Can your child or grandchild REALLY give you Covid?

Children are ‘more likely to be hit by a bus’ than catch coronavirus at school. Classrooms are ‘safe’. The chances of kids becoming seriously ill with Covid? ‘Strikingly low,’ according to the latest studies. 

These have been the messages coming from Ministers and scientists over the past fortnight – aimed at reassuring parents, as schools across England prepare to reopen for nearly nine million pupils this week. Meanwhile, mounting evidence shows that denying pupils a face-to-face education puts them at risk of long-term mental ill health, and scuppers their career prospects for life.

So few could now be in any doubt that getting kids back into classrooms is a priority. But while it’s clear that, for children at least, the risks of keeping them away from school are far greater than any posed by Covid-19, many families are now justifiably wondering: what is the risk to us?

After all, if they’re out there, possibly picking up the virus, could they then bring it back home to parents and, more worryingly, grandparents or others who are vulnerable? Just this week, researchers writing in the British Medical Journal concluded that no healthy children have died of Covid-19 in the UK.

And just six of 650 children hospitalised with the virus died – all of whom had ‘profound’ and ‘life-limiting’ health conditions. Fewer than a fifth needed intensive care treatment – most of whom, again, were already unwell. And only one per cent of the 130,000 cases between January and May were children aged 15 and under, according to Public Health England.

This, according to health chiefs, is proof that children have a ‘limited role’ in the transmission of the disease. But it would be disingenuous to suggest that reopening schools will be entirely risk-free.

It’s a conundrum that has troubled Leeds University virologist Stephen Griffin, who has two children aged seven and three, who will be returning to school and pre-school next week.

His wife has been shielding throughout the pandemic because she has autoimmune conditions and a heart condition.

‘Everyone always wants to know if it’s safe for the kids, understandably,’ says Dr Griffin. ‘But what we should also be asking is, ‘Is it safe for our population?’ I absolutely believe we should be prioritising the kids’ return to school,’ he adds. ‘But we haven’t eliminated transmission of the virus within communities, which means there will be a trade-off.’

And as Dr Griffin points out, there is no clear guidance for families on how to manage the latest risk. Part of the problem is we don’t yet know how well children spread the virus – either to one another, or us. Even a joint statement by the British Chief Medical Officers last week admitted the evidence on whether children transmit corona was ‘weak’.

Jeffrey Shaman, expert in infectious disease at Columbia University in New York, said: ‘The question is, what happens when children get it?

‘Are they effectively dead ends? Or are they capable of communicating the virus and spreading it to other people? And I think the evidence is not conclusive.’ 

Small studies suggest children hospitalised with Covid-19 carry as much of the virus as adults – and may be as infectious.

But as University of Bath infection expert Dr Andrew Preston points out: ‘Those displaying symptoms would be isolating, not walking around in schools.’

The real-world evidence shows the virus can, and does, spread among school populations – as seen last week in Dundee, where 21 staff members and two children in one school tested positive. But experts say this, and many other examples from around the world, doesn’t suggest children are ‘super-spreaders’, as they are known to be with viruses such as flu. In the main, evidence shows the virus is brought into schools from the community, mainly by staff.

And it’s spread most commonly between staff members. Indeed, studies have consistently found adults are far more likely to pass on the infection than children – although why that is remains unclear. An Australian study found that, after a school outbreak of 18 positive corona cases – nine teachers and nine children – was discovered, the virus was passed on to just two further people outside this group, both children, despite close contact with 863 others, who were all tested. 

In an outbreak in Ireland, despite three children and three teachers testing positive, and coming into close contact with more than 1,000 others between them, the only further cases involved teachers passing it on outside school. In the UK, the latest Public Health England data, based on one million children – mostly primary age who returned to schools in June – identified 30 ‘outbreaks’ of at least two cases.

Eight of these outbreaks involved children – mainly from key worker families, who picked up the infection at home – passing it on to other children, or adults at school. But there were no cases of either children or school staff then infecting a family member.

Despite this, because most schools have been closed, or open to a very limited number of students, all experts agree there is lack of evidence about what will happen next.

Dr Alasdair Munro, an expert in paediatric infectious disease at University Hospital Southampton NHS Foundation Trust, who has been reviewing the evidence on the transmission of Covid-19 by children, acknowledges: ‘The risk [of reopening] is primarily of increasing community transmission by teachers spreading infection to each other, parents, grandparents etc, who will, in turn, spread it on.

‘Children seem less likely to transmit than adults, but they certainly can transmit.’

It is known from other studies that households – by their very nature, a confined space that a number of people share – are the most common place to become infected.

Yang Yang, a biostatistician at the University of Florida’s College of Public Health, is currently involved in a study based on 20,000 households. He says his early results do show children infect adults living in the same home.

Age appears to be a significant factor – with teens possibly posing a greater risk than younger kids.

One big South Korean study found children under ten were half as infectious as those aged ten to 19. And at a French school in a badly affected area, just one child under 15 tested positive for the virus, compared with 40 per cent of teachers and older pupils.

It has also been reported that a secondary school in Israel traced a large outbreak involving 153 pupils and 25 teachers back to two infected students. Its health ministry says the rising number of infections among students is the ‘primary factor’ in the country’s recent spike in cases. But the incident does seem to be unusual.

It is not clear why teens pose a greater risk, as they’re no more likely to become unwell with Covid-19.

However, Dr Griffin points out they also develop more ACE2 receptors – the immune cells that the new coronavirus binds to, causing infection, like a key in a lock – around this time as part of normal development. This all suggests that it is secondary schools, not primary schools, which may be the biggest risk for transmission.

Dr Munro said: ‘These are small numbers, but there are early lessons from them.’

The biggest sign yet that the Government agrees that there is at least the potential for teenagers to transmit the virus comes from its controversial U-turn this week to introduce face masks in secondary schools.

From next week, pupils in Year Seven (ages 11 and 12) and above will have to wear masks in crowded common areas, such as corridors, where social distancing is difficult, but not in classrooms.

Masks will only be compulsory in classrooms in areas which are in local lockdown – elsewhere, it’ll be up to the headmaster.

And on Friday night, Public Health England issued new guidance advising secondary schools in areas with significant rises in cases to adopt a rota system that limits the number of children at school.

The edict on masks is based on advice from the World Health Organisation, which also recommends children aged 12 and over (like adults) should wear masks in any situation where they cannot stay one metre away from others, such as on trains and in shops.

But there is no specific scientific evidence that masks can prevent the virus spreading in schools.

Experts do, however, point to the fact that masks can prevent the spread of flu among children.

Dr David Strain, clinical senior lecturer at the University of Exeter, said: ‘In the absence of clarity, given the known detrimental impact of school closures, we must err on the side of caution in order to ensure that when schools re-open they remain open.’

Despite these measures, Paul Hunter, Professor of Medicine at the University of East Anglia, warns: ‘Once schools return, and if the general incidence in the UK increases, we are likely to see many more school-based outbreaks, with considerable disruption this autumn.’

Dr Griffin argues that all these theories will be stress-tested from next week onward.

‘Over lockdown, when only essential key worker children were back, staff numbers were reduced and they were taking appropriate precautions,’ he says. ‘Next week you’ll have teachers, staff, and parents coming to the gate. The spread might not be as rampant as flu, but I’d be surprised if it didn’t just run through the school population as we’ve seen in Scotland.’

So what can be done to protect the most vulnerable?

Astonishingly, despite insisting that children rarely transmit the virus, the joint Chief Medical Officer’s statement this week put the responsibility for stopping school and community outbreaks… on children.

They said youngsters ‘should be engaged in the process of establishing Covid-19-secure measures – to help protect their wider families, teachers and other school staff.’ There was little more specific forthcoming.

For Dr Griffin and his family, there is anxiety. He feels a trade- off has been made, which feels ‘upsetting’. ‘We’ll wash the kids when they come home and wash their clothes.’

There’s limited evidence that mask-wearing in households where someone is infected could reduce the risk of further spread.

Otherwise, the best measures are those which everyone has been taking since the start of the pandemic, Dr Griffin suggests: isolating infected cases, cleaning surfaces regularly, washing hands and ventilating the house.

If you have any symptoms, don’t hug that vulnerable relative. But, of course, the million dollar question is, what if no one has any symptoms – is hugging the grandkids allowed then?

When asked what to do by a family with two ten-year-olds who had been ‘shielding to keep Granny safe’, Dr Munro said it was ‘very difficult’ and a ‘cost benefit decision like all things in life’.

‘Children certainly do not present zero risk – just likely a lower risk than another adult might,’ he wrote. ‘These types of decisions should be based on individual risk in context of local rates of community transmission, not easy.’

He added: ‘Constant shouting from unions about ‘when it’s safe’ have not helped.

‘It’s never ‘safe’. We must decide when the relative unsafety of doing something is worse than the relative unsafety of not doing it.’

And of course, no amount of government guidance will ever be able to tell you that.

Covid Q&A: When can football fans return? And is Trump right about plasma?

When can I go to a football match again?

The Government is due to make an announcement in the first week of October regarding public attendance of spectator sports, including football.

It is expected that officials will increase the number of people permitted to attend sporting events following this announcement – but it is not guaranteed.

Premier League football continues behind closed doors. Fans are, however, allowed to attend football matches in the seventh tier of the game and below, which usually attract fewer than 100 visitors. Fans are urged not to chant or shout for fear of spreading the virus.

Yesterday, as part of Government-approved trials to assess the safety of matches, Brighton & Hove Albion allowed 2,500 season-ticket holders to watch a pre-season friendly against Chelsea at their Amex Stadium. Fans had to wear masks when not at their seats and stewards carried out random temperature checks.

Can blood plasma, donated from Covid survivors help those struck down with the virus? I heard Donald Trump touting the benefits of this. 

Last week President Trump green-lighted the emergency approval of blood plasma extracted from Covid survivors, or convalescent plasma, as a treatment for Covid-19, in the US.

According to a top doctor at the US Food and Drug Administration, Stephen Hahn, the treatment could be lifesaving. The plasma of people who’ve suffered Covid-19 contains antibodies that could help those who are currently ill. But we don’t know how effective it is for saving the most seriously ill.

The largest study, conducted by US researchers involving 35,000 patients, found that a transfusion of convalescent plasma given early on in the illness reduced the risk of dying – providing the plasma was very high in antibodies. However, experts have criticised the quality of the study, and it’s possible other factors may be behind the effect – such as other medication or the reduced potency of the virus over time. But research into the effect of plasma on other infections suggests there may be something in it – and two trials in the UK are currently under way.

According to the available evidence, Dr Stephen Griffin, virologist at the University of Leeds, says plasma with high numbers of antibodies seems to reduce the risk of death in severely ill Covid patients by roughly 3.5 per cent.

Will I have to go under quarantine if I visit an area in the UK that’s under local lockdown restrictions? 

Last week, the Government added yet more nations to the list of quarantine countries. Those who travel to the UK from these countries must stay home for 14 days.

Paul Charles, a travel consultant and chief executive at a travel PR firm – notes that nations with an infection rate of at least 20 per 100,000 for a period of seven days or more will likely be added to the quarantine list. But Britain’s Covid-19 hotspots, such as Oldham, for instance, have an infection rate of more than double this – and no quarantine rules are in place for those returning from these areas.

Why? ‘In most of these UK areas, such as Greater Manchester and West Yorkshire, meeting people indoors is not permitted, so few people are travelling there anyway,’ says Professor Keith Neal, Emeritus Professor of the Epidemiology of Infectious Diseases, University of Nottingham.

‘Those that do will be low risk because they will be permitted to only socialise outdoors, where risk of transmission is low.’ Prof Neal adds that local quarantines would be ‘unfeasible’.