Althoughand the adolescent program is well advanced,primary school-aged children remain unvaccinated and many will not have had a first dose by the first day of the school year. Some are again calling for schools to be closed or attendance restricted until this wave subsides or all school-aged children are vaccinated. As paediatricians and infectious diseases specialists,we reject such calls. Here are our reasons.
Firstly,schools are an essential service. This is clearer now than ever before. Many children have suffered immeasurably from the wider effects of the COVID-19 pandemic. A major contributor to this has been disruption to face-to-face learning and the loss of the critical social scaffold that school provides. The burdens have not been felt equally;face-to-face support is most important to the least advantaged.
Secondly,whether vaccinated or not,school-aged children are at low risk of becoming unwell if infected by SARS-CoV-2. We have released that provides a detailed look at COVID-19 in children during the 2021 Delta outbreak. Our findings reinforce those from other countries (such as the United States and Britain). At least one in five children experience no symptoms following infection. Of those with symptoms,a runny nose is most common.
One in 85 children were admitted to hospital for medical care. This percentage of children requiring hospital admission was much lower than the 5 per cent often quoted from public databases. Children were twice as likely to be admitted to hospital for social support reasons rather than medical ones – either because their carers were affected by COVID-19 or because key services supporting children out of the home were unable to accommodate them. This highlights chronic under-funding for many services caring for children in the community,including disability support services.
Additionally,some children were admitted with alternative diagnoses – such as broken bones or appendicitis – but found to be incidentally infected with SARS-CoV-2 on a screening test. are common in children and will increase further with the more transmissible Omicron variant. It is important we understand that often the COVID-19 hospitalisation rates reported – particularly from other countries – don’t take into account the fact that children may have been admitted to hospital for a reason other than COVID-19 and were in fact asymptomatic on admission.
In those admitted for medical care,most were young children (aged under two) with symptoms common to many other viral infections in this age group – such as reduced appetite or upper respiratory tract symptoms. Hospital admissions were usually brief (about two days) and were the result of a cautious approach to care,to monitor feeding and rule out other infections. The rate of hospitalisation in young children was on par with that for other common viruses in children,such as.
More than 90 per cent of children admitted to hospital in our study didn’t need oxygen therapy,revealing how differently this virus behaves in children. The study also revealed that teenagers with obesity were the ones who developed symptoms we more commonly associate with COVID-19 – like a cough and difficulty breathing. These made up most of the intensive care admissions (less than one in 1000 overall infections) and all recovered. Fortunately,teenagers have had access to vaccination in Australia for months and in NSW have now received their first vaccine dose.
Children with chronic and complex medical conditions were relatively more likely to be admitted to hospital. Interestingly,asthma alone did not increase risk,a finding that has been. In addition,almost all the evidence (however imperfect) points to the fact that the in its direct effects than prior variants.
Thirdly,. While our own research is yet to evaluate the long-term outcomes for children in NSW infected by SARS-CoV-2,the international literature strongly suggests children are at much lower risk of “long COVID” than adults. Many of the persistent symptoms commonly associated with “long COVID” are actually and are also prevalent in non-infected children. The great majority of children will recover completely from COVID-19.
Finally,schools are much more controlled environments than shopping centres or nightclubs. Principals and teachers have done an excellent job of implementing procedures to limit transmission risk. A significant body of evidence shows that transmission in schools rises and falls simply as a reflection of transmission in the wider community and. In Australia,transmission of COVID-19 in educational institutions has been,rather than in the other direction. As adults are now a highly vaccinated population,this risk is further mitigated.
We therefore conclude that SARS-CoV-2 infection in children,especially those aged under 12,is similar in severity to other respiratory viruses that children encounter,like RSV and influenza. Schools now have practices in place to limit respiratory virus transmission that are better than ever before. As a result,the extraordinary intervention of restricting face-to-face learning is not justified. We do not do it in response to the annual epidemics of these other viruses and nor should we any longer for COVID-19.
This is all the more important given the enormous impact the pandemic has had on children’s education and development over the past two years. The argument that children’s lives – their schooling,sport,creative and social activities – be paused to reduce community transmission and protect adults is unsustainable. All Australian adults have had the opportunity to access vaccines that are highly effective at reducing hospitalisation (more effective than influenza vaccines,even with Omicron). We also have several effective treatments for COVID-19,with more being developed.
The pandemic has driven waves of fear and anxiety that overwhelm and exhaust us all. This is particularly true for our children,who we all want to protect. The impact COVID-19 has had on their education and development has been enormous,. Globally,470 million children are unable to access remote learning and due to school closures.
The Australian Technical Advisory Group on Immunisation recommends be vaccinated and vaccines will be available in Australia for five- to 11-year-olds this week. This should bring additional hope,and will be further supported by getting the percentage of teenagers vaccinated up over 90 per cent.
This year we must prioritise children’s lives in our community response to the pandemic,and that begins with maintaining face-to-face learning for all. Further shielding of children is disproportionate to the acute or long-term effects of infection with SARS-CoV-2. We also need to remember that as we protect our own children,it is important to ensure we protect the world – because on our interconnected planet,.
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