School re-opening decision taken by the government in this Sept, how the children will face this epidemic encephalitis.

Should families double down on social distancing now that their kids are going back to school? A new education system published in JAMA Pediatrics suggests that children can shed SARS-CoV-2, the virus that causes COVID-19, even if they never develop symptoms or even for long after symptoms have cleared. It found a significant variation in how long children continued to shed the virus through their respiratory tract and, therefore, could potentially remain infectious.

School reopen soon in India

 

As we all know, that was also the beginning of the coronavirus summer stampede, a terrible rise in cases and hospitalizations that peaked in July — followed by a peak in deaths in August — that prompted Texans to clamp down again, as they did in late March and early April.

While children infected with SARS-CoV-2 are less likely than adults to develop severe illness or complications, they are still at risk of becoming ill. “Recent COVID-19 hospitalization surveillance data shows that the rate of hospitalization among children is low (8 per 100,000 population) compared with that in adults (164.5 per 100,000 population),” the CDC said. Such research comes at an important time for families and communities. Amid pressure from the teacher’s union to delay the start of the school year, New York City Mayor Bill de Blasio announced Tuesday that in-person classes will be pushed back until Sept. 21, 11 days later than planned. Remote learning, also originally slated to start out on Sept. 10, will now commence on Sept. 16.

Schools and colleges are reopening. The results of that experiment are still out. Labor Day weekend might be meaningless in terms of the pandemic, but the gatherings over the three-day Memorial Day weekend was blamed for adding fuel to the summer spread. Policymakers and public health experts are wary. While the virus was detectable for an average of about 2.5 weeks in the entire group, a significant portion of the children —about a fifth of the asymptomatic patients and about half of the symptomatic ones — were still shedding virus at three weeks. The researchers also found that the duration of COVID-19 symptoms also varied widely, from three days to nearly three weeks.

A recent systematic review estimated that 16% of children with SARS-CoV-2 infection are asymptomatic, but evidence suggests that as many as 45% of pediatric infections are asymptomatic, according to the Centers for Disease Control and Prevention. The signs and symptoms of COVID-19 in children are similar to other infections and non-infectious processes, including influenza. A school outbreak can lead to community, hence staggered school re-openings, social distancing and reduced class sizes. “If we discover a particular number of symptomatic people testing positive, we expect an equivalent number of asymptomatic carriers that are far more difficult to spot and isolate,” said Enrico Lavezzo, a professor in the University of Padua’s department of molecular medicine.

 

The latest study in the peer-reviewed JAMA Paediatrics focused on 91 pediatric patients at 22 hospitals in South Korea. “Unlike within the American health system, those that test positive for COVID-19 in South Korea occupies the hospital until they clear their infections albeit they aren’t symptomatic,” said Roberta DeBiasi, chief of the Division of Infectious Disease at the Children’s Hospital in Washington, D.C. The patients here were identified for testing through contact tracing or developing symptoms. The hospital staff tested them every three days on average, providing a picture of how long viral shedding continues over many weeks.

 

Other countries have not fared so well with school re-openings. Israel, which also reopened schools this week, had less success when it reopened schools on May 17 amid high temperatures that made it difficult for students to wear masks, full classrooms that made social distancing near-impossible and, perhaps, the illusion that the virus had been vanquished, creating a false sense of security. The risk, as Israel discovered, is providing an environment where children unwittingly spread the virus to each other, which can lead to community transmission. That’s particularly worrying for those who have underlying conditions and the elderly who are more vulnerable to the most severe effects of the virus. Community transmission also makes contact tracing more difficult.

Among the important findings from the study: Children, a group widely thought to develop a mostly mild disease that quickly passes, can shed virus for weeks, DeBiasi and Meghan Delaney, chief of the Division of Pathology and Lab Medicine at the Children’s National Hospital in Washington, D.C., wrote in a commentary piece to accompany the study in JAMA Paediatrics. Even asymptomatic children continued to shed coronavirus after testing positive, making them potential key vectors. In this study at least, there were a large number of asymptomatic patients: About one-fifth of the group in South Korean hospitals. They said the study provides important insight on the role children might play in the spread of COVID-19.

 

But the study also has obvious limitations. One of these relates the link between testing and transmission. A “positive” or “negative” result may not necessarily mean that a child is infectious, “with some positives reflecting bits of genetic material that may not be able to make someone sick,” or, on the opposite hand, “negatives reflecting low levels of the virus which will still be infectious.”

 

They may have tested different parts of the respiratory tract and different testers may yield different results. It’s unclear whether symptomatic children shed different quantities of the virus than symptomatic patients. They tested for the active virus – not antibodies – excluding those who may have had and cleared an asymptomatic or mild infection, an important factor for understanding herd immunity. However, DeBiasi said studies such as these can add to the knowledge of public-health efforts being developed and refined to bring COVID-19 under control. Each of those pieces of data that we, our collaborators and other scientists around the world are working to collect is critical for developing policies which will slow the rate of viral transmission in our community.

So, Opening school is a big step in figuring out how to do normal things during a pandemic, and a test — along with the hurricane season already underway and the Labor Day gatherings just ahead — of how much the state can open.