COVID-19 in schools –the experience in NSW

The Commonwealth Chief Medical Officer referred last week to a study undertaken by NSW Health into the impact and transmission of COVID-19 in schools.

The study has been released today and the summary of findings is –

  • In NSW, from March to mid-April 2020, 18 individuals (9 students and 9 staff) from 15 schools were confirmed as COVID-19 cases; all of these individuals had an opportunity to transmit the COVID-19 virus (SARS-CoV-2) to others in their schools.
  • 735 students and 128 staff were close contacts of these initial 18 cases.
  • One child from a primary school and one child from a high school may have contracted COVID-19 from the initial cases at their schools.
  • No teacher or staff member contracted COVID-19 from any of the initial school cases.

The study goes on to indicate (emphasis added) that –

“SARS-CoV-2 transmission in children in schools appears considerably less than seen for other respiratory viruses,such as influenza. In contrast to influenza, data from both virus and antibody testing to date suggest that children are not the primary drivers of COVID-19spreadin schools or in the community. This is consistent with data from international studies showing low rates of disease in children and suggesting limited spread among children and from children to adults.”

It does, however, note that the reduction in face to face attendance by students and school holidays may have had an impact on the results.

This research is noted as preliminary but does indicate that it supports overseas studies in –

China (https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf)

“Data on individuals aged 18 years old and under suggest that there is a relatively low attack rate in this age group (2.4% of all reported cases).  Within Wuhan, among testing of ILI samples, no children were positive in November and December of 2019 and in the first two weeks of January2020. From available data, and in the absence of results from serologic studies, it is not possible to determine the extent of infection among children, what role children play in transmission, whether children are less susceptible or if they present differently clinically(i.e. generally milder presentations). The Joint Mission learned that infected children have largely been identified through contact tracing in households of adults. Of note, people interviewed by the Joint Mission Team could not recall episodes in which transmission occurred from a child to an adult.”

“Disease in children appears to be relatively rare and mild with approximately 2.4% of the total reported cases reported amongst individuals aged under 19 years. Avery small proportion of those aged under 19 years have developed severe (2.5%) or critical disease (0.2%).”

“COVID-19 is not SARS and it is not influenza.  It is a new virus with its own characteristics.  For example, COVID-19 transmission in children appears to be limited compared with influenza, while the clinical picture differs from SARS.”

Netherlands (https://www.rivm.nl/en/novel-coronavirus-covid-19/children-and-covid-19)

“RIVM research into the reports shows that the spread of COVID-19 mainly takes place between persons of approximately the same age. This is based on data from patients with symptoms and concerns people between 40 and 80 years. Children are less likely to be infected by adults. When this does happen, it turns out that it is mainly in the home situation. Patients under 20 years play a much smaller role in the spread than adults and the elderly.”

“International research also confirms that the percentage of children among the confirmed COVID-19 patients is small, varying from 1% in young children up to 6% in older children. For example, China, Korea, Italy, Spain and the United States have already conducted research on COVID-19 and children.  International research shows that the disease in children is generally much milder than in adults. However, the symptoms are the same as for adults. Worldwide, a limited number of children has died from COVID-19. The most common complaints in children are coughing, fever and sore throats. Contact research shows that none of the children has infected other people.”

Iceland (https://www.nejm.org/doi/full/10.1056/NEJMoa2006100)

“In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males.”

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