Is it safe to send children back to school?

Minister of Education Rob Fleming looks on as Provincial Health Officer Bonnie Henry announces plans to return BC children to school by Sept. 8, 2020 (BC Ministry of Health).

This week, BC officially unveiled its plan for reopening schools in the midst of the COVID-19 pandemic. With only a month remaining until the typical start of the scholastic year, school reopening has rapidly become one of Canada’s most contentious political issues. Below, UVic researcher Harley Gordon lays out the facts we have — and some we don’t — about whether it’s safe to send your children back to school.

Children are not immune to COVID-19, but they are extremely resilient

As of August 6th, 8,902 people have died of COVID-19 in Canada. Only one of them was under 19, and the coroner had stated that although they had COVID-19 when they died, their death was not a result of the disease. And this is a trend observed around the world. For one of the only times in history, there is a worldwide pandemic that largely leaves our children unscathed.

And it’s not just children. An incredible  96.8% of COVID-19 deaths in Canada were from individuals 60 years or older. This contrasts sharply with the seasonal flu that affects both the very young and the very old.

Even in the United States, where COVID-19 is running rampant, it’s sparing the school-age children. From February to August 1st, there have been 142,000 COVID-19 deaths in the US. Twenty of them have been children aged 5 to14. That’s 20 shattered homes, to be sure, but contrast that with the 50 children between the ages of 5-14 who have died of influenza during the same reporting period. It’s the rare parent who will keep their children out of school for the entirety of flu season.

‍

Proportion of Canadian COVID-19 deaths by age group

Created with Raphaël 2.1.2

0

X

2,000

4,000

6,000

6,366

80+

1,616

70-79

636

60-69

209

50-59

50

40-49

15

30-39

9

20-29

1

0-19

Schools, which are normally hotspots for infectious disease, may not have the same effect on COVID-19

If children contract COVID-19, they are still infectious, even if they are asymptomatic or have mild symptoms, according to a recent commentary by the American Academy of Pediatrics. But because their symptoms are usually mild, there is less coughing, this dramatically reduces the infectiousness of the infected. Added to that, small children are unable to cough with much force in either case, which again limits the formation of infectious respiratory droplets. In short, a child with COVID-19 is way safer to be around than an adult with COVID-19.

And the younger the child, the less infectious they are.  A South Korean study had found that very low transmission occurred between household members and children 0-9 years old, while children 10-19 were able to spread the virus more effectively. Children age 10-19 are still low risk in terms of severe reactions, but they contribute to the spread of disease far more than their under-9 peers.

Again, this is kind of a weird trend for a pandemic. Polio, flu outbreaks, smallpox; all of them thrived in the tight-knit, not tremendously hygienic world of schools. . That’s why public health policy surrounding schools is mostly informed by  influenza outbreaks from the past, but COVID-19 is different. The American Academy of Pediatrics argues that the benefits of keeping children in school outweighs the risk of the virus.

Total 2018 deaths for Canadians aged 0 to 14

Accidents (largely drownings and car crashes)

124

Cancer

115

Congenital disorders

50

Suicide

46

Flu and pneumonia

22

Heart disease

13

Murder

10

Lung disease

6

Stroke/cerebral hemorrhage

5

Fatal birth defects

5

Shown is the most recent year for which data is available

Opening schools will probably increase  the number of cases, but that’s not necessarily a reason to keep them closed

Israel re-opened schools fully in May, and it did not go well. In June 1,400 Israelis were diagnosed with COVID-19, and 47% of them were infected from exposure at a school. Schools have since closed again, but they are planning to re-open in September.

That said, some countries have had success with sending their children back to school. Two countries; Japan and Uruguay, have opened schools with modified schedules to keep class sizes small, masking requirements and physical distancing requirements among adults.  This is similar to the approach that BC is planning on taking come September.

In short, when it comes to things that threaten your children’s lives, COVID-19 ranks well below a long list of causes including accidental drownings, car crashes and the flu. The greatest risk of returning to school, in fact, is that these children could carry the virus to grandparents or at-risk adults in the home. Thus, it may be best to keep them a little distant from elderly or at-risk family members. Teach them to wash their hands, wear a mask, and stay home if they're feeling ill.

Ultimately it’s your decision as a parent to send your child back to school. Flexibility come September is probably your best plan.