Kids could trigger another wave of COVID and the fall may be worse, says health professor

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It’s August now, which means kids nationwide are starting school in a few weeks. In California, most of them will be doing it remotely, but elementary schools can seek a waiver to be exempt from the ban on in-person instruction. 

Political leaders, including President Trump, are insisting that kids should return to classrooms. At one point, Trump threatened to pull federal funding from public schools that don’t comply. Part of this pressure comes from evidence that suggests kids are less likely to contract COVID-19.

Now a new CDC study following hundreds of cases out of a Georgia sleepaway camp is starting to call that into question. Nearly 600 campers and staffers arrived at camp with proof that they were tested for the virus. By the time the camp was forced to shut down, more than three-quarters of the kids that were tested had positive results.

KCRW talks about the study with Andrew Noymer, associate professor of population health and disease prevention at UC Irvine. He focuses on demography, epidemiology, and public health.

KCRW: How did the sleepaway camp in Georgia end with hundreds of children and staff testing positive for the virus?

Andrew Noymer: “It's a bit like a similar sleepaway camp that happened in Georgia a few months ago. The U.S. Army has a sleepaway camp for new recruits called Fort Benning. And you bring people into an environment where they're in contact with each other, and the virus can spread. What this tells us, though, is that it doesn't just happen among adults, it happens among kids. And that's why this is important.”

The kids were around 12 years old on average. Why do we think there has been so little contagion among kids? 

“Kids typically are asymptomatic. They tested positive, but they weren't all sick. We haven't seen this before, because we haven't looked for it as much.”

Because so many of these kids are asymptomatic, it might be difficult to track cases, and there could be other examples like this around the US, but we just don't know about it? 

“That’s exactly right. … My biggest fear for schools, and the biggest risk associated with schools, is not that we'll have lots of sick children. We may have lots of infected children. But I'm worried that children will catalyze another phase of the epidemic, spreading to household members. Because kids, it's important to remember, they get infected, but they don't experience a severe syndrome. There were not many, many sick kids at this camp. There were just kids who tested positive.”

When it comes to the likelihood of spreading the virus, does it matter if you're asymptomatic or not?

“That’s one of the reasons why this study is so important. Because we know, and we have known for some time, that there are pre-symptomatic and asymptomatic spreaders. But at the same time, spreading and showing symptoms sort of go hand in hand. It's the sneezing and coughing that spread SARS-CoV-2. And because kids, by and large, don't show symptoms, and because frankly they're physically smaller, there is a story that well maybe they're just not going to spread it that much. 

But we see spreading at this camp, so we think that kids can make asymptomatically spread just like adults do.” 

Why has there been so little data about children's vulnerability to the virus?

“That's partly one of the million dollar questions of this epidemic. It's clear that kids don't get sick. I mean, there are exceptions. But they do get infected, meaning that the virus is in their bodies, but then it gets cleared by their immune system, and then they go on with life. 

Adults have the same thing, but they go through a phase of illness. And in some cases, that illness is severe. 

So with kids, they've been less studied partly because they're less symptomatic. And so we're going to see more studies like the one that the CDC ran.”

If COVID-19 is milder and death rates are lower in children, is there an argument for reopening schools?

“I think schools can open potentially. It's going to depend on a lot of local factors. It's going to depend a lot on the transmission rates in the community. … Schools offer an enormous welfare benefit to children. I mean, education is so important. And schools provide sort of de facto day care.

… So closing schools is not a decision to be taken lightly. And I mean, it's been clear for some time, and this study really gives us quantitative evidence, that the big problem with opening schools is not the kids are going to all get sick. Some of them will, but compared to adults, very few. 

The problem is that kids may catalyze another wave — if you think this is bad, the fall and winter may be worse. And kids going to school and coming home from school every evening may be part of that dynamic. 

… I think schools can open, and in ways that will depend on the local community. I'm not a fan of a nationwide policy [saying] schools must be open or schools must be done remotely. 

… The local epidemiological situation needs to be taken into account. And schools I don't think can open just business as usual. There needs to be masking and some social distancing, to the extent possible. Some sort of podding so kids aren't moving between different classrooms all the time. And fever checks at school.”

This camp in Georgia did not follow CDC reopening guidance. If schools follow guidelines correctly, do you think we can avoid this next phase of COVID?

“There are still a lot of unknowns. And this study gives us new information. But your listeners are probably saying to themselves, ‘Yes, but a sleepaway camp is not the same thing as an elementary school.’ And that's absolutely correct. So it's not a perfect analogy. We're still flying with incomplete data. And just the intensity of a sleepaway camp is slightly different than a school. 

But one thing’s been clear from the start is that the CDC cannot give anyone a watertight guarantee that following their guidance is going to prevent this epidemic from spreading. This epidemic has had one trick up its sleeve after another. So I wouldn't go so far to say even if a school follows CDC guidance to the letter that they're absolutely safe from having an epidemic.”

— Written by Amy Ta, produced by Caleigh Wells