Schools and Spread

We travel (virtually) to the Great State of Michigan (boldface mine):

According to state data, since February 19, average daily new COVID-19 cases among children under 10 jumped 230%, more than any other age group. The second-highest increase in infections is in the 10 to 19 age group, which saw cases rise 227%. The trends in these groups exceed that of the state as a whole.

The rise in cases among kids has been evident elsewhere across the country. In Minnesota, people under age 20 made up nearly a quarter of reported cases in March, up from less than 15% at the end of February. Similar trends have been seen in other states as well, including Illinois and Massachusetts. According to the most recent data from the American Academy of Pediatrics, more than 64,000 new cases in children were reported nationwide between March 18 and March 25, the highest weekly total in a month.

According to physicians and infectious disease experts in Michigan, much of the rise in pediatric cases can be linked to the reopening of schools and youth sports. State data shows more than 40% of new outbreaks (defined as two or more cases linked by place and time) have come from either K-12 schools or youth programs. But Dr. Natasha Bagdasarian, senior public health physician at the Michigan Department of Health and Human Services, says social gatherings after youth sporting events are also contributing to the spread.

“If everyone is removing their mask and going out to dinner to celebrate a big win then all of those precautions go out the door,” she said. “So really, this seems to have driven this surge.”

This article gets at something very important: too often, when we assess the risk of an activity, we only assess the risk of the actual activity, not the events that stem from that activity–in this case, post-game celebrations.*

It also supports what it seen when detailed contact tracing is done: there is spread, not just among students, but out into the larger community. This shouldn’t be surprising: with most respiratory viruses, the grandkids kill their grandparents. It would be very unusual for kids to not be ‘good spreaders’ (not impossible, just not likely).

Worse, as the B.1.1.7 variant continues to spread (and the outbreak linked to above involved the B.1.1.7 variant)–it, along with the B.1.526/E484K variant, account for more than half of sequenced viral genomes in New York City, so it’s coming–it also affects spread within and ‘through’ children (boldface mine):

Osterholm previously supported sending children back to school. He said the virus was not a major threat to children. Now, the situation has changed.

“Please understand, this B.1.1.7 variant is a brand new ball game,” Osterholm said on NBC’s Meet the Press. “It infects kids very readily. Unlike previous strains of the virus, we didn’t see children under 8th grade get infected often or they were not frequently very ill, they didn’t transmit to the rest of the community.”

…In Minnesota, Osterholm said more than 740 schools reported cases of the variant. In Michigan more young people are ending up in hospitals fighting more serious symptoms than previously seen in children with COVID-19…

Seeing that happen in his own backyard, Osterholm is now questioning his own previous advice.

Anywhere you look where you see this emerging, you see that kids are playing a huge role in the transmission of this,” Osterholm said. “All the things that we had planned for about kids in schools with this virus are really no longer applicable. We’ve got to take a whole new look at this issue.

Vaccinations are expected to help fight off the B.1.1.7 variant. However, Osterholm said there’s simply not enough time to just rely on vaccinations.

“We’re not going to have nearly enough (vaccine doses) in the next 6 to 8 weeks to get through this surge, and we’re going to have to look at other avenues to do that just as every other country in the world who’s had a B.1.1.7 surge has had to do.”

I’m not convinced that the characteristics of B.1.1.7 alone are driving this, since we have really opened up schools full throttle over the last couple of months in many places, even though CDC guidelines would indicate keeping them closed.

That said, vaccination will work, but new data suggests two shots are needed and there is limited effectiveness of partial vaccination against B.1.1.7, which will add a couple of weeks to the timeline for herd immunity (or at least, herd ‘slow the spread down significantly’).

When the retrospectives are done, we’re going to look back on school openings and have some regrets.

*When it comes to dining, we often neglect how people get to the restaurant. I see too many cases of people who clearly don’t live together spilling out of a single car in D.C.

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