State of Connecticut
Albert Ko: No “one size fits all.”
Children are fairly safe from Covid-19. What is less clear is whether they will spread the disease to adults if schools fully reopen in the fall.
So said public health experts as New Haven Public Schools prepare to follow state guidance to host every child every day in the fall.
“The bottom line is that the impacts of Covid-19 on children is minimal or very low compared to other age groups,” said Yale School of Public Health professor Albert Ko.
Fall Plans
In late June, Gov. Ned Lamont announced that the state expects every public school to reopen fully for the fall semester if health indicators for the state continue to show that community transmission of the disease is low.
Superintendent Iline Tracey was initially surprised that the state was pushing for a full reopening rather than a hybrid of in-person and remote learning. She said that an early survey of parents showed that roughly half of respondents wanted to keep their children at home.
Tracey has been working on plans for different reopening scenarios for the fall. Board of Education members, especially pediatrician Tamiko Jackson-McArthur, have pushed Tracey to present the specifics of that plan at the next board meeting.
“Can we have a meeting just on reopening? That’s a hot ticket issue right now,” Jackson-McArthur asked at the board’s last June meeting.
Tracey is currently seeking family and staff input on her team’s draft reopening plan. Read the draft plan here. Families and staff members can provide feedback on that plan here.
As New Haven Public Schools works out the safest way to reopen school buildings, the Independent asked public health experts a more basic concern from parents and teachers: Would it be safer to not to reopen at all?
The experts answered that continuing distance learning would not necessarily be safer for kids, taking mental health and development into account. The key question is whether reopening puts adult family members and school staff members at risk.
Low Risk To Children
Covid-19 affects children much less severely than adults.
Albert Ko answered questions from the New Haven Independent in between calls from the White House Coronavirus Task Force. Ko studies infectious diseases and is involved in initiatives to speed up the development of vaccines in emergencies like the Covid-19 pandemic.
New Haven Director of Public Health Maritza Bond also agreed to talk about schools reopening as she juggled interviews with different members of the press about the city’s response to the virus.
Both Bond and Ko agreed that children have been affected far less than other age groups by Covid-19.
Bond said that by Thursday, there had been 2,712 Covid-positive cases in the city. Only 4 percent, or less than 100, of those cases involved children between the ages of 5 and 17. Around 1 percent were of cases of children under the age of 5.
The risk of severe symptoms or death among children is also very low, Ko said.
The Covid-linked inflammatory disease that can affect children — multisystem inflammatory syndrome in children (MIS‑C) — has continued to be rare in New Haven and Connecticut.
Bond said that one New Haven child was diagnosed with the syndrome. Ko said that the state has seen a total of around 10 cases.
Most children who get MIS‑C need to go to the hospital. There are treatments, and most patients get better, according to the Mayo Clinic and the CDC.
The likelihood of getting a severe version of Covid-19 seems to go up for children with certain conditions like diabetes, heart disease, asthma and sickle cell disease.
The city health department is working with Tracey on the school reopening plan. Bond said they will need to monitor and screen children for these comorbidities and be prepared for the way they can impact the outcome of Covid-19.
Ko recommended that parents of children with these diseases talk to a primary health care provider about the risk to their child of going back to school.
“It’s not one-size-fits-all,” Ko said. “It’s not like all diabetes or all heart disease is the same.”
Ko said that researchers still do not know exactly what factors put people at greater risk of dying from Covid-19. Is it the underlying condition that puts someone at risk, or their age and the underlying conditions are showing up because older people have more of them?
Lower Transmission To Adults?
The question remains whether children are as likely to infect others with Covid-19 as adults.
The bigger question mark for the fall school year is whether gathering children will increase Covid-19 among adults.
Some research suggests that children are not likely as adults to infect others. At least one study indicates that both groups are equally infectious, according to a deep dive by ProPublica.
Meanwhile, reopening schools in Denmark did not seem to cause an uptick in Covid-positive cases. Closer to home, YMCAs have been providing childcare for essential worker families and have not seen clusters of outbreaks.
Ko said that he has not seen a definitive ruling on the question yet.
“We don’t really have good evidence. We are kind of concerned. If children are infectious and live in multigenerational homes, then people with the highest risk can get infected,” Ko said.
There is not enough research on children in general, Ko and Bond agreed. It is hard to tell whether children are not getting Covid-19 or whether they have very mild or no symptoms and are not getting tested for the disease.
“There’s very limited research out there on children, so we will tread as carefully as possible,” Bond said.
Ko said that he hopes to see more research through antibody tests on who has been infected so far. He said that he hopes to see these kinds of studies include children.
Safety Measures
Paul Bass Photo
Bond: Children faring well so far.
This need for further research on children points to why school safety measures will be so important this fall, Ko said.
Face masks, physical distancing between students, spending time outside or with windows open will all be important to ensuring students do not spread the virus amongst themselves or to close adults, Ko said.
It’s also important to remember how crucial socializing with peers and educators are to the health and development of children, he added. This consideration kept Ko from saying that it would be safer for children to stay home and continue distance learning.
“When we think about public health, we’re not thinking just about Covid, we’re thinking about the health of children,” Ko said. “You can’t parse it out that easily.”
To pull off a safe reopening, New Haven schools will likely need more resources or more tailored guidance from the state, Bond emphasized.
Bond has not seen data to show that New Haven children have comorbidities at a higher rate than, for example, the rural area of eastern Connecticut, where she has worked in the past. She is concerned about the density of the city population, the large numbers of children in each classroom, and inequities in funding that she sees.
“An urban city is already impacted in so many different ways and to then have unfunded expectations … it’s my hope that’s taken into consideration,” Bond said.
Bond said that local school districts are submitting their plans to the state. She said that she hopes this will be an avenue for the state to tailor fall reopening requirements to the differences between rural, suburban and urban districts.