We shouldn’t delay the start of the school year because of Omicron. 2 pediatric infectious disease experts explain

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With Omicron’s daily infection rates numbering in the tens of thousands, there were calls for states to delay the start of the new school year, which begins at the end of January.

The vaccination program for children aged 5 to 11 began on Monday but appointments are already underway delayed. And even if everything goes on time, not all children will have received their first dose by the start of Term 1 in the most affected states.



Read more: Why was my child’s vaccination canceled? We depend on overseas supply and a complex logistics network


Queensland has moved its start date two-week return for young students until February 7, with Prime Minister Annastacia Palaszczuk saying it is too risky for children to return on January 24, when the Omicron outbreak is likely to peak. South Australia may also delay the start of the school year, although the details are still uncertain.

We know the known harms school closures: declining mental health, increasing obesity and child abuse, impaired social development, and of course loss of learning. Longer-term harms that we don’t know about, but can include weaker job prospects and shorter lifespan. This is a critical issue for the children of Victoria and New South Wales. Yet two years after the start of this pandemic, we are once again discussing whether schools should be a priority for opening.

Currently, children are not the main driving force behind Omicron – it is the age group 20-29 years . Although mobility patterns change after the holiday period, the age distribution may change. Previous studies have found school personnel are not at greater risk of infection than the general population. This may be due to reduction measures be in place at school, like social distancing and mask mandates.

The transmission is most common in households. Studies have shown that secondary infections in children are inferior in schools than in households, which is probably due to school mitigation measures.



Read more: From WWII to Ebola: What we know about the long-term effects of school closures


Before Omicron, evidence of school closures reducing community transmission was inconclusive. And with Omicron infection currently existing in all settings, it is uncertain whether school closings will be effective in controlling its spread.

During the summer, hundreds of thousands of spectators will attend major sporting events, while nightclubs, gymnasiums and karaoke bars remain open. To suggest that schools cannot open while these events are unfolding speaks volumes about the importance we place on educating children.

Omicron appears to be less severe in children than Delta

For the vast majority of children, COVID is a mild illness. We have seen serious illness happen more often with the Delta variant, but this is still rare.

Data on the severity of Omicron in children is still emerging. A US study suggests Omicron is less severe in children than Delta. Children are 70-80% less likely to visit an emergency department for care with an Omicron infection and about 50-60% less likely to be hospitalized for treatment. Nevertheless, this one is still closely watched.

Because Omicron is highly contagious, many more children will be infected and a small percentage of them will be admitted to hospital. Often times they can have COVID but be admitted for another reason. In the United States, pediatric hospitalizations are at their highest rate than at any time during the pandemic with alarming headlines about exponential growth rates.

However, the data from the new york state on COVID hospitalization shows that for children aged 0 to 4, the rates fell from 0.4 to 4 per 100,000 during Omicron. For children aged 5 to 11, the increase increased from 0.2 to 0.8 per 100,000. The increase for adolescents aged 12 to 18 increased from 0.1 to 1.5 percent 000. Despite this exponential growth, these rates are very low.



Read more: No, we shouldn’t be too worried about contracting COVID from young children


Victoria has approximately 500,000 primary school age children and 500,000 secondary school students. Based on US data, we can expect an equivalent of about 5 to 20 admissions with and for COVID per week in unvaccinated children of elementary school age and one to four admissions per week. week in unvaccinated adolescents in the coming month.

These numbers would decrease rapidly with vaccination. This is the case even after a single dose, which should provide more than 80% protection.

Vaccines are important in children

Vaccination is effective in preventing serious illness, although serious illness is rare in elementary school.

From children hospitalized in New York state, 91% of 5-11 year olds were not vaccinated and 4% fully vaccinated. There were few admissions among children who had received one or both doses of the vaccine.

Among the 12-17 year olds hospitalized, 65% were not vaccinated. And 55% of hospitalizations were unvaccinated children aged 0 to 4 years.

Vaccination protects children against a serious, but rare and treatable disease linked to COVID that involves inflammation of several organs (multisystem inflammatory syndrome, MIS-C). A study of french found that a single dose of mRNA vaccine reduced the risk of developing MIS-C in adolescents by 91% and that there were no cases of MIS-C in fully vaccinated adolescents.

A review compared the symptoms of the disease in children who had COVID with those who did not. Several months after the acute infection, children who had had COVID were only slightly more likely than children who did not have headaches, cognitive difficulties, loss of smell and sore throats. But there was no difference between children previously positive for COVID and negative for COVID for other symptoms such as abdominal pain, cough and fatigue.

These lingering symptoms after a COVID infection are what is considered a long COVID. But that doesn’t mean they’re permanent. This may mean that they just take a little longer to resolve than the acute symptoms. It is not known if the vaccination prevents this.



Read more: Are children long COVID? And how often? A pediatrician examines the data


For school personnel, two doses of AstraZeneca or Pfizer vaccine provide moderately high protection (about 70%) against serious illness by Omicron, and this increases further after a booster (for about 90%). Hospitalizations occur mainly in the unvaccinated elderly.

Since most school staff are vaccinated, they are well protected against serious illness.

We need a national plan

Australia is late for a national, sustainable lifestyle with COVID.

Although the vaccines are very effective against serious illnesses, they offer little protection against infection with Omicron itself, which is now the dominant variant.

Additional measures are therefore needed to prevent infections and epidemics in schools.

Staying home if symptomatic is critical and remains a policy. Symptom monitoring should be established. Infections will be more frequent in the coming weeks, meaning there is an urgent need to plan the workforce in schools, as in all sectors.

Right now, testing and cohorts (dividing children into groups in the classroom and not allowing mixing between grade levels) are key to limiting transmission.

New South Wales has launched a “test to stay” program. This reduces the number of close contacts required to isolate. If a child is in a cohort with someone who tests positive, they have a daily rapid antigen test. If the test is negative and they have no symptoms, they can still go to school. All states should use this system when there is high transmission in the community.

Social distancing of student and staff offices should be maintained with indoor masks for students and staff. Other mitigation measures such as improving air circulation are important. Wider measures using HEPA filters should be funded, but this should not delay the reopening of schools.

Schools should be classified as an essential service and be the first to open and the last to close. To succeed in cricket and tennis but not to open schools on time would be a political failure.

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