We asked over 2,000 Australian parents how they fared in lockdown. Here’s what they said



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Subhadra Evans, Deakin University; Antonina Mikocka-Walus, Deakin University, and Elizabeth Westrupp, Deakin University

Parents have faced unprecedented stress during the pandemic as they care for children while juggling paid work from home.

However, very little research so far has focused on family well-being during the pandemic.

So we asked more than 2,000 parents to tell us in their own words about the pandemic’s impact on their families. We did this in April 2020, during Australia’s first lockdown. Our published study is the largest of its kind in Australia, and one of very few internationally looking into families’ experiences of the pandemic.

Families’ responses followed six key themes.

1. Boredom, depression and mental health

Parents reported a spectrum of emotions. They said they and their children were stressed, trapped and bored. New and existing mental health conditions also challenged the equilibrium in a number of families. One mother of two children said:

My mental health has taken a really bad hit and I’m struggling to support my children.

2. Families missed things that keep them healthy

Families missed sport, extracurricular activities, visits with family and friends, playgrounds, places of worship, trips to connect with the natural world, and other family supports. A mother of three children said:

We used to see family, friends, go to church and do kids’ activities like playgroup a lot […] Cutting all of that out to stay home has been hard. We miss being able to see our family and friends, to do activities outside of home that are more than a walk around the block. We’re all tense and exhausted.

3. Changing family relationships

Family relationships changed, which we called the “push-pull of intimacy”.

Strained relationships were common, including increased conflict and arguments between parents, parents and children, and between siblings.

The demands of caring for children was a source of discord, requiring more from already exhausted parents or creating tension in the family as a result of bickering and fighting as a result of being “cooped up”. One mother of two said:

We have too much time together. We are often irritable with each other. My child wants more social interaction from me that I can’t give.

For many, there was a sense that goodwill between family members was “wearing thin”. But in some families, closer bonds emerged. A father of three said:

It’s been great. Lots of quality time together.

Father holding birthday cake in front of computer screen with children for a Zoom birthday party
Families faced many new challenges during lockdown.
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4. The unprecedented demands of parenthood

The loss of important structures in the community, particularly schools, reveals the extent to which such institutions play a pivotal role in raising healthy families and children, with parents alone unable to provide the proverbial village that children need. A mother of three said:

COVID-19 had turned me into a stay-at-home mum, primary teacher, speech therapist, occupational therapist, strict budgeter, with no social outlet or relief. And I’m doing this alone with my health-care worker husband being overworked.

5. The unequal burden

For people with physical or mental health conditions, lockdown restrictions were especially hard to endure. A father of one child told us about his family’s experience of being confined to a small space:

My wife is on the spectrum which makes being in a confined space with others quite difficult for her — and those around her. Confined space gives her little room for calming, so her anger events have increased.

Families living in small apartments with limited outdoor space were also highly challenged, using words such as “suffocating” and “going insane”. Families facing economic worries were also a group in need. A single mother of two children said:

Shopping alone is now a huge stress as I don’t want to expose my babies […T]he price rise in food has caused us now to only be able to buy enough food for a week so we are having less in each meal to ensure the children eat three meals a day. Most days I now miss meals so they can eat.

6. Holding on to positivity

Parents told us the pandemic provided an opportunity to cultivate “appreciation”, “tolerance and understanding” as well as “learning to cope and develop patience”.

Some parents said they were grateful for what they had and were relatively fortunate compared with others.

Parents were also grateful for access to the internet, a safe space to call home, enough food to eat, time to spend together, good health, financial stability and “having enough”. One mother of two children said:

I was quite panicked to begin with, but the kids love being with us all the time and are building relationships with each other.




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It’s OK to be OK: how to stop feeling ‘survivor guilt’ during COVID-19


Why these findings matter

Our large, diverse sample of Australian parents captured a range of experiences. Although more than 80% of our participants were mothers, we also heard fathers’ experiences.

Some of these experiences are likely to be similar to those of families around the world. However, the Australian experience may also be unique. Coming out of a tragic season of bushfires, many families may have already had stretched emotional and financial resources to handle another crisis.

The unique experiences of Victorian families, who endured a second period of longer and harsher lockdown, are worthy of follow-up research, as their resilience was likely pushed to the limit.

COVID-19 is not over, and we need to continue to ask parents and individuals how they are doing. Studies like ours, together with those comparing family experiences around the world, will also help researchers, policymakers, and service providers understand how to preserve community and family supports if we have future lockdowns or pandemics.


If this article has raised issues for you, or if you’re concerned about someone
you know, call Lifeline on 13 11 14.
The Conversation

Subhadra Evans, Senior lecturer, Psychology, Deakin University; Antonina Mikocka-Walus, Associate Professor in Health Psychology, Deakin University, and Elizabeth Westrupp, Senior Lecturer in Psychology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Children may transmit coronavirus at the same rate as adults: what we now know about schools and COVID-19



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Zoë Hyde, University of Western Australia

The role children, and consequently schools, play in the COVID-19 pandemic has been hard to work out, but that puzzle is now finally starting to be solved.

The latest research shows infections in children frequently go undetected, and that children are just as susceptible as adults to infection. Children likely transmit the virus at a similar rate to adults as well.

While children are thankfully much less likely than adults to get seriously ill, the same isn’t true for the adults that care for them. Evidence suggests schools have been a driver of the second wave in Europe and elsewhere. This means the safety of schools needs an urgent rethink.

It’s hard to detect COVID-19 in children

Infections with SARS-CoV-2, the virus that causes COVID-19, in children are generally much more mild than in adults and easy to overlook. A study from South Korea found the majority of children had symptoms mild enough to go unrecognised, and only 9% were diagnosed at the time of symptom onset.

Researchers used an antibody test (which can detect if a person had the virus previously and recovered) to screen a representative sample of nearly 12,000 children from the general population in Germany. They found the majority of cases in children had been missed. In itself, that’s not surprising, because many cases in adults are missed, too.

But what made this study important, was that it showed young and older children were similarly likely to have been infected.

Official testing in Germany had suggested young children were much less likely to be infected than teenagers, but this wasn’t true. Younger children with infections just weren’t getting tested. The study also found nearly half of infected children were asymptomatic. This is about twice what’s typically seen in adults.

But children do transmit the virus

We’ve known for a while that around the same amount of viral genetic material can be found in the nose and throat of both children and adults.

But that doesn’t necessarily mean children will transmit the same way adults do. Because children have a smaller lung capacity and are less likely to have symptoms, they might release less virus into the environment.

However, a new study conducted by the US Centers for Disease Control and Prevention (CDC) found children and adults were similarly likely to transmit the virus to their household contacts.

Another study, of more than 84,000 cases and their close contacts, in India found children and young adults were especially likely to transmit the virus.




Read more:
Children might play a bigger role in COVID transmission than first thought. Schools must prepare


Most of the children in these studies likely had symptoms. So, it’s unclear if asymptomatic children transmit the virus in the same way.

But outbreaks in childcare centres have shown transmission by children who don’t show symptoms still occurs. During an outbreak at two childcare centres in Utah, asymptomatic children transmitted the virus to their family members, which resulted in the hospitalisation of one parent.

What we know about outbreaks in Australian schools

Schools didn’t appear to be a major driver of the epidemic in Victoria, although most students switched to remote learning around the peak of the second wave.

However, schools did contribute to community transmission to some extent. This was made clear by the Al-Taqwa College cluster, which was linked to outbreaks in Melbourne’s public housing towers.

When researchers analysed cases in Victorian schools that occurred between the start of the epidemic and the end of August 2020, they found infections in schools mirrored what was happening in the community overall. They also found 66% of all infections in schools were limited to a single person.




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Behind Victoria’s decision to open primary schools to all students: report shows COVID transmission is rare


A closed-school sign on the gate.
Most students in Victoria switched to remote learning at the peak of the second wave.
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This might seem encouraging, but we have to remember this virus is characterised by superspreading events. We now know that about 10% of infected people are responsible for about 80% of secondary COVID-19 cases.

Two major studies from Hong Kong and India revealed about 70% of people didn’t transmit the virus to anyone. The problem, is the remainder can potentially infect a lot of people.

What happened in Victorian schools was entirely consistent with this.

The risk associated with schools rises with the level of community transmission. The picture internationally has made this clear.

What we know about outbreaks in schools, internationally

After schools reopened in Montreal, Canada, school clusters quickly outnumbered those in workplaces and health-care settings combined. President of the Quebec Association of Infectious Disease Microbiologists, Karl Weiss, said

Schools were the driver to start the second wave in Quebec, although the government did not recognise it.

A report by Israel’s Ministry of Health concluded school reopening played at least some role in accelerating the epidemic there, and that schools may contribute to the spread of the virus unless community transmission is low. In the Czech Republic, a rapid surge in cases following the reopening of schools prompted the mayor of Prague to describe schools as “COVID trading exchanges”.

The opposite pattern has been seen when schools have closed. England just witnessed a drop in new cases, followed by a return to growth, coinciding with the half-term school holidays. This was before any lockdown measures were introduced in the country.

These observations are consistent with a study examining the effect of imposing and lifting different restrictions in 131 countries. Researchers found school closures were associated with a reduction in R — the measure of how fast the virus is spreading — while reopening schools was associated with an increase.

The risk has been spelled out most clearly by the president of the Robert Koch Institute, Germany’s equivalent of the US Centers for Disease Control and Prevention. Last week, he reported the virus is being carried into schools, and also back out into the community.

What we need to do

It won’t be possible to control the pandemic if we don’t fully address transmission by children. This means we need to take a proactive approach to schools.

At a minimum, precautionary measures should include the use of face masks by staff and students (including primary school students). Schools should also improve ventilation and indoor air quality, reduce class sizes, and ensure kids and staff practise hand hygiene.

School closures have a role to play as well. But they must be carefully considered because of the harms associated with them. But these harms are likely outweighed by the harms of an unmitigated epidemic.




Read more:
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In regions with high levels of community transmission, temporary school closures should be considered. While a lockdown without school closures can probably still reduce transmission, it is unlikely to be maximally effective.The Conversation

Zoë Hyde, Epidemiologist, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID-19 vaccines could go to children first to protect the elderly



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Julian Savulescu, University of Oxford and Margie Danchin, Murdoch Children’s Research Institute

Several COVID-19 vaccines are in late-stage clinical trials. So discussion is turning to who should receive these vaccines first, should they be approved for use. Today, we discuss two options. One is to prioritise the elderly. This article looks at the benefits of vaccinating children first.


The World Health Organisation is discussing how best to allocate and prioritise COVID-19 vaccines when they arrive.

It is focusing on the immediate crisis. To reduce deaths quickly when there are extremely limited vaccine doses available, vaccinating older, more vulnerable people is expected to be the best option, even if the vaccine is relatively poor at protecting them. That is because the elderly are so much more likely to die from the disease.

But as we produce more vaccines, the goal will be returning to normality where we can freely mix without increased risk. If vaccines are not very effective in older adults, we will need many more people to be vaccinated, including children. One possible strategy is to prioritise children.

Why children first?

The risks and benefits of particular COVID-19 vaccination strategies depend on information we don’t yet have. For example, we don’t yet know whether vaccines work or are safe for specific population groups, such as the young or the old.

But it is worth thinking about the ethics of different strategies in advance. In a pandemic, time can save lives.

A COVID-19 vaccine may be less effective in the elderly because their immune systems decline naturally with age, making them perhaps less able to trigger an efficient, protective immune response after vaccination.

We see this with the flu vaccine, which only reduces influenza-like illnesses by around one-third in the over-65s and deaths by around half.




Read more:
Why are older people more at risk of coronavirus?


If there are similar results for a COVID-19 vaccine, to return to normality, we may need to also prevent community transmission through vaccinating young people, who generally mount a stronger immune response. This would in turn protect older, more vulnerable people because the virus would be less likely to reach them.

Yes, this is controversial. Children cannot autonomously consent to being vaccinated. Adults, who make these decisions on their behalf, are also likely to benefit from a reduced risk of contracting the virus within their own household, making the decision a possible conflict of interest.

When would this be OK?

We do sometimes make altruistic decisions on behalf of children. Children can be life-saving bone marrow donors for siblings, for example, despite the risks.

We can also apply the idea that we can restrict liberty where there is a risk of harm to others. For instance, if a child is infected with COVID-19, they need to be isolated and quarantined just like adults.

However, vaccination differs from both examples in one key respect. With vaccination, there is unlikely to be a single identified person the child will help, or whom they are uniquely placed to help. Instead, the potential benefits are collective, to the wider public.

If a child lived with a sibling who had an underlying condition that makes them particularly vulnerable to COVID-19, or lived with their grandparents, vaccination might be an easier choice.

Child sitting on grandfather's lap reading together
If a child lived with grandparents, vaccination might be an easier choice.
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Three factors could help us decide

When weighing up whether children should be vaccinated ahead of adults, we can ask:

1. How severe is the threat to public health?

So far, more than a million people have died from COVID-19. There’s also the risk of overwhelming health systems and the additional collateral damage in terms of economic, social, educational and risk of excess non-COVID-19 deaths as a result (for example through suicide, or delayed access to health care). COVID-19 affects everyone in society, including children.

2. Are there alternatives?

If vaccination works well enough in vulnerable people, or there are other strategies to achieve the same effect, such as general adult vaccination, we should use those instead.

3. Is the response proportional to the threat?

As we vaccinate the vulnerable, and the general adult population, even if it is not fully effective, we will reduce the severity of the crisis. We should assess at that stage whether the remaining problem warrants vaccinating children.

Assuming we meet these conditions, we argue prioritising childrens’ vaccination, on a voluntary basis at least, is the right strategy.

How about mandatory vaccinations?

Mandatory vaccination can be justified if voluntary strategies do not achieve herd immunity, or do not achieve it fast enough to protect the vulnerable.

To gauge whether mandatory vaccination is worth it, we might also need to consider how lethal and infectious a virus is.

For instance, smallpox had a death rate of up to 30% (although contagion requires fairly prolonged contact). It was eradicated by 1979 through vaccination, which was mandatory in many countries. With COVID-19, 0.1-0.35% of infections are fatal.

By definition, mandatory vaccination involves some form of coercion. This can include withholding financial benefits or access to early childhood education (No Jab, No Pay or No Jab, No Play in Australia); preventing children from entering school (USA, with specific rules varying by state) to fines (Italy). France even has legal provision for imprisonment for parents who refuse certain vaccines.

Mandatory vaccination (of some kind) could be justified in groups who are at increased personal risk from COVID-19 — such as health-care workers, the elderly, men, or people with other health conditions — if incentives such as increased freedoms, or even payment are not sufficient. For these groups, the vaccine is win-win: it both protects others and the person vaccinated.

And mandatory vaccinations for children?

The situation is more tricky with children. Unless they have underlying health conditions or have a rare but serious inflammatory condition after infection, children are less likely to have severe COVID-19 or die from it.

So the risk of the vaccine itself (as yet unknown) weighs more heavily.

On the other hand, children benefit from grandparent relationships, and other freedoms afforded by a pandemic-free society.




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Mandatory vaccination might be justified in children if the following criteria are met:

  • the vaccine is proven to be very safe for children (including in the long term, as yet unknown), and safer than the effects of the disease

  • children are significant spreaders of infection (which does not appear to be the case for COVID-19, at least for pre-teens)

  • there are other non-COVID benefits to children, such as return to normal social and educational life (school), and access to normal health-care services which they otherwise could not have

  • measures are reasonable and proportionate, for instance, by limiting child care benefits (rather, for instance, than sending parents to prison).

We are certainly not close to meeting these criteria for mandatory vaccination of children against COVID-19 yet, especially as we don’t know how effective and safe candidate vaccines are in different populations.




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The Conversation


Julian Savulescu, Visiting Professor in Biomedical Ethics, Murdoch Children’s Research Institute; Distinguished Visiting Professor in Law, University of Melbourne; Uehiro Chair in Practical Ethics, University of Oxford and Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Heading back to the playground? 10 tips to keep your family and others COVID-safe



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Thea van de Mortel, Griffith University

In some Australian states, kids have been back on slides, swings and monkey bars for months. But in Victoria, many families are only now getting back to playgrounds, after they were closed for much of the second lockdown.

With lots of kids running around, and parents looking on, how can you ensure your trip to the playground is COVID-safe for you, your children and others?

A good place to start is to understand how COVID-19 spreads, and what you can do to interrupt it.

Droplets big and small

According to the US Centers for Disease Control and Prevention, the main way SARS-CoV-2 (the virus that causes COVID-19) spreads is by droplet transmission.

Droplets containing virus particles are released from the mouth or nose when someone who is infectious coughs, sneezes, laughs, talks or even breathes. The more vigorous the activity, the greater the volume of droplets and spread (so, for example, laughing releases more droplets than breathing).

Larger droplets fall to the ground relatively quickly and within a short distance of where they were released. But you can inhale them if you’re standing close to an infected person.

Smaller droplets, or aerosols, can travel further and hang around for longer in the air. Scientists are still working to understand the importance of this form of transmission — commonly termed airborne transmission — in the spread of COVID-19.

A young girl on equipment in the playground with her mother.
COVID-19 meant playgrounds were closed for a while.
Shutterstock

Another possible route of transmission is contact with contaminated surfaces. This happens when infectious droplets fall onto surfaces, or contaminated hands touch surfaces. If an uninfected person touches the contaminated surface and then touches their face or food, they may ingest virus particles and become infected.

A recent laboratory study found SARS-CoV-2 particles can remain both detectable and viable (able to cause infection) on surfaces for many days, particularly if the surfaces are smooth, such as metal or plastic. As with airborne transmission, scientists are still figuring out how common this mode of transmission is for COVID-19.




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Playgrounds are outdoors, so that’s a plus

The good news about playgrounds is they’re generally outdoors in parks. The risk of inhaling infectious droplets is reduced because the large volume of air has a dilution effect, compared with being in a confined space indoors with other people. Outdoor breezes can also disperse particles.

The temperature also appears to influence the risk. Warmer temperatures have been shown to reduce the viability of SARS-CoV-2 more quickly than cooler temperatures, while sunlight may also help inactivate the virus. In Australia, of course, we’re now heading into the warmer and sunnier summer period.

On the other side of the coin, public playground equipment may not be cleaned regularly. So there could be some risk of transmission via contaminated surfaces.

And while warmer weather and particularly being outdoors may protect us to a degree, as with anything during the pandemic, a small level of risk remains.




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10 tips to stay COVID-safe at the playground

  1. Check the restrictions and requirements in your state around mask wearing, how far you can travel, and the number of people permitted in a space before heading to a playground.

  2. Don’t go to the playground if you or your child is sick or has any COVID-19 symptoms (fever, cough, sniffles, upset tummy).

  3. Keep your distance (at least 1.5 metres) from anyone not in your household. While it’s tempting to socialise with other parents, avoid congregating closely with others.

  4. Take disinfectant wipes or wet wipes with you and wipe down areas little hands frequently touch (such as swing chains) before your kids use the equipment, particularly if they’re too young to understand instructions.

  5. Take hand sanitiser with you (minimum 60% alcohol). Ensure your children sanitise their hands before getting on the equipment, after playing, before eating and before leaving the playground. Supervise young children when they use alcohol-based hand sanitiser. Parents should regularly sanitise too.

  6. Avoid using shared taps or water fountains; instead, bring bottled drinks. Frequently touched surfaces such as taps are more likely to be contaminated.

  7. Remind children to avoid touching their face while using the play equipment.

  8. Avoid physical contact between your kids and other kids in the area.

  9. Avoid sharing toys with other children. If you bring toys, make sure they’re washable.

  10. Use the playground outside of peak use periods to reduce the amount of contact with others.

A man meets his son at the end of a slide.
If possible, it’s good to visit the playground at a time it might be quieter.
Shutterstock

While younger children may not understand or follow instructions well about keeping away from other children or touching their face, fortunately, they appear to have a lower risk of being diagnosed with COVID-19, and of developing severe disease if they are infected.

The focus with young children should be on frequent hand hygiene and preventing physical contact with non-family members as much as possible.

With little COVID-19 transmission in Australia now, and most playgrounds being outdoors, a trip to the playground is fairly low-risk, and we know physical activity carries many benefits for children and adults alike. But we can all do our part to minimise any risk of transmission.The Conversation

Thea van de Mortel, Professor, Nursing and Deputy Head (Learning & Teaching), School of Nursing and Midwifery, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Children may need to be vaccinated against COVID-19 too. Here’s what we need to consider



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Ketaki Sharma, University of Sydney; Kristine Macartney, University of Sydney, and Nicholas Wood, University of Sydney

An ideal COVID-19 vaccine would not only protect people from becoming ill, it would also stop the virus spreading through the population. The best way to do this is to vaccinate as many people as possible.

If the best available vaccine is only moderately protective — for example, if it only prevents 50% of infections — we might need to vaccinate children as well as adults to interrupt the spread.

There is no COVID-19 vaccine being developed specifically for children. So if children are to be vaccinated, they will likely receive the same vaccine as adults. They might require a different dosing schedule, but that is not yet clear.

So what are the issues with developing a safe and effective COVID-19 vaccine for children? And where are we up to with clinical trials including them?

Why children?

Children don’t appear to be “super-spreaders” of COVID-19, although they can still be infected. And if infected, they have a lower risk of severe illness or death than adults.

However, some children may have a higher risk of severe illness, such as those with existing medical problems. We are also learning more about a rare but serious inflammatory condition reported in some children after COVID-19 infection.

There is also a broader issue at stake. Delaying children’s access to vaccines could delay our recovery from COVID-19. This would prolong the pandemic’s considerable impact on children’s education, health and emotional well-being.




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Rare multisystem inflammatory syndrome in children linked to coronavirus


Would children react differently to a vaccine?

The way a child’s immune system reacts to pathogens or vaccines can be different to adults. Age can determine the number of required doses. For example, infants sometimes require more doses of a vaccine than older children.

Age can also influence the side-effect profile of a vaccine. For example, mild fever following vaccination can be common in babies and young children.

So vaccine developers need to include children in their clinical trials so they can gather age-specific information on the immune response, the effectiveness of the vaccine in preventing disease, and any side-effects.

Are COVID-19 vaccines already being tested in children?

Vaccine trials are usually done in stages. They typically start with healthy, young and middle-aged adults.

Once a vaccine is confirmed to be safe in these earlier trials, developers then test the vaccine in older and younger age groups.

Children playing outside under a colourful parachute
Some vaccine developers have already announced plans to test their COVID-19 vaccines in children.
Shutterstock

Several COVID-19 vaccine developers already have plans to include children in their clinical trials.

University of Oxford researchers will recruit children aged 5-12 into a phase 2/3 trial of its vaccine. This is one of the vaccines for which the Australian government has a supply agreement, should clinical trials prove successful.




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Pfizer will enrol children aged 12 and older in a phase 2/3 trial of its vaccine. Multiple developers in China and in India are also including children in COVID-19 vaccine trials, some as young as six.

All of these trials are ongoing and have not released results.




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How could we get more children included in trials?

We need more children included in clinical trials, an issue recognised globally. For instance, the US Food and Drug Administration announced it will work as quickly as possible with vaccine developers to set up trials for COVID-19 vaccines in children.

The US National Institutes of Health is developing a protocol for researchers to include children in vaccine trials in a safe but timely way.

Having a universal protocol, which we don’t yet have for COVID-19 vaccine trials, would make it easier for researchers to include children in future trials, and to compare different vaccines.

There are no protocols yet including children in COVID-19 vaccine trials run in Australia. Any Australian studies would only likely examine the immune response and safety in children (phase 1 and 2 trials). They would probably not examine effectiveness (phase 3 trials) because of the low rates of COVID-19 here.




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Before any child is enrolled in a trial their parent or guardian will be asked to read an information sheet that explains the risks and benefits of taking part. Safety data from earlier trials in adults would need to be included in child-specific information sheets, so parents are aware of the known risks before they decide to enrol their child.

In Australia, it may be a challenge to enrol children in COVID-19 vaccine trials, as the disease burden is low compared with other countries, so parents may not want their child to take part.

However, it is important we learn as much as we can about how COVID-19 vaccines perform in children, and participating in such research helps us gather this valuable information.

How is vaccine safety assessed?

Vaccine trials are closely supervised by an independent data and safety monitoring board, who follow strict protocols and have the authority to pause a trial if there are safety issues.

Australia also has strict guidelines for the registration of vaccines. A vaccine will only be licensed if its safety has been demonstrated in large studies, usually including many thousands of people. Usually, vaccines are registered according to the age groups in which trials have been done.

Even after a vaccine is licensed in Australia, its safety continues to be monitored. A doctor, patient or parent can report side-effects to the authorities.




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Alternatively, researchers can more actively engage with the public to monitor side-effects, such as with the AusVaxSafety system.

In this system, when a GP gives someone a vaccine, that person receives a text message three days later to ask about side-effects and to complete a survey on their smart phone or computer. This is “real time”, important safety data.

We already use this system to monitor the safety of each year’s flu vaccines and will potentially use it when COVID-19 vaccines are rolled out into the community.

In a nutshell

Although there has been extraordinary progress in COVID-19 vaccine trials, only some vaccine developers have taken steps to recruit children so far. That needs to change if we are to protect children and the wider community. So we need protocols that make it easier for researchers to recruit children into COVID-19 vaccine trials.

As early data in adults accumulates, providing information to parents — and where age-appropriate, their children — to consent to their child participating in trials has a lot of benefits. It will also ultimately help us in the race to end this pandemic.The Conversation

Ketaki Sharma, PhD student, University of Sydney; Kristine Macartney, Professor, Discipline of Paediatrics and Child Health, University of Sydney, and Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Will COVID lockdowns hurt your child’s social development? 3 different theories suggest they’ll probably be OK



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Laurien Beane, Australian Catholic University and Anthony Shearer, Australian Catholic University

Social distancing during COVID-19 has seen a radical upheaval to the way we work and socialise.

But what are the implications for young children? Many children have been uprooted from their places of education and care, and may struggle to understand why their routine has been disrupted.

If you’re a parent, particularly in Victoria, you may be wondering whether this period — a significant amount of time relative to the life of a young child — might affect your child’s social development.

The good news is, with less of the day-to-day rush, many young children have probably benefited from extra socialisation at home with their families.

Looking through a theoretical lens

We can explore the ways COVID-19 might affect children’s social development by considering three theories in psychology.

1. Supporting the individual child (attachment theory)

It’s important for young children to develop strong and secure “attachments” with parents and caregivers. These emotional and physical bonds support children’s social development.

Psychologists have shown very young children who develop strong and secure attachments become more independent, have more successful social relationships, perform better at school, and experience less anxiety compared with children who didn’t have strong and secure attachments.

Where the extra time children have spent with parents and caregivers during COVID-19 has been in a supportive environment, this may help the development of these attachments.




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Don’t worry, your child’s early learning doesn’t stop just because they’re not in childcare


2. Supporting the child in the family (family systems theory)

Beyond parents and caregivers, it’s important for children to develop secure attachments within the whole family.

For young children, research shows these connections with family members can lead to improved social development, while fostering the child’s ability to develop their own identity as part of a family unit.

Young children might have spent more time with siblings and other family members during lockdown, possibly developing deeper connections with them.

3. Supporting the child in the community (sociocultural theory)

Sociocultural theory considers social interaction to underpin the ways children learn, allowing them to make meaning from the world around them.

While learning can and does take place between children and adults, there’s lots of research showing all children benefit from socialising with peers of the same age.

Evidence also indicates children learn to respond to social situations in social environments. This could be in early learning settings, on the playground, or with their families.

Two young children jumping on a trampoline.
Young children may have developed stronger connections with siblings and other family members during lockdown.
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COVID-19 has curtailed many interactions children would regularly have in early learning and social contexts. But at the same time, it’s created opportunities for other meaningful interactions such as at home with family.

Day-to-day life with family, or socially distanced interactions within the community, still provide great opportunities for social development.

We can’t know for sure what toll this pandemic will take on children’s social development.

But it’s important to remember children are always learning wherever they may be, and whoever they may be with. So try to focus on the benefits you’ve gained spending time with your child at home.




Read more:
How parents can help their young children develop healthy social skills


It won’t be the same for everyone

COVID-19 has brought tough times for many Australian families. We know added financial pressures can adversely affect family life, and may be compounded during lockdown by a lack of external support.

The Australian Early Development Census consistently identifies lower socioeconomic status as one of the risk factors for poorer “social competence” — a child’s ability to get along with and relate to others.

This doesn’t mean all children in families experiencing socioeconomic hardship during COVID-19 will necessarily face challenges in their social development. It’s more complex that that. However, some might.

Other risk factors for social competence may have also been heightened during the pandemic. These include family conflict, anxiety or illness (of the child or the parent), and trauma, such as exposure to stressful events, grief, or loss.

Children who already live in vulnerable situations may have become even more vulnerable during this time.

A mother tries to work on her laptop while her young child is bothering her.
More time with family won’t always be a positive.
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Getting back to ‘normal’

Alongside risk factors, a range of protective factors may reduce the impacts of adversity on a child.

We should think about providing young children with extra support, helping them regulate their emotions, fostering warm relationships, promoting resilience and encouraging problem solving, and facilitating social contact within the COVID-19 social distancing norms, such as video chats.




Read more:
Are the kids alright? Social isolation can take a toll, but play can help


As children begin the transition back to early childhood education and care, some “clinginess” is natural.

Having a distressed child at drop-off time can be confronting. But trust in their capacity to regulate their emotions when you leave, and their ability to rediscover relationships with their educators, carers and friends. They should soon readjust.

To support smooth transitions back into early childhood education and care, talk positively with your child about the people they’re going to see, such as teachers and their friends, and encourage them to ask any questions they may have.

If you’re worried about how the lockdown has affected your child, you can always speak to your child’s educator, the centre director, or your GP about connecting with services designed to support you and your child.The Conversation

Laurien Beane, Course Coordinator, Queensland Undergraduate Early Childhood, Australian Catholic University and Anthony Shearer, Academic, Australian Catholic University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Behind Victoria’s decision to open primary schools to all students: report shows COVID transmission is rare



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Fiona Russell, University of Melbourne; Edward Kim Mulholland, Murdoch Children’s Research Institute; Kathleen Ryan, Murdoch Children’s Research Institute; Kathryn Snow, University of Melbourne; Margie Danchin, Murdoch Children’s Research Institute, and Sharon Goldfeld, Murdoch Children’s Research Institute

At the weekend, Victorian Premier Dan Andrews announced all the state’s primary school kids would return to school for Term 4. This is an update from the previously planned staggered return to primary school, which would begin only with students in the early years — prep (first year) to Year 2.

The change was informed by our analysis of Victorian health and education department data on all cases and contacts linked to outbreaks at schools and early childhood education and care services (childcare and preschool).

We included data between January 25 (the date of the first known case in Victoria) and August 31.

Our analysis found children younger than 13 seem to transmit the virus less than teenagers and adults. In instances where the first case in a school was a child under 13, a subsequent outbreak (two or more cases) was uncommon. This finding played a key role in helping make the decision for primary school children to return to school.

Here is what else we found.

1. Outbreaks in childcare and schools are driven by community transmission

Infections linked to childcare, preschools and schools peaked when community transmission was highest in July, and declined in August. In addition, they were most common in the geographical areas where community transmission was also high.

This suggests infections in childcare, preschools and schools are driven primarily by transmission in the broader community. Controlling community transmission is key to preventing school outbreaks.

2. School infections are much lower than in the community

There were 1,635 infections linked with childcare, preschools and schools out of a total of 19,109 cases in Victoria (between January 25 and August 31).

Of 1 million students enrolled in all Victorian schools, 337 may have acquired the virus through outbreaks at school.




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Of 139 staff and 373 students who may have acquired infection through outbreaks at childcare, preschools or schools, eight (four staff and four students) were admitted to hospital, and all recovered.

The infections in childcare, preschools and schools were very rarely linked to infections in the elderly, who are the most vulnerable to COVID-19.

3. Most infections in schools and childcare centres were well contained

Of all the outbreaks in Victorian childcare centres, preschools and schools, 66% involved only a single infection in a staff member or student and did not progress to an outbreak. And 91% involved fewer than ten cases.

Testing, tracing and isolation within 48 hours of a notification is the most important strategy to prevent an outbreak.

The majority of infections in childcare, preschools and schools were well contained with existing controls and rapid closure (within two days), contact tracing and cleaning.




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Are the kids alright? Social isolation can take a toll, but play can help


4. Households are the main source of infection, not schools

The investigations of cases identified in schools suggest child-to-child transmission in schools is uncommon, and not the primary cause of infection in children. Household transmission has been consistently found to be the most common source of infection for children.

Closing schools should be a last resort

Based on our findings and a review of the international literature, we recommend prioritising childcare centres, preschools and schools to reopen and stay open to guarantee equitable learning environments — and to lessen the effects of school closures.

Children do transmit the virus and outbreaks can occur. But based on the international literature, this mostly happens when there are high rates of community transmission and a lack of adherence to mitigation measures (such as social distancing) at the school or childcare centre.

Childcare centres, preschools and schools play a critical role not only in providing education, but also offering additional support for vulnerable students.

With childcare centres and schools being closed, along with the additional economic and psychological stress on families, family conflict and violence has increased. This has led to many children and young people feeling unsafe and left behind in their education and suffering mental-health conditions.

Closing all schools as part of large-scale restrictions should be a last resort. This is especially the case for childcare centres, preschools and primary schools, as children in these age groups are less likely to transmit the virus, and be associated with an outbreak.

Now that community transmission in Victoria is so low, it’s time for all kids to go back to school.




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From WW2 to Ebola: what we know about the long-term effects of school closures


The authors would like to thank their advisory committee from the Department of Education and Training and the Department of Health and Human Services. They would also like to thank outbreak epidemiologists at the DHHS and medical students Alastair Weng, Angela Zhu, Anthea Tsatsaronis, Benjamin Watson, Julian Loo Yong Kee, Natalie Commins, Nicholas Wu, Renee Cocks, Timothy O’Hare, and research assistant Kanwal Saleem, and Belle Overmars.The Conversation

Fiona Russell, Principal research fellow, University of Melbourne; Edward Kim Mulholland, Professor, Murdoch Children’s Research Institute; Kathleen Ryan, Research Fellow, Asia-Pacific Health, Infection and Immunity Theme, Murdoch Children’s Research Institute; Kathryn Snow, Epidemiologist, University of Melbourne; Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute, and Sharon Goldfeld, Director, Center for Community Child Health Royal Children’s Hospital; Professor, Department of Paediatrics, University of Melbourne; Theme Director Population Health, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Are the kids alright? Social isolation can take a toll, but play can help



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Pasi Sahlberg, UNSW and Sharon Goldfeld, Murdoch Children’s Research Institute

Many parents are worried the disruptions of COVID lockdowns and school closures may affect their children’s mental health and development.

In the Royal Children’s Hospital’s National Child Health Poll in June 2020, more than one-third of parents reported the pandemic has had negative consequences on their children’s mental health. Almost half of parents said the pandemic had also been harmful to their own mental health.

Many parents spent at least some months this year supporting their children to learn from home (and still are, in Victoria). This already substantial challenge was complicated by children not being able to go out and play with other children. In Victoria, such restrictions are still in place, although some have been relaxed and playgrounds are open.

Still, it’s fair to say that across the country, some children are not socially engaging with their peers in the same way they did before. This is not only detrimental to children’s learning but also their physical and mental health. It is understandable if parents are worried.

What social isolation means for kids

In June 2020, in the context of COVID-19, a group of researchers in the UK reviewed 80 studies to find how social isolation and loneliness could impact the mental health of previously healthy children. They found social isolation increased the risk of depression and possibly anxiety, and these effects could last several years.




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The review also concluded loneliness puts children’s well-being at risk of these things long after the social isolation period is over.

The impact of social isolation may be particularly significant for children with special educational needs, when support provided at school to them is interrupted.

Other children – perhaps those living in medium and high-density housing with limited access to outdoor play space – may also be particularly vulnerable to the effects of social isolation.

Father and son racing a toy train on a track.
Playing with your kids can help them feel less lonely.
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Some parents with only one child have also voiced concerns about loneliness.

It is difficult to substitute what real human interaction with peers means to a child. Active engagement in creative play alone or physical activity with parents can be helpful for children who miss the company of their friends.

The power of play

What could possibly fix this situation? The answer is: help children play.

The benefits of regular play are many and they are well documented in research. Paediatricians say play improves children’s language skills, early maths knowledge, peer relations, social and physical development and learning how to get new skills.

When children can’t play for any reason, anxiety and toxic stress can harm the healthy development of social behaviours.




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Let them play! Kids need freedom from play restrictions to develop


During the pandemic, play can be an effective tonic for stress and can encourage the development of positive behaviours.

When children play together, play effects become even more powerful. Experts say social play can help children develop skills in cooperation, communication, negotiation, conflict resolution and empathy.

In social play, children can rehearse and role play real-world situations safely. Through play, they make sense of the world and process change. Parents playing with their children help children play better with their peers.

Group of kids playing
When children play together, the benefits of normal play are enhanced.
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Now is the time to stress the importance of play. A survey done by the Gonski Institute in 2019 showed four out of five Australians believe today’s children are under pressure to grow up too quickly. More than 70% think the lifelong benefits children gained from play, such as creativity and empathy, are mostly ignored today.

Research from previous pandemics shows we need well-planned and coordinated solutions to potentially long-term emotional issues. We can embrace the role of play to mitigate the losses children have experienced while living through a pandemic.

What can parents do?

Children need both guided indoor play and free play ourdoors. Playing with family members at home, or with friends at school, are good for social play.

Digital devices can provide children a way to play together with their friends when they can’t meet with them. But the benefits of play are more long-lasting through social play in person.

Parks, green spaces and quiet streets are suitable for outdoor play. Natural environments both soothe and stimulate children, while connecting them to their environment and community. So here are four things you can do to encourage play.

1. Make time for play

The most important thing you can do is to make time every day for your children to play. Take play time seriously and show your children you value it for the benefit of their well-being, health and learning.

2. Set clear guidelines to technology use at home

It is important to talk with your children about safe and responsible use of digital media and technology. This may require agreeing to put some limits to the use of screens at home, and encourage children to actively engage with friends by playing interactive games when using digital devices.




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Child’s play in the time of COVID: screen games are still ‘real’ play


3. Go out whenever possible

A recent review of nearly 200 studies found “green time” — time in parks, nature reserves and woods — appeared to be associated with favourable psychological outcomes, while high levels of screen time appeared to be associated with unfavourable psychological outcomes.

Parks and playgrounds are open now in Victoria, while in other states they have been for some time.

So find fun outdoor exploratory activities for your children, and where possible bring other kids along.

4. Be a role model of all of the above

Children often mimic their parents. The best way to ensure children grow up healthy and happy is to be a role model to them. More play, and enough quality time outdoors with children is good for your own health and happiness, too.


For more see the Raising Children Network and the Gonski Institute.The Conversation

Pasi Sahlberg, Professor of Education Policy, UNSW and Sharon Goldfeld, Director, Center for Community Child Health Royal Children’s Hospital; Professor, Department of Paediatrics, University of Melbourne; Theme Director Population Health, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is it time for Australia to implement kids-only COVID-19 briefings?



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Susan Whatman, Griffith University

There are many ways children absorb public health messaging about COVID-19. They may receive information from social media platforms like TikTok, via direct text messages, or through daily briefings from state chief medical officers and politicians on television.

The messages to stay safe during the pandemic are essential, but there are a couple of things we need make sure of when communicating advice to children.

First, they must be educated as well as informed. For example, children may be told to wash their hands without being educated about how it helps their personal safety. Knowing the how and why of health behaviours develops children’s health literacy and increases their likelihood of adopting the behaviour.

Second, children need the opportunity to ask questions and have them answered by experts in ways they can understand.

This is where formal COVID briefings for children could help.

Teachers can’t do it all

COVID-19 messaging in classrooms has focused on making sure staff and students are safe by adjusting teaching to account for social distancing requirements.

A recent survey in New South Wales found teachers are feeling pressure to meet daily sanitising requirements with limited supplies. They are overwhelmed with the responsibility to keep children safe and don’t necessarily have the time and energy to help them understand more about the pandemic.

Boy watching virtual class on laptop.
Children-specific briefings might take some of the pressure of teachers who are already overworked adapting to new ways of learning.
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Even teachers who are delivering lessons remotely during lockdown are adapting to the time demands of teaching via technology. So they don’t have the opportunity to explore children’s hopes, fears and thirst for knowledge about coronavirus.

Other countries have done it

Norway’s Prime Minister Erna Solberg hosted a press conference for children in March, together with the minister of children and families and the education minister.

Children were invited to send their questions in advance to the local media, who passed the questions along to the prime minister to answer.




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Children might play a bigger role in COVID transmission than first thought. Schools must prepare


New Zealand’s Prime Minister Jacinda Ardern also hosted a live-streamed press conference especially for children.

And Finnish Prime Minister Sanna Marin brought along her minister for education and minister for science and culture to a similar press conference in April, where children 7-12 years old were invited to submit video questions.

Which approach was best?

All three conferences respected children’s right to be heard and honoured their right to political participation in having a say over the COVID education they received.

But there was a key difference between the Scandinavian conferences and New Zealand’s. In place of politicians, accompanying Ardern were Siouxsie Wiles, a microbiologist, and Michelle Dickinson, a children’s science communicator also known as “Nanogirl”.

One of Dickinson’s videos, which she posted on Twitter, explains, using age-appropriate language and models, how soap destroys the virus. It’s been viewed more than 34,500 times.

Politicians have a responsibility to explain how the government is addressing public needs relevant to their portfolio, but there is no certainty a particular minister is an expert in that field. This is why an expert panel should be offered to children to answer the unpredictable and varied questions they might ask.




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How should a kids-only briefing be run in Australia?

In deciding how to run such a conference in Australia, we can learn from the questions asked by the children at these previous events.

The Norwegian conference prioritised mental health, distributing advice from the World Health Organisation (WHO) to “support each other” and offer “compassion and kindness”.

The New Zealand conference took a more educative approach to explain how things happen, such as how soap destroys the fat layer of the virus. This resonates with many of the key ideas of the Australian Health and Physical Education curriculum, such as taking a strengths-based approach (seeing young people as having resources to solve problems), developing health literacy, and focusing on educative outcomes, rather than just focussing on changing a child’s behaviour.

Two children wearing masks looking out a window
Having an expert explain to children the psychology behind the uncertainty, anxiety and helplessess of living under COVID restrictions could be beneficial.
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The Finnish conference was dominated by questions like “when can we go back to school?”, “is the situation in Finland good? (compared to other countries)” and “why can’t I hold my birthday party?”

The role of the experts could be to help children gain a better understanding of the psychology behind the uncertainty, anxiety and helplessness they may be feeling from living under COVID restrictions.

Kids should hear from experts

It is entirely appropriate that our prime minister should lead an Australian panel of experts from a variety of disciplines to answer questions from children. A COVID briefing for children would help the government take children’s views seriously and switch the narrative from one-way, informed compliance to a two-way educated conversation.




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‘Stupid coronavirus!’ In uncertain times, we can help children through mindfulness and play


Children deserve to have access to expert knowledge in order to make informed decisions about their own health behaviours and their role in the wider community in these COVID-19 times.

Health education is comprised of many sub-disciplines, requiring general classroom teachers to acquire new and diverse knowledge sets at a time when rapidly changing teaching demands have pushed them to the brink of exhaustion.

A televised COVID briefing with a multidisciplinary panel of experts would not only satisfy children’s right to access quality knowledge, but also create an enduring, age-appropriate resource to help schools, teachers and the wider community into the future.The Conversation

Susan Whatman, Senior Lecturer in HPE and Sports Pedagogy, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Children might play a bigger role in COVID transmission than first thought. Schools must prepare



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Zoë Hyde, University of Western Australia

Over the weekend, the World Health Organisation made an announcement you might have missed.

It recommended children aged 12 years and older should wear masks, and that masks should be considered for those aged 6-11 years. The German Society for Virology went further, recommending masks be worn by all children attending school.

This seems at odds with what we assumed about kids and COVID-19 at the start of the pandemic. Indeed, one positive in this pandemic so far has been that children who contract the virus typically experience mild illness. Most children don’t require hospitalisation and very few die from the disease. However, some children can develop a severe inflammatory syndrome similar to Kawasaki disease, although this is thankfully rare.

This generally mild picture has contributed to cases in children being overlooked. But emerging evidence suggests children might play a bigger role in transmission than originally thought. They may be equally as infectious as adults based on the amount of viral genetic material found in swabs, and we have seen large school clusters emerge in Australia and around the world.

How likely are children to be infected?

Working out how susceptible children are has been difficult. Pre-emptive school closures occurred in many countries, removing opportunities for the virus to circulate in younger age groups. Children have also missed out on testing because they typically have mild symptoms. In Australia, testing criteria were initially very restrictive. People had to have a fever or a cough to be tested, which children don’t always have. This hindered our ability to detect cases in children, and created a perception children weren’t commonly infected.

One way to address this issue is through antibody testing, which can detect evidence of past infection. A study of over 60,000 people in Spain found 3.4% of children and teenagers had antibodies to the virus, compared with 4.4% to 6.0% of adults. But Spain’s schools were also closed, which likely reduced children’s exposure.

Another method is to look at what happens to people living in the same household as a known case. The results of these studies are mixed. Some have suggested a lower risk for children, while others have suggested children and adults are at equal risk.

Children might have some protection compared to adults, because they have less of the enzyme which the virus uses to enter the body. So, given the same short exposure, a child might be less likely to be infected than an adult. But prolonged contact probably makes any such advantage moot.

The way in which children and adults interact in the household might explain the differences seen in some studies. This is supported by a new study conducted by the Centers for Disease Control and Prevention. Children and partners of a known case were more likely to be infected than other people living in the same house. This suggests the amount of close, prolonged contact may ultimately be the deciding factor.

How often do children transmit the virus?

Several studies show children and adults have similar amounts of viral RNA in their nose and throat. This suggests children and adults are equally infectious, although it’s possible children transmit the virus slightly less often than adults in practice. Because children are physically smaller and generally have more mild symptoms, they might release less of the virus.

In Italy, researchers looked at what happened to people who’d been in contact with infected children, and found the contacts of children were more likely to be infected than the contacts of adults with the virus.

Teenagers are of course closer to adults, and it’s possible younger children might be less likely to transmit the virus than older children. However, reports of outbreaks in childcare centres and primary schools suggest there’s still some risk.

What have we seen in schools?

Large clusters have been reported in schools around the world, most notably in Israel. There, an outbreak in a high school affected at least 153 students, 25 staff members, and 87 others. Interestingly, that particular outbreak coincided with an extreme heatwave where students were granted an exemption from having to wear face masks, and air conditioning was used continuously.

At first glance, the Australian experience seems to suggest a small role for children in transmission. A study of COVID-19 in educational settings in New South Wales in the first half of the year found limited evidence of transmission, although a large outbreak was noted to have occurred in a childcare centre.

This might seem reassuring, but it’s important to remember the majority of cases in Australia were acquired overseas at the time of the study, and there was limited community transmission. Also, schools switched to distance learning during the study, after which school attendance dropped to 5%. This suggests school safety is dependent on the level of community transmission.

Additionally, we shouldn’t be reassured by examples where children have not transmitted the virus to others. Approximately 80% of secondary COVID-19 cases are generated by only 10% of people. There are also many examples where adults haven’t transmitted the virus.

As community transmission has grown in Victoria, so has the significance of school clusters. The Al-Taqwa College outbreak remains one of Australia’s largest clusters. Importantly, the outbreak there has been linked to other clusters in Melbourne, including a major outbreak in the city’s public housing towers.

Close schools when community transmission is high

This evidence means we need to take a precautionary approach. When community transmission is low, face-to-face teaching is probably low-risk. But schools should switch to distance learning during periods of sustained community transmission. If we fail to address the risk of school outbreaks, they can spread into the wider community.

While most children won’t become severely ill if they contract the virus, the same cannot be said for their adult family members or their teachers. In the US, 40% of teachers have risk factors for severe COVID-19, as do 28.6 million adults living with school-aged children.

Children walk to school with masks
In the US, 40% of teachers have risk factors for severe COVID-19, as do 28.6 million adults living with school-aged children.
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Recent recommendations on mask-wearing by older and younger children mirror risk-reduction guidelines for schools developed by the Harvard T. H. Chan School of Public Health. These guidelines stress the importance of face masks, improving ventilation, and the regular disinfection of shared surfaces.

The changing landscape

As the virus has spread more widely, the demographic profile of cases has changed. The virus is no longer confined to adult travellers and their contacts, and children are now commonly infected. In Germany, the proportion of children in the number of new infections is now consistent with their share of the total population.

While children are thankfully much less likely to experience severe illness than adults, we must consider who children have contact with and how they can contribute to community transmission. Unless we do, we won’t succeed in controlling the pandemic.The Conversation

Zoë Hyde, Senior Research Officer, University of Western Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.