Study flags children as super spreaders of coronavirus

It has been five months since schools were abruptly shut to curb the spread of the Covid-19 disease, throwing thousands of parents into dilemma on how best to keep children busy.

After the earlier proposed September reopening date was pushed to January 2021, many parents were forced to awaken to the reality that they will have to individually find ways of keeping their children occupied and supportthem to continue learning at home in the coming months.

Nevertheless, attaining this goal has been an uphill task. Many parents are either working or away from home for most part of the day in search of income that can enable them to make ends meet for the family.

As such, children are often left on their own. This increases their risk to various harms such as sexual abuse, which leads to the rising cases of teenage pregnancies that have been extensively reported in the media.

School closures have also increased the vulnerability of children to violence, substance abuse and psychological distress (anxiety, loneliness and isolation).

It is for this reason that the World Health Organisation (WHO) and Unicef urged countries to consider opening schools, albeit with caution.

As governments plan for gradual resumption to learning, health experts are calling for due diligence and strict adherence to Covid-19 prevention measures to avert a spike in infections when schools reopen.

Such strategies will come in handy, as a new study published in the Paediatrics Journal provides critical data showing that children play a larger role in the community spread of Covid-19 than previously thought.

The study, which involved 192 children (between the ages of 0 and 22 years), was conducted by researchers from the Massachusetts General Hospital (MGH) and Mass General Hospital for Children (MGHfC) in the United States.

Those infected by the coronavirus disease were shown to have a significantly higher level of virus in their airways than hospitalised adults in Intensive Care Units (ICUs) for Covid-19 treatment.

"I was surprised by the high levels of virus we found in children of all ages, especially in the first two days of infection," said Dr Lael Yonker, the lead author of the study and director of the MGH Cystic Fibrosis Centre.

"I was not expecting the viral load to be so high. You think of a hospital, and of all of the precautions taken to treat severely ill adults. Yet, the viral loads of these hospitalised patients are significantly lower than a 'healthy child' who is walking around with a high coronavirus disease viral load."

Since high viral loads increase the transmissibility of Covid-19, the researchers note that the findings of the study carry implications for the reopening of schools, daycare centres and other locations with a high density of children and close interaction with teachers and staff members.

They note that children can carry a high viral load, meaning they are more contagious regardless of their susceptibility to developing Covid-19 infection.

"During this Covid-19 pandemic, we have mainly screened people with symptoms of the disease, so we have reached the erroneous conclusion that the vast majority of people infected are adults. However, our results show that kids are not protected against this virus. We should not discount children as potential spreaders for this virus," said Dr Alessio Fasano, the director of the Mucosal Immunology and Biology Research Centre at MGH and senior author of the study.

The researchers note that children with Covid-19 are not as likely to become as seriously ill as adults.

But once infected, many will act as carriers of the disease with few or no symptoms at all of Covid-19. They can thus spread infection and bring the virus into their homes.

This will pose a great risk to families with vulnerable older adults as well as those with members that have low immunity or underlying conditions such as hypertension or diabetes.

As most nations prepare to reopen schools, the researchers note that the most critical question is what steps will be taken to keep the children, teachers and personnel safe.

They note that screening methods such as body temperatures and symptoms monitoring which are currently being used to identify people suffering from Covid-19 may not work in schools.

This is because infected children will most likely present with no symptoms at all. As such, they will be considered safe, only for them to spread the infection to their teachers and other employees that can be adversely affected by the coronavirus disease.

The researchers emphasise infection control measures such social distancing, wearing masks, effective hand washing with soap and water, as well as a combination of remote and in-person learning.

Effective monitoring systems, testing, isolation and contact tracing capacities are also important to quickly detect Covid-19 cases and initiate a timely response in the event of flare ups within and outside the school.

"This study provides much-needed facts for policymakers to make the best decisions possible for schools, day care centres and other institutions that serve children," says Fasano.

He notes: "Kids are a possible source of spreading this virus, and this should be taken into account in the planning stages for reopening schools."

According to the researchers, a hurried return to school without proper planning could result in an uptick in cases of Covid-19 infections.

"If schools were to reopen fully without necessary precautions, it is likely that children will play a larger role in this pandemic."