed to respond to _this_ pandemic. The children need an education, parents need to work. That is the fact of the times.
Should this be an ongoing conversation to prepare for the _next_ pandemic? Certainty. But we lost the benefit of time on this one.
Should this be an ongoing conversation to prepare for the _next_ pandemic? Certainty. But we lost the benefit of time on this one.
Respectfully, this is a sunk cost fallacy. The idea that we’ve already screwed up so there’s no way to radically change course is a recipe for disaster. Even the UK, who foolishly tried to go the probably-nonexistent “herd immunity” route realized their error, turned things around, and is now doing much better than the US (although worse than Europe, because of their early mistakes).
It is only a fallacy if incorrectly applied :D
In some cases, it is better to continue course with known variables.
Also, I wouldn't say it is non-existent. As I said in another response, I currently see a lot of evidence for the cross-reactive t-cell immune response causing the virus to burn out after around 25% infection rate.
In some cases, it is better to continue course with known variables.
Also, I wouldn't say it is non-existent. As I said in another response, I currently see a lot of evidence for the cross-reactive t-cell immune response causing the virus to burn out after around 25% infection rate.
There are no “known variables” under the circumstances you describe in a novel pandemic because we don’t know the long term consequences of the disease.
There’s likewise no firm understanding of the duration or quality of immunity, nor will there be for probably years, making every appeal to herd immunity little more than dangerous speculation.
There’s likewise no firm understanding of the duration or quality of immunity, nor will there be for probably years, making every appeal to herd immunity little more than dangerous speculation.
We don't know the long term consequences of completely shutting down a majority of society for an unknown period of time, including depriving children of an education. So let's not compare unknowns. This whole thing is an unknown and we need to accept some risk in each direction or be motionless.
But the variables in the other direction aren't firmly known either. We don't know that suppression can be maintained in the medium term, and we don't know that a vaccine will be able to eliminate the virus in the long term. We have no option but to make choices based on dangerous speculation.
> We expect a girl making minimum wage at Kroger to accept that she is an essential worker. Why do we not expect the same from school staff?
I wish that as a society we could decide that anyone we're going to call an "essential worker" and draft to the biohazardous front lines should bloody well be paid at least as much as the rest of us who can be gone for a week with little ill effect to society at large.
Not just during an emergency either - they're essential the rest of the time too.
I wish that as a society we could decide that anyone we're going to call an "essential worker" and draft to the biohazardous front lines should bloody well be paid at least as much as the rest of us who can be gone for a week with little ill effect to society at large.
Not just during an emergency either - they're essential the rest of the time too.
Over here in Asia where we live in joint families or our parents/grandparents live in the same house as us for our entire lives this is a non-issue, I always found it weird how people in the west headed out to live independently as soon as they turn 18 or go to college. I knew a guy in Germany who was working a job and said he was peer pressured to leave his parents home because it was seen as something negative, that he was still "freeloading" by the time he was ~24.
It could be argued that the multi-generational home is one of the cultural ingredients for such a bad outbreak in Italy. That is a lot more common in that country than in some other parts of Europe.
It is also somewhat common in immigrant groups in western Europe and the US (though somewhat out of economic necessity rather than cultural norms) and those groups are also the hardest hit in the US (apart for retirement homes).
Causality is hard to prove, but it is something worth looking at.
It is also somewhat common in immigrant groups in western Europe and the US (though somewhat out of economic necessity rather than cultural norms) and those groups are also the hardest hit in the US (apart for retirement homes).
Causality is hard to prove, but it is something worth looking at.
The teachers don't expect the same, because they are still getting paid.
I'm not saying they don't have legitimate questions about how schools will reopen safely, but to be frank, it's really easy to argue that it's "just not safe enough", when you're still pulling a paycheck sitting at home and the closing of schools is felt by working parents who are SOL -- not by yourself.
I'm not saying they don't have legitimate questions about how schools will reopen safely, but to be frank, it's really easy to argue that it's "just not safe enough", when you're still pulling a paycheck sitting at home and the closing of schools is felt by working parents who are SOL -- not by yourself.
Most teachers would rather be in the classroom than do online learning. They'd also like people to be safe.
The issue comes with trying to force kids to wear masks when so many parents are against them in many places, maintain social distancing, and keeping things clean and sanitized.
Keeping kids focused and learning has become difficult enough, but add on all those measures plus the possibility of contracting covid, just means you will lose a lot of experienced teaching staff.
The issue comes with trying to force kids to wear masks when so many parents are against them in many places, maintain social distancing, and keeping things clean and sanitized.
Keeping kids focused and learning has become difficult enough, but add on all those measures plus the possibility of contracting covid, just means you will lose a lot of experienced teaching staff.
"Most" is doing a lot of heavy lifting in that sentence. And lets also be real, there is a self-reporting bias there, where I doubt very many people (myself included) would admit to _wanting_ to not work and still get paid, even if that is the motivation.
Most teachers are still working doing online learning though, which why I stated they'd prefer to be in the classroom. Online learning is all the worst parts of teaching with very little of the joy.
Sure, if someone wanted to pay me to do whatever I wanted I'd take it no qualms whatsoever. But yes, I may not admit to it.
Sure, if someone wanted to pay me to do whatever I wanted I'd take it no qualms whatsoever. But yes, I may not admit to it.
I think that like most things in the states, this is super dependent on where you are. I know in my area, teachers were _not_ working every day, despite still doing online learning. They were supposed to check in with the kids every few days. In fact, most went on unemployment (at the request of the district) to be able to make the lower work scheme work without impacting district budgets.
Are you kidding? Every teacher I know has had to radically reinvent their classrooms for fully remote learning on the fly with minimal support and are working around the clock to do so.
Ding ding ding.
I heard of teachers outright disappearing, claiming "technical issues" during this time.
I heard of teachers outright disappearing, claiming "technical issues" during this time.
Of course there will be people like this. Do you think they are anywhere close to the majority?
No but it's unacceptable.
Case counts in children is irrelevant. For an infection to become a case it has to be diagnosed, and that typically only happens with symptoms. But we know young people rarely have symptoms, so obviously they rarely count as cases.
INFECTIONS, however, matter a LOT. If you're infected you can pass a virus on without ever being counted as a "case." And we have zero reason to think children can't be infected. Hell, tigers and mink can be infected. Of course children can be infected. This thing is crazy infectious.
Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases."
INFECTIONS, however, matter a LOT. If you're infected you can pass a virus on without ever being counted as a "case." And we have zero reason to think children can't be infected. Hell, tigers and mink can be infected. Of course children can be infected. This thing is crazy infectious.
Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases."
The report mentions this and for Sweden there was a study that found that school staff had no increased risk of exposure.
In that report (see reference 6) for example taxi drivers had 4 times the increased risk of exposure compared to teachers of primary school.
In that report (see reference 6) for example taxi drivers had 4 times the increased risk of exposure compared to teachers of primary school.
And yet, in other cases (e.g. Israel) infections have spiked after school reopenings. The evidence is highly mixed, so it's very important not to cherry-pick cases that only support one's hoped-for policy outcome.
> Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases."
Actually this is exactly the big question right now -- ignoring "cases", are children as infectious as adults?
We don't know, signs point to "not as infectious, but probably nonzero".
Actually this is exactly the big question right now -- ignoring "cases", are children as infectious as adults?
We don't know, signs point to "not as infectious, but probably nonzero".
So in a classroom with 15 kids breathing in and out, talking etc, for hours, with an airborne virus, seems the teachers will catch it.
We don't know this either. May be age-dependent.
Ever caught a cold from your kid, who didn't have it bad? I have. It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception.
> Ever caught a cold from your kid, who didn't have it bad? I have.
Of course, and so has every parent -- what, exactly, are you implying, that the people studying this haven't had this experience? And are therefore not considering that kids can have mild symptoms but still be contagious?
If so, that's an awful lot of ignorance that you are ascribing to everyone studying this with an opinion that doesn't match your lived experience with other viruses.
If not, please enlighten me.
> It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception.
Yes. You are literally commenting in a thread about a paper that is trying to provide evidence ("burden of proof") by looking at differential rates of illness, and not simply drawing inferences from general facts about viruses -- which is what you are doing here.
Of course, and so has every parent -- what, exactly, are you implying, that the people studying this haven't had this experience? And are therefore not considering that kids can have mild symptoms but still be contagious?
If so, that's an awful lot of ignorance that you are ascribing to everyone studying this with an opinion that doesn't match your lived experience with other viruses.
If not, please enlighten me.
> It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception.
Yes. You are literally commenting in a thread about a paper that is trying to provide evidence ("burden of proof") by looking at differential rates of illness, and not simply drawing inferences from general facts about viruses -- which is what you are doing here.
> But we know young people rarely have symptoms
And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent.
The fact that children tend not to be diagnosed because they tend much more strongly than adults to be asymptomatic when infected is not irrelevant to their propensity to spread the disease.
And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent.
The fact that children tend not to be diagnosed because they tend much more strongly than adults to be asymptomatic when infected is not irrelevant to their propensity to spread the disease.
Asymptomatic spread nonexistent?
"Our results indicate that silent disease transmission during the presymptomatic and asymptomatic stages are responsible for more than 50% of the overall attack rate in COVID-19 outbreaks."
https://www.pnas.org/content/early/2020/07/02/2008373117
"Our results indicate that silent disease transmission during the presymptomatic and asymptomatic stages are responsible for more than 50% of the overall attack rate in COVID-19 outbreaks."
https://www.pnas.org/content/early/2020/07/02/2008373117
Sure, if you add presymptomatic and asymptomatic spread you get a large number (because the most infectious period is the presymptomatic period right before symptoms develop.) That doesn't even begin to contradict asymptomatic spread, distinguished from presymptomatic spread, being rare to nonexistent. Usually, this makes little difference because you can individually distinguish the two only in retrospect, but when you have a population (like children) that demonstrably has a much lower propensity to develop disease symptoms when infected and a much higher propensity to remain asymptomatic, it makes a big difference.
You should publish your findings showing it is "rare to nonexistant" so that these researchers no longer waste time studying asymptomatic spread...
>>And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent.
Our knowledge is not that precise yet.
What we do know, based on models, is that "silent" transmission accounts for about 50% of covid-19 infections.
https://abcnews.go.com/Health/asymptomatic-presymptomatic-pe...
Our knowledge is not that precise yet.
What we do know, based on models, is that "silent" transmission accounts for about 50% of covid-19 infections.
https://abcnews.go.com/Health/asymptomatic-presymptomatic-pe...
We don't know this. We would need full contact tracing and much faster testing to know this. Plus, we now know antibodies may _not_ be the biggest contributor to the immune response. It seems T-Cells are in some cases able to fight the disease without ever mounting an antibody response Thus no antibodies.
But the ol' maxim applies here: absence of evidence is not evidence of absence
But the ol' maxim applies here: absence of evidence is not evidence of absence
> absence of evidence is not evidence of absence
That applies to infection/transmission via schools in general. Precisely because we don't have decent testing and tracing, we have a large number of cases whose origin is unknown. Schools have to be considered as one possibility, especially considering the several cases where reopening schools has been strongly correlated with spikes in infections. The precise mechanism doesn't matter. It's a red herring. Whether it's kid to kid, parent to teacher, cafeteria workers, whatever, it seems to happen some of the time. Until we've clearly ruled out a cause for those unknowns, we have to consider it still operative.
That applies to infection/transmission via schools in general. Precisely because we don't have decent testing and tracing, we have a large number of cases whose origin is unknown. Schools have to be considered as one possibility, especially considering the several cases where reopening schools has been strongly correlated with spikes in infections. The precise mechanism doesn't matter. It's a red herring. Whether it's kid to kid, parent to teacher, cafeteria workers, whatever, it seems to happen some of the time. Until we've clearly ruled out a cause for those unknowns, we have to consider it still operative.
The second bullet point of the conclusion states...
| Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted.
I feel like that is probably the next most important question to answer.
| Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted.
I feel like that is probably the next most important question to answer.
Or we could take a look at Israel where they opened up schools and saw a significant spike[1].
[1] https://www.npr.org/sections/coronavirus-live-updates/2020/0...
[1] https://www.npr.org/sections/coronavirus-live-updates/2020/0...
They opened up schools, as well as pretty much everything else. So it is not really clear whether the schools were the biggest contributor to the spread.
I don't see why it's an "or". If data from Finland and Sweden suggests school has no impact, and data from Israel suggests it could, that's all the more reason transmission studies are needed.
[deleted]
Or South Africa where they tried to open up schools for only two grades (7th and 12th).
"Since the first phase of the schools reopening last month, 968 schools have had to close due to outbreaks and 2,400 teachers and 1,260 learners have tested positive for COVID-19."
Source: https://medicalxpress.com/news/2020-07-south-africa-phase-re...
Or the Georgia summer camp that had an outbreak involving 85 campers and staff:
https://www.wftv.com/news/trending/85-campers-staff-test-pos...
Or the Missouri summer camp that had an outbreak involving 82 kids and staff:
https://www.foxnews.com/us/missouri-summer-camp-closes-after...
A lot of this is anecdotal, sure, but I find it hard to believe that kids don't spread the virus if we're seeing large outbreaks like these already.
"Since the first phase of the schools reopening last month, 968 schools have had to close due to outbreaks and 2,400 teachers and 1,260 learners have tested positive for COVID-19."
Source: https://medicalxpress.com/news/2020-07-south-africa-phase-re...
Or the Georgia summer camp that had an outbreak involving 85 campers and staff:
https://www.wftv.com/news/trending/85-campers-staff-test-pos...
Or the Missouri summer camp that had an outbreak involving 82 kids and staff:
https://www.foxnews.com/us/missouri-summer-camp-closes-after...
A lot of this is anecdotal, sure, but I find it hard to believe that kids don't spread the virus if we're seeing large outbreaks like these already.
If you want an example involving younger kids, there was recently an outbreak involving 12 staff and 8 kids at an Oregon daycare that serves kids ages 6 and under [1].
It might be impossible to know whether the adults infected the kids or vice versa (or both), but Coronavirus cases are growing fastest among kids younger than 10 in Oregon right now [2], so ... to me, it makes sense to assume that kids can spread it until it's proven otherwise.
Lastly, for those who don't know, the CDC internally lists reopening schools as the "highest risk" for Coronavirus spread. [3]
[1] https://www.wweek.com/news/state/2020/06/30/oregon-child-car...
[2] https://www.oregonlive.com/coronavirus/2020/07/coronavirus-i...
[3] https://www.cnn.com/2020/07/11/politics/cdc-documents-warn-h...
It might be impossible to know whether the adults infected the kids or vice versa (or both), but Coronavirus cases are growing fastest among kids younger than 10 in Oregon right now [2], so ... to me, it makes sense to assume that kids can spread it until it's proven otherwise.
Lastly, for those who don't know, the CDC internally lists reopening schools as the "highest risk" for Coronavirus spread. [3]
[1] https://www.wweek.com/news/state/2020/06/30/oregon-child-car...
[2] https://www.oregonlive.com/coronavirus/2020/07/coronavirus-i...
[3] https://www.cnn.com/2020/07/11/politics/cdc-documents-warn-h...
> 2,400 teachers and 1,260 learners have tested positive for COVID-19.
It's pretty interesting that almost twice as many teachers as students tested positive. Presumably there are ~20x more students than teachers?
It may very well be the case that children are far less likely to either catch or spread the virus, but far less likely is not the same as not spreading it at all.
It's pretty interesting that almost twice as many teachers as students tested positive. Presumably there are ~20x more students than teachers?
It may very well be the case that children are far less likely to either catch or spread the virus, but far less likely is not the same as not spreading it at all.
Assuming children do not spread covid-19 as much as adults, it would be fair to say they still do spread at some degree. Therefore, the question is what is the risk tolerance that is acceptable to society? Are we as a society willing to accept that some adults will be infected and/or die as a result of children going to school? What's the acceptable risk tolerance for teachers? If there is an assumption that some teachers will die, how many is too many?
There is an acceptable risk because we already accept the risk from children being vectors for spreading annual seasonal diseases that do end up killing adults and children. What is that level? Doubt anyone wants to specify an exact number because then they will be forever tarred with that number of deaths. One thing is very obvious about this pandemic: the degree to which it has been politicized has made it impossible to respond in a manner that is similar to other threats of similar risk.
> respond in a manner that is similar to other threats of similar risk
Is there another example in the U.S where U.S citizens reacted reasonably and averted disaster?
Is there another example in the U.S where U.S citizens reacted reasonably and averted disaster?
It could be argued that the response to the Spanish Flu, Polio, HK Flu, H1N1, Zika, Swine etc. It appears by most measures this is an order of magnitude less lethal than Spanish Flu. THIS one, however, is political.
0.65% IFR as of the latest CDC estimates (July 10)[1]
We had fewer people in 1918 so this would still mean millions of deaths if we let this run it's course without mitigation.
My other concern is whether this virus will have adverse effects later in life when one's immune system weakens.
This virus may very well drastically drop our overall life expectancy.
1. https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
We had fewer people in 1918 so this would still mean millions of deaths if we let this run it's course without mitigation.
My other concern is whether this virus will have adverse effects later in life when one's immune system weakens.
This virus may very well drastically drop our overall life expectancy.
1. https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scena...
The update the CDC made is interesting. AS the footnote in the estimate table states, the IFR is taken from the pre-print _A systematic review and meta-analysis of published research data on COVID-19 infection-fatality rates_ by Meyerowitz-Katz, G., & Merone, L. et. al. The conclusion of their paper states:
> Based on a systematic review and meta-analysis of published evidence on COVID-19 until May, 2020, the IFR of the disease across populations is 0.68% (0.53-0.82%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents the ‘true’ point estimate..._
There have been several reports that the IFR has lowered since late May, so it will be interesting to see if they rerun their metanalysis with June/July data. Their paper also makes the point that this could be an underestimate due to reporting issues (under-reported deaths). But likewise it could be an overestimate due to under-reporting infections (with so many asymptomatic cases). I am a little concerned over the lack of mention of that fact in the paper, which to me is as important as the under-reported deaths.
I understand your concern regarding long-term impacts. While we can't dismiss those concerns, it would be the only coronavirus in the history of known coronaviruses to do anything like that. So with our knowledge of this virus and the family of viruses, we can say that is "unlikely".
Tissue damage from a lung infection is _not_ rare. The flu does this (https://www.sciencedaily.com/releases/2009/07/090717150302.h.... Any pneumonia can cause scarring of the lung tissue, viral or otherwise.
If you are referring to the clotting and inflammation, again this is not altogether rare for a serious infection. Inflammation is common and not normally dangerous. The clotting is interesting, but also not unheard of. Also some interesting evidence that this may be a secondary infection (perhaps caused by venting? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836438/) https://principia-scientific.org/cv-19-autopsies-show-blood-...
There are going to be a lot of deaths. I can't argue out of that reality. It is really unfortunate. We will all known somebody who dies from this, or at least are within a free degrees. The debate, in my opinion, isn't on preventing all deaths, it won't happen. It is how do we minimize death while preventing long term societal and economic damage. And how do we protect the most vulnerable without causing those damages elsewhere.
I know it sounds weird, but the age stratification of the IFR is a HUGE gift of this virus. It is more age stratified than the flu or other common pandemic sources. We are very lucky. Next time we may not be, so I hope we can learn from this on how to prepare for what we feared this was.
> Based on a systematic review and meta-analysis of published evidence on COVID-19 until May, 2020, the IFR of the disease across populations is 0.68% (0.53-0.82%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents the ‘true’ point estimate..._
There have been several reports that the IFR has lowered since late May, so it will be interesting to see if they rerun their metanalysis with June/July data. Their paper also makes the point that this could be an underestimate due to reporting issues (under-reported deaths). But likewise it could be an overestimate due to under-reporting infections (with so many asymptomatic cases). I am a little concerned over the lack of mention of that fact in the paper, which to me is as important as the under-reported deaths.
I understand your concern regarding long-term impacts. While we can't dismiss those concerns, it would be the only coronavirus in the history of known coronaviruses to do anything like that. So with our knowledge of this virus and the family of viruses, we can say that is "unlikely".
Tissue damage from a lung infection is _not_ rare. The flu does this (https://www.sciencedaily.com/releases/2009/07/090717150302.h.... Any pneumonia can cause scarring of the lung tissue, viral or otherwise.
If you are referring to the clotting and inflammation, again this is not altogether rare for a serious infection. Inflammation is common and not normally dangerous. The clotting is interesting, but also not unheard of. Also some interesting evidence that this may be a secondary infection (perhaps caused by venting? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836438/) https://principia-scientific.org/cv-19-autopsies-show-blood-...
There are going to be a lot of deaths. I can't argue out of that reality. It is really unfortunate. We will all known somebody who dies from this, or at least are within a free degrees. The debate, in my opinion, isn't on preventing all deaths, it won't happen. It is how do we minimize death while preventing long term societal and economic damage. And how do we protect the most vulnerable without causing those damages elsewhere.
I know it sounds weird, but the age stratification of the IFR is a HUGE gift of this virus. It is more age stratified than the flu or other common pandemic sources. We are very lucky. Next time we may not be, so I hope we can learn from this on how to prepare for what we feared this was.
The polio waves in the 40s and 50s I'd argue were handled pretty optimally. Public accommodations were (for over a decade!) shut down when needed to control the epidemic in their area, and the government pushed hard to fund vaccine development. But as far as I've read, there were no significant voices arguing either "polio is just a bad flu" or "we'd better shut down schools until the vaccine is ready".
> There is an acceptable risk because we already accept the risk from children being vectors for spreading annual seasonal diseases that do end up killing adults and children.
This seems to be a common thought, but it is an error to assume that incidence of death = acceptance of death.
The truth is, the socially and politically acceptable incidence of death from seasonal communicable diseases is 0. Yes, deaths still occur, but that is in spite of absolutely tremendous investment of resources to try our very best to get it down to 0.
To pick on the flu, for example, there is no tactic or resource that we have available that we have not deployed. We have invested many $billions to create an annual national vaccination program that aims for 100% uptake and is even backed by a special liability regime to manage lawsuit risk. It is the largest vaccine program we have for any disease.
We have also invested (and continue to invest) additional $billions in studying every aspect of the disease, how it invades the body, how it spreads, how it harms people, etc. We have spent even more to create public awareness of flu symptoms, treatments, and appropriate behaviors.
The fundamental difference between the flu and COVID-19 is the possibility of significant asymptomatic or presymptomatic contagion. With the flu, you're not really contagious until you are symptomatic, so getting people (including kids) to stay home when they feel sick does as much good as a lockdown would. We don't really know for sure with COVID-19. So far it seems like a big possibility, hence the emphasis on masks, separation, stay at home, etc.
Also unlike the flu, we don't know what COVID-19 does to the human body. We don't know how long post-infection immunity lasts, and we don't know what chronic ailments might linger with survivors.
The reality is that we can't compare it with "other threats of similar risk" because we don't know what the risk is yet. That's why it is appropriate for the current response to COVID-19 to differ from the way we fight the flu and other more well-understood communicable diseases.
This seems to be a common thought, but it is an error to assume that incidence of death = acceptance of death.
The truth is, the socially and politically acceptable incidence of death from seasonal communicable diseases is 0. Yes, deaths still occur, but that is in spite of absolutely tremendous investment of resources to try our very best to get it down to 0.
To pick on the flu, for example, there is no tactic or resource that we have available that we have not deployed. We have invested many $billions to create an annual national vaccination program that aims for 100% uptake and is even backed by a special liability regime to manage lawsuit risk. It is the largest vaccine program we have for any disease.
We have also invested (and continue to invest) additional $billions in studying every aspect of the disease, how it invades the body, how it spreads, how it harms people, etc. We have spent even more to create public awareness of flu symptoms, treatments, and appropriate behaviors.
The fundamental difference between the flu and COVID-19 is the possibility of significant asymptomatic or presymptomatic contagion. With the flu, you're not really contagious until you are symptomatic, so getting people (including kids) to stay home when they feel sick does as much good as a lockdown would. We don't really know for sure with COVID-19. So far it seems like a big possibility, hence the emphasis on masks, separation, stay at home, etc.
Also unlike the flu, we don't know what COVID-19 does to the human body. We don't know how long post-infection immunity lasts, and we don't know what chronic ailments might linger with survivors.
The reality is that we can't compare it with "other threats of similar risk" because we don't know what the risk is yet. That's why it is appropriate for the current response to COVID-19 to differ from the way we fight the flu and other more well-understood communicable diseases.
Even when kids go to the physical school, teachers could still video in for the teaching.
Yeah, sounds a bit crazy, but could probably be made to work.
Yeah, sounds a bit crazy, but could probably be made to work.
Let's say you're putting a group of twenty-five random sixteen year olds together without a live coach. What could possibly go wrong?
The 16 year olds could step up. These are tough times.
I have much less faith in 8 years olds.
I like the young proctor suggestion a lot!
I have much less faith in 8 years olds.
I like the young proctor suggestion a lot!
They could hire one or two 19-20 year old proctors to be in the room with the kids. Would be pretty safe.
At least in the United States, I suspect that the adults spreading it are doing it enough that it won't even register as a blip on the radar.
My wife is a teacher and my daughter will have to return to day care if schools resume.
What bothers me the most is that just like retail / grocery store workers we put people with the lowest earning potential and generally worst benefits directly in the path of this. I don’t want to get COVID but unless I convince my wife to quit her job my odds of getting it greatly increase due to situations out of my control.
What bothers me the most is that just like retail / grocery store workers we put people with the lowest earning potential and generally worst benefits directly in the path of this. I don’t want to get COVID but unless I convince my wife to quit her job my odds of getting it greatly increase due to situations out of my control.
I don't want to get covid either but the risk is low enough that it doesn't bother me at all. I try to live my life as it was before pandemic as much as i can.
Isn't living life in the same way pre-covid the reason the US is having so many new cases?
It is. I think that's pretty universally acknowledged, even by those who think it's the right strategy.
Yes but many new cases doesn't mean its bad. Most of it are either asymptomatic or having mild symptoms.
It does seem that way, and I hope it remains so. The demographics have shifted younger. I do worry about my parents, grandparents and friends who have preexisting conditions and the increase risk with so many more cases around.
The main question is susceptibility. The projection for models have been wrong. Out by orders of magnitudes on deaths. According to them Sweden should have 10 times the deaths they have.
The most obvious answer is that quite a lot of the population are already not susceptible to this virus for whatever reason.
And we also know that the excess death rate on the under 40s is negligible - which is the majority of the population. The median age of deaths is over 80 in Europe.
Since it affects the older population more than the younger, you want to catch it as early as possible. Catching it next year is more likely to kill you than catching it this year.
There is no longer any justification for holding back the majority of the population when we can just retire the old and ask them to keep out of the way until the virus fully burns out.
The most obvious answer is that quite a lot of the population are already not susceptible to this virus for whatever reason.
And we also know that the excess death rate on the under 40s is negligible - which is the majority of the population. The median age of deaths is over 80 in Europe.
Since it affects the older population more than the younger, you want to catch it as early as possible. Catching it next year is more likely to kill you than catching it this year.
There is no longer any justification for holding back the majority of the population when we can just retire the old and ask them to keep out of the way until the virus fully burns out.
This is bad advice. We have no idea if it can be caught twice.
https://www.theguardian.com/world/2020/jul/12/immunity-to-co...
https://www.theguardian.com/world/2020/jul/12/immunity-to-co...
We know that some process has caused deaths to drop to near-zero in the places that were disaster zones at the beginning of April, even though they're no longer shut down and haven't entirely eliminated the virus. It's hard to imagine what that process could be if not immunity.
(Of course, since I'm sure I'll be called on this, the fact that herd immunity is possible does not by itself prove it's a wise course of action.)
(Of course, since I'm sure I'll be called on this, the fact that herd immunity is possible does not by itself prove it's a wise course of action.)
> It's hard to imagine
Hard for who? This is Epidemiology 101 stuff. You don't have to totally eliminate a virus to go back to normal. If the few infected individuals are quickly identified and isolated, along with contacts, outbreaks can be contained quite well. Test, trace, and isolate. We've been managing many other diseases this way for years. There's little mystery to it.
Hard for who? This is Epidemiology 101 stuff. You don't have to totally eliminate a virus to go back to normal. If the few infected individuals are quickly identified and isolated, along with contacts, outbreaks can be contained quite well. Test, trace, and isolate. We've been managing many other diseases this way for years. There's little mystery to it.
The mystery is that the drop happened even in areas such as Sweden which did not do this.
People in Sweden did social distance, did stop going out to bars and cafes etc.
Poor quality stuff. If this can be caught again, there is no natural herd immunity.
> It's hard to imagine what that process could be if not immunity.
The first paragraph of the article amiga_500 linked says: "People who have recovered from Covid-19 may lose their immunity to the disease within months, according to research suggesting the virus could reinfect people year after year, like common colds."
I don't think there is significant doubt that immunity exists; the question is how long it remains in effect. The drop in deaths that you mention would be compatible with a several month long effective immunity period, but a herd immunity approach would probably not work well if reinfection is possible every year.
The first paragraph of the article amiga_500 linked says: "People who have recovered from Covid-19 may lose their immunity to the disease within months, according to research suggesting the virus could reinfect people year after year, like common colds."
I don't think there is significant doubt that immunity exists; the question is how long it remains in effect. The drop in deaths that you mention would be compatible with a several month long effective immunity period, but a herd immunity approach would probably not work well if reinfection is possible every year.
> Since it affects the older population more than the younger, you want to catch it as early as possible. Catching it next year is more likely to kill you than catching it this year.
That might be true if you assume that there will not be a vaccine AND that medicine will not advance in the near future. But we have already seen medicine get better at treating Covid. (For example, doctors have learned not to use ventilators so much and proning is used more often, from what I understand.) I would rather get Covid now than a few months ago both because the medicine has gotten better and because the hospitals in my area are less overwhelmed—despite the fact that I am a few months older now. Furthermore, if I do have to die from Covid, I'd rather live a little longer first!
> retire the old and ask them to keep out of the way
Plenty of high-risk folks are not of retirement age. And many who are older live with younger family members for various reasons. It is not feasible for all of the high-risk people to "keep out of the way." Who will take care of high-risk elderly and disabled people who need help with bathing and toileting? What should grandparents do who are the guardians of their grandchildren? It's obvious that you have not thought this through.
That might be true if you assume that there will not be a vaccine AND that medicine will not advance in the near future. But we have already seen medicine get better at treating Covid. (For example, doctors have learned not to use ventilators so much and proning is used more often, from what I understand.) I would rather get Covid now than a few months ago both because the medicine has gotten better and because the hospitals in my area are less overwhelmed—despite the fact that I am a few months older now. Furthermore, if I do have to die from Covid, I'd rather live a little longer first!
> retire the old and ask them to keep out of the way
Plenty of high-risk folks are not of retirement age. And many who are older live with younger family members for various reasons. It is not feasible for all of the high-risk people to "keep out of the way." Who will take care of high-risk elderly and disabled people who need help with bathing and toileting? What should grandparents do who are the guardians of their grandchildren? It's obvious that you have not thought this through.
If you haven't read it yet, this short report seems to conclude that for reasons that are not yet well understood, children are not very likely to contract the disease, and if they do contract it, are not that likely to spread it to others. As a result, school closings (or the lack thereof) do not seem to have a major effect on the spread of the disease. Pulling some key quotes:
"Outbreak investigations in Finland has not shown children to be contributing much in terms of transmission and in Sweden a report comparing risk of covid-19 in different professions, showed no increased risk for teachers."
"In conclusion, closure or not of schools had no measurable direct impact on the number of laboratory confirmed cases in school-aged children in Finland or Sweden"
"In the contact tracings in primary schools in Finland, there has been hardly any evidence of children infecting other persons. The Swedish comparison of number of reported cases among staff in day care and primary school to number of cases in other professions does not show any increased risk for teachers. This also indicates that the role of children in propagating this infection is likely to be small. Various papers on contact tracing have also found that children rarely are the first case in family clusters (4, 12, 13)."
"Closing of schools had no measurable effect on the number of cases of covid- 19 among children."
"Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted."
Intriguing.
This Mercury News article from a couple days ago tells the same general story, and offers some theories on how things might work biologically:
Coronavirus: Why kids aren’t the germbags, and grownups are.
As school districts sweat over reopening plans, a growing body of research suggests young children are unlikely to transmit COVID-19 virus. They get it from us.
https://www.mercurynews.com/2020/07/10/coronavirus-why-kids-...
"Outbreak investigations in Finland has not shown children to be contributing much in terms of transmission and in Sweden a report comparing risk of covid-19 in different professions, showed no increased risk for teachers."
"In conclusion, closure or not of schools had no measurable direct impact on the number of laboratory confirmed cases in school-aged children in Finland or Sweden"
"In the contact tracings in primary schools in Finland, there has been hardly any evidence of children infecting other persons. The Swedish comparison of number of reported cases among staff in day care and primary school to number of cases in other professions does not show any increased risk for teachers. This also indicates that the role of children in propagating this infection is likely to be small. Various papers on contact tracing have also found that children rarely are the first case in family clusters (4, 12, 13)."
"Closing of schools had no measurable effect on the number of cases of covid- 19 among children."
"Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted."
Intriguing.
This Mercury News article from a couple days ago tells the same general story, and offers some theories on how things might work biologically:
Coronavirus: Why kids aren’t the germbags, and grownups are.
As school districts sweat over reopening plans, a growing body of research suggests young children are unlikely to transmit COVID-19 virus. They get it from us.
https://www.mercurynews.com/2020/07/10/coronavirus-why-kids-...
I don't see any data for adult infections. That's what we're concerned about mostly when opening schools. That the kids will infect the adults who will infect each other. I can't believe they have the audacity to publish this paper and its conclusions which clearly cannot be drawn from the data presented. This is pure and utter garbage, garbage that will be used by idiots to make policy decisions that will kill people unnecessarily. The paper should be retracted and peer reviewers should rip it up. What idiocy.
6% of infected people in Orange County, California are children 0-17 - this is after many restrictions. Even if the percentage stays at 6% after schools reopen, we're talking about a huge ripple effect on the whole population. Unlike adults, kids really can't follow strict measures - America is no Finland, no Sweden, no Asia!
Can anyone comment if this document 'Covid-19 in school children - A comparison between Sweden & Finland' is an official report ? I'm unable to find it by browsing or searching for it on the website.
Frustratingly unhelpful paper, for those looking for useful, applicable measures and measurements.
No details around:
* distancing measures * space utilization * travel arrangements * coplay arrangements
No details around:
* distancing measures * space utilization * travel arrangements * coplay arrangements
I guess this is the closest to what you are looking for. Google translate is usually pretty good.
https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utb...
https://www.folkhalsomyndigheten.se/smittskydd-beredskap/utb...
The reason the comparison is interesting is that Sweden didn't really implement such measures. Schools there have been operating pretty much as normal.
I understand and appreciate the Swedish strategy...and its failings for its adult population. With respect to what may be claimed "success" in its juvenile population, because of potential applicability (or not) to other communities, details of "normal" are essential. Those are entirely absent from this report.
More directly- as a parent in NYC, I am unhappily looking forward to people citing this unhelpful paper and "the Swedish model" claiming return to school will be safe. No and no is what I say to them.
Cheers.
More directly- as a parent in NYC, I am unhappily looking forward to people citing this unhelpful paper and "the Swedish model" claiming return to school will be safe. No and no is what I say to them.
Cheers.
Why is no one mandating open windows and good air flow?
If this thing is an aerosol and kids are going to school, seems to me we could do class outdoor until further notice.
If this thing is an aerosol and kids are going to school, seems to me we could do class outdoor until further notice.
Right now, the options are either send them to school, where there are (in the US) government employees making sure they are safe. The workers are well represented by a strong union, have good healthcare and reasonable wages. The other option is to send them to private day care, where private citizens with no oversight, very low pay and no worker protections are being asked to shoulder the risk. It seems like we have no problem hoisting even more responsibility upon the poor and least represented in society.
Teaches are essential workers, much like firefighters, DMV workers or court clerks. We expect a girl making minimum wage at Kroger to accept that she is an essential worker. Why do we not expect the same from school staff?
Disclosure: I have siblings and other close relatives that work for and in school in the US. I am not externalizing the risk.