Why heading back to school isn’t as big a risk as it sounds

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Next week, after six months out, children will finally return to school for the autumn term. Boris Johnson has stated that failure to reopen schools “is not an option” while England’s chief medical officer Chris Whitty has said that the harm from children missing school now strongly outweighs the risk of them contracting or transmitting Covid-19.
But some parents, particularly those who have been shielding, have said they are scared to send their children back. So what do we know about going back to school?


From an epidemiological standpoint, it’s now been well established that children with coronavirus do not tend to get as ill as adults. While there have been reports of children developing an inflammatory syndrome similar to Kawasaki disease, a disease of the lymph nodes, these cases are vanishingly rare. The Office for National Statistics reported that there were just ten deaths among those aged 19 and under in England and Wales between March and June, compared to 46,725 deaths among those aged 20 and over.
“What’s happened between June and now, is that we now know that young children, so those under ten, have negligible risk from the virus and don’t appear to be transmitting it much either,” says David Strain, clinical senior lecturer and honorary consultant at University of Exeter Medical School. “In June, we knew that the children could catch the virus, and they had no disease. But we didn’t know, at that point, whether they could then take that virus home and spread it on to their parents and grandparents.”
One worry is that children will spread the virus to vulnerable members of their household – an elderly relative or shielder. But, luckily, children aren’t as contagious as adults. A University College London and London School of Hygiene & Tropical Medicine study found they were about half as likely to catch contagion as adults, and therefore less likely to pass it on to household members. A Public Health England study found that, among 67 single confirmed cases and 30 Covid-19 outbreaks during June, infections and outbreaks “were uncommon across all educational settings”. Staff members also had an increased risk of SARS-CoV-2 infections compared to students in any educational setting, and the majority of cases linked to outbreaks were in staff.
Studies in Iceland, South Korea, Netherlands and Italy all found evidence that children were less likely to have or have had the virus than adults. Studies clusters of cases in the French Alps concluded that none of the infections were likely to have been introduced by children.


“Children aren’t good spreaders,” says Keith Neal, emeritus professor of the epidemiology of infectious diseases at the University of Nottingham. “When a child is the first case in a household, the risk of transmission is between a third and the half compared to an adult.”
Schools can also make some fairly basic interventions to mitigate risks – providing hand sanitisers, ventilating classrooms, keeping classes in socially distanced “bubbles”, and (if possible) keeping these class sizes small.
Masks are a possibility, too. The Scottish government has given secondary schools, attended by older children who are likely to meet with more people, [link url=”https://www.theguardian.com/world/2020/aug/25/should-children-in-england-wear-face-masks-in-schools”]“obligatory” guidance[/link] that pupils should wear masks in corridors, communal areas and school buses. Johnson has said secondary schools situated in areas of England subject to tighter coronavirus restrictions should as well. But making children wear face masks for seven hours a day will not be easy.
“If you’re going to recommend face masks, then your population must be sufficiently compliant and make them a net positive rather than a net negative,” says Michael Head, senior research fellow in global health at the University of Southampton. “Schoolchildren may fiddle with the face mask, pull them down, and on rare occasions swap them.”


But masks may help stop school superspreader events, says Strain. In Berlin, where children are allowed to take off their masks when lessons begin, coronavirus cases were reported in at least 41 schools, just two weeks after the German capital’s 825 schools reopened. Similarly, in Scotland, 17 members of staff and two pupils tested positive for coronavirus at a school in Dundee less than two weeks after Scottish schools returned. High school pupils in Scotland will now wear face coverings from August 31. “That school, along with the WHO recommendations is why Scotland very quickly said, ‘Okay, everybody should be wearing a mask,’” says Strain.
In general, though, countries seem to be reopening schools without great difficulty. Sage has reported that, in countries where schools have reopened, “data suggests it has made little difference to community transmission”.
What is clear is that children staying out of school is hugely damaging – not just in regards to the loss of education, but whether the children come from vulnerable settings, are neglected at home, or at risk of domestic violence. Schools provide a refuge for these children. “We’ve seen an entire generation lose six months worth of education – for some this is their formative years,” says Strain. “This is further driving health and educational inequalities.”
With this in mind, schools, like any other public space, cannot be guaranteed 100 per cent safe. Cases are inevitable. “If we are going to put a lot of people together in a room in an indoor environment, and that will increase the number of cases,” says Head. “There will no doubt be an increase in the number of cases in the early weeks of September, simply because there are more opportunities for the virus to spread.”
It may be that other less critical public institutions, such as pubs, may have to shut down to keep schools open. “At the moment, the best place for children is in the school,” says Strain.
Will Bedingfield is a staff writer for WIRED. He tweets from @WillBedingfield
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