CLEVELAND, Ohio — A recent study examining children as transmitters of the coronavirus raises questions about Ohio Gov. Mike DeWine’s announcement this week that the state’s schools might reopen part-time in August.
The study out of Germany looked at concentrations of the virus in the respiratory tract of various age groups and found that the “viral load” in children and adults to be similar. The researchers conclude that schools should be cautious about “unlimited” re-opening.
“There are reasons to argue against the notion of adult-like infectivity in children, such as the fact that asymptomatic children do not spread the virus by coughing, and have smaller exhaled air volume than adults,” the study states. “However, there are other arguments that speak in favour of transmission, such as the greater physical activity and closer social engagement of children.”
It is not immediately clear whether the DeWine administration considered the German findings in reaching a tentative decision about reopening schools. A call to the Ohio Department of Public Health has yet to be returned.
Cleveland.com also asked U.S. health experts about the risks cited by the research, and the difficulty schools would face in having children maintain social distancing, use face masks and take other steps to avoid spreading the virus.
Jason Farley, professor and nurse epidemiologist at Johns Hopkins University School of Nursing in Maryland said he doesn’t know enough about Ohio to render an opinion about whether the state should open schools in August.
“‘Should we’ all depends on your local epidemiology,” he said.
But Farley said DeWine and other governors face a “challenging decision” in determining when and how to re-open schools. He said the findings of the German researchers suggest children can be more or less infectious depending on your perspective.
“The higher the viral load, the higher the chance of transmissibility,” he said, but the study also found there could be mitigating factors with children when it comes to the likelihood of transmission, such as their distance from others and the smaller volume of air they expel.
If Ohio schools do re-open in August, Farley recommends that all children wear masks, even the younger ones, and that teachers have sanitizing products at their disposal for multiple cleanings a day. While young children may not spew the virus as far as an adult when they cough, he said, they are very likely to contaminate the surfaces around them.
“Teachers should be thinking about managing the physical environment as much as they’re managing the learning environment,” he said. That also could mean limiting the movement of students around the building and even holding classes outside.
Mercedes Carnethon, a professor of epidemiology at Northwestern University in Illinois, was unwilling to say whether reopening schools in August is too early.
But she said the German study suggests that children do get the virus and can infect others even if they are asymptomatic.
“So it would be a mistake to conclude that children don’t get it,” she said, and better to assume that they are “super spreaders.”
She also is less confident that younger children are be able to adhere to the techniques that adults use to prevent spread in the work place, such as wearing of masks and staying away from others.
The danger involved in children going back to school is that they would then go home to adults who are more vulnerable to the disease, she said.
“This is particularly profound in people who live in multi-generational households,” Carnethon said, and that includes a disproportionate number of minority families.
But the risk of not re-opening schools is significant, too, she said. Children would not be getting the education they need and may even be forced into group settings such as day care because their parents have essential jobs and are required to work.
Carnethon said returning to school represents a “calculated risk” as long as a vaccine against COVID-19 is not available. More information should be forthcoming to help draw more reasoned conclusions, she added.
Dr. Leila Hojat, an infectious disease physician at University Hospitals, said she thinks it’s too early to say whether schools should return in August.
“Where we think we might be in August, today, might be very different from a month from now and I think we should wait and see overall,” she said.
She said it will be much more difficult to open schools with any degree of confidence if the number of cases in the community starts amplifying over the summer.
She said one of the best public health measures Ohio imposed was to close schools. She cited a recent study out of China that analyzed social distancing and determined that as the spread of the virus increases elsewhere, school closings “can reduce the peak incidence by 40-60% and delay the epidemic.”
When schools do reopen, she said, districts should use different classroom setups, staggered days and remote learning to keep farther children apart.