The second bullet point of the conclusion states...
| Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted.
I feel like that is probably the next most important question to answer.
Or South Africa where they tried to open up schools for only two grades (7th and 12th).
"Since the first phase of the schools reopening last month, 968 schools have had to close due to outbreaks and 2,400 teachers and 1,260 learners have tested positive for COVID-19."
If you want an example involving younger kids, there was recently an outbreak involving 12 staff and 8 kids at an Oregon daycare that serves kids ages 6 and under [1].
It might be impossible to know whether the adults infected the kids or vice versa (or both), but Coronavirus cases are growing fastest among kids younger than 10 in Oregon right now [2], so ... to me, it makes sense to assume that kids can spread it until it's proven otherwise.
Lastly, for those who don't know, the CDC internally lists reopening schools as the "highest risk" for Coronavirus spread. [3]
> 2,400 teachers and 1,260 learners have tested positive for COVID-19.
It's pretty interesting that almost twice as many teachers as students tested positive. Presumably there are ~20x more students than teachers?
It may very well be the case that children are far less likely to either catch or spread the virus, but far less likely is not the same as not spreading it at all.
They opened up schools, as well as pretty much everything else. So it is not really clear whether the schools were the biggest contributor to the spread.
I don't see why it's an "or". If data from Finland and Sweden suggests school has no impact, and data from Israel suggests it could, that's all the more reason transmission studies are needed.
Assuming children do not spread covid-19 as much as adults, it would be fair to say they still do spread at some degree. Therefore, the question is what is the risk tolerance that is acceptable to society? Are we as a society willing to accept that some adults will be infected and/or die as a result of children going to school? What's the acceptable risk tolerance for teachers? If there is an assumption that some teachers will die, how many is too many?
There is an acceptable risk because we already accept the risk from children being vectors for spreading annual seasonal diseases that do end up killing adults and children. What is that level? Doubt anyone wants to specify an exact number because then they will be forever tarred with that number of deaths. One thing is very obvious about this pandemic: the degree to which it has been politicized has made it impossible to respond in a manner that is similar to other threats of similar risk.
It could be argued that the response to the Spanish Flu, Polio, HK Flu, H1N1, Zika, Swine etc. It appears by most measures this is an order of magnitude less lethal than Spanish Flu. THIS one, however, is political.
The update the CDC made is interesting. AS the footnote in the estimate table states, the IFR is taken from the pre-print _A systematic review and meta-analysis of published research data on COVID-19 infection-fatality rates_ by Meyerowitz-Katz, G., & Merone, L. et. al. The conclusion of their paper states:
> Based on a systematic review and meta-analysis of published evidence on COVID-19 until May, 2020,
the IFR of the disease across populations is 0.68% (0.53-0.82%). However, due to very high
heterogeneity in the meta-analysis, it is difficult to know if this represents the ‘true’ point estimate..._
There have been several reports that the IFR has lowered since late May, so it will be interesting to see if they rerun their metanalysis with June/July data. Their paper also makes the point that this could be an underestimate due to reporting issues (under-reported deaths). But likewise it could be an overestimate due to under-reporting infections (with so many asymptomatic cases). I am a little concerned over the lack of mention of that fact in the paper, which to me is as important as the under-reported deaths.
I understand your concern regarding long-term impacts. While we can't dismiss those concerns, it would be the only coronavirus in the history of known coronaviruses to do anything like that. So with our knowledge of this virus and the family of viruses, we can say that is "unlikely".
There are going to be a lot of deaths. I can't argue out of that reality. It is really unfortunate. We will all known somebody who dies from this, or at least are within a free degrees. The debate, in my opinion, isn't on preventing all deaths, it won't happen. It is how do we minimize death while preventing long term societal and economic damage. And how do we protect the most vulnerable without causing those damages elsewhere.
I know it sounds weird, but the age stratification of the IFR is a HUGE gift of this virus. It is more age stratified than the flu or other common pandemic sources. We are very lucky. Next time we may not be, so I hope we can learn from this on how to prepare for what we feared this was.
The polio waves in the 40s and 50s I'd argue were handled pretty optimally. Public accommodations were (for over a decade!) shut down when needed to control the epidemic in their area, and the government pushed hard to fund vaccine development. But as far as I've read, there were no significant voices arguing either "polio is just a bad flu" or "we'd better shut down schools until the vaccine is ready".
> There is an acceptable risk because we already accept the risk from children being vectors for spreading annual seasonal diseases that do end up killing adults and children.
This seems to be a common thought, but it is an error to assume that incidence of death = acceptance of death.
The truth is, the socially and politically acceptable incidence of death from seasonal communicable diseases is 0. Yes, deaths still occur, but that is in spite of absolutely tremendous investment of resources to try our very best to get it down to 0.
To pick on the flu, for example, there is no tactic or resource that we have available that we have not deployed. We have invested many $billions to create an annual national vaccination program that aims for 100% uptake and is even backed by a special liability regime to manage lawsuit risk. It is the largest vaccine program we have for any disease.
We have also invested (and continue to invest) additional $billions in studying every aspect of the disease, how it invades the body, how it spreads, how it harms people, etc. We have spent even more to create public awareness of flu symptoms, treatments, and appropriate behaviors.
The fundamental difference between the flu and COVID-19 is the possibility of significant asymptomatic or presymptomatic contagion. With the flu, you're not really contagious until you are symptomatic, so getting people (including kids) to stay home when they feel sick does as much good as a lockdown would. We don't really know for sure with COVID-19. So far it seems like a big possibility, hence the emphasis on masks, separation, stay at home, etc.
Also unlike the flu, we don't know what COVID-19 does to the human body. We don't know how long post-infection immunity lasts, and we don't know what chronic ailments might linger with survivors.
The reality is that we can't compare it with "other threats of similar risk" because we don't know what the risk is yet. That's why it is appropriate for the current response to COVID-19 to differ from the way we fight the flu and other more well-understood communicable diseases.
My wife is a teacher and my daughter will have to return to day care if schools resume.
What bothers me the most is that just like retail / grocery store workers we put people with the lowest earning potential and generally worst benefits directly in the path of this. I don’t want to get COVID but unless I convince my wife to quit her job my odds of getting it greatly increase due to situations out of my control.
I don't want to get covid either but the risk is low enough that it doesn't bother me at all. I try to live my life as it was before pandemic as much as i can.
It does seem that way, and I hope it remains so. The demographics have shifted younger. I do worry about my parents, grandparents and friends who have preexisting conditions and the increase risk with so many more cases around.
The main question is susceptibility. The projection for models have been wrong. Out by orders of magnitudes on deaths. According to them Sweden should have 10 times the deaths they have.
The most obvious answer is that quite a lot of the population are already not susceptible to this virus for whatever reason.
And we also know that the excess death rate on the under 40s is negligible - which is the majority of the population. The median age of deaths is over 80 in Europe.
Since it affects the older population more than the younger, you want to catch it as early as possible. Catching it next year is more likely to kill you than catching it this year.
There is no longer any justification for holding back the majority of the population when we can just retire the old and ask them to keep out of the way until the virus fully burns out.
> Since it affects the older population more than the younger, you want to catch it as early as possible. Catching it next year is more likely to kill you than catching it this year.
That might be true if you assume that there will not be a vaccine AND that medicine will not advance in the near future. But we have already seen medicine get better at treating Covid. (For example, doctors have learned not to use ventilators so much and proning is used more often, from what I understand.) I would rather get Covid now than a few months ago both because the medicine has gotten better and because the hospitals in my area are less overwhelmed—despite the fact that I am a few months older now. Furthermore, if I do have to die from Covid, I'd rather live a little longer first!
> retire the old and ask them to keep out of the way
Plenty of high-risk folks are not of retirement age. And many who are older live with younger family members for various reasons. It is not feasible for all of the high-risk people to "keep out of the way." Who will take care of high-risk elderly and disabled people who need help with bathing and toileting? What should grandparents do who are the guardians of their grandchildren? It's obvious that you have not thought this through.
We know that some process has caused deaths to drop to near-zero in the places that were disaster zones at the beginning of April, even though they're no longer shut down and haven't entirely eliminated the virus. It's hard to imagine what that process could be if not immunity.
(Of course, since I'm sure I'll be called on this, the fact that herd immunity is possible does not by itself prove it's a wise course of action.)
Hard for who? This is Epidemiology 101 stuff. You don't have to totally eliminate a virus to go back to normal. If the few infected individuals are quickly identified and isolated, along with contacts, outbreaks can be contained quite well. Test, trace, and isolate. We've been managing many other diseases this way for years. There's little mystery to it.
> It's hard to imagine what that process could be if not immunity.
The first paragraph of the article amiga_500 linked says: "People who have recovered from Covid-19 may lose their immunity to the disease within months, according to research suggesting the virus could reinfect people year after year, like common colds."
I don't think there is significant doubt that immunity exists; the question is how long it remains in effect. The drop in deaths that you mention would be compatible with a several month long effective immunity period, but a herd immunity approach would probably not work well if reinfection is possible every year.
| Children are not a major risk group of the covid-19 disease and seem to play a less important role from the transmission point of view, although more active surveillance and special studies such as school and household transmission studies are warranted.
I feel like that is probably the next most important question to answer.