Thursday, January 20

The case of the 12 children infected with covid by their teacher: lessons for going back to school | Science


The explosive delta variant of the coronavirus, first detected in India nine months ago and already prevalent on the planet, has transformed the war against the pandemic. The enemy has changed. The delta is almost twice as contagious than previous versions of the virus, as illustrated the best analyzed school shoot to date: the one that occurred in the Catholic school Our Lady of Loreto, in Novato (California, United States). There, on May 19, an unvaccinated teacher with symptoms of covid continued teaching, even removing her mask from time to time to read aloud. In just one week, half of his 24 students had tested positive, even though the windows were open, the children did wear masks and there was an air purifier in the classroom. Delta leaves no room for mistakes.

The epidemiologist Tracy Lam-Hine, main author of the study of the outbreak in the Nuestra Señora de Loreto, believes that the case is a wake-up call, now that in many countries they are starting to go back to school after the holidays. “The most important lesson is that we cannot rely on just one layer of protection or even two. We have to use all prevention strategies at the same time ”, emphasizes the researcher, from the county Health Department.

The Spanish Association of Pediatrics has had to reinforce your own recommendations for going back to school in the face of “the irruption” of the delta variant, whose viral load in those infected is up to 1,000 times greater than previous versions of the virus, according to a preliminary study in China. If a covid patient infected two or three people on average at the beginning of the pandemic, can now infect five, more than the flu. Spanish pediatricians have asked to keep the mandatory mask for children over six years of age, even in outdoor recess.

The fear is that the little ones will become a reservoir for the virus. 93% of those over 40 in Spain are already vaccinated, but only 55% of children older than 12 years have received the full guideline, how do you remember Maria Jose Mellado, Head of Pediatrics at Hospital La Paz, in Madrid. There are still no authorized injections for those under 12 years of age, so none are vaccinated. “It is evident that, currently, the population most susceptible to becoming infected are children under 12 years of age and those older who have not yet completed the vaccination schedule,” warns Mellado, president until last June of the Spanish Association of Pediatrics.

The cumulative incidence at 14 days in adolescents is still soaring, with 193 cases per 100,000, more than double that of the sixties. However, coronavirus infection is usually asymptomatic or very mild in the very young. The data is relatively reassuring. Since June 20 there have been almost 315,000 cases in those under 19 years of age in Spain, with 1,900 hospitalized (0.6%), 91 admitted to the ICU (0.03%) and seven deaths (0.002%), according to the National Epidemiology Center. Covid can strike healthy children, but above all it is a risk for those with previous illnesses and for unvaccinated adult relatives.

The Spanish Association of Pediatrics has regretted the decision of the Ministries of Health and Education to reduce the minimum distance between students from 1.5 meters to 1.2 meters, “which will lead to more children per class.” At the Nuestra Señora de Loreto school, distance was key. The teacher mainly infected the children closest to her, as shown by the exhaustive analysis of the outbreak, published in the web from the US Centers for Disease Control and Prevention.

The pediatric Quique Bassat insists that it is still necessary to maintain these precautions in schools. “The worst thing that could happen to us is having a super contagious event like the ones in June in the Balearic Islands [con cientos de jóvenes infectados en viajes de fin de curso]. If we maintain strict measures until we have a much lower incidence, we will minimize this risk and, instead of waves, at most we will have self-limited outbreaks ”, says Bassat, pediatrician at the Barcelona Institute of Global Health and coordinator of the team of the Spanish Association of Pediatrics that has advised the Government for the return to schools.

Bassat calls on all school workers to get vaccinated as soon as possible if they have not already done so. The percentage of vaccinated teachers in Spain is very high, as suggested by the data from the communities that have given figures to this newspaper (95% in Extremadura, 94% in Aragon and 92% in Catalonia), but there are still thousands of teachers without immunization , like the teacher of Our Lady of Loreto.

The pediatrician believes that, to relax the measures, the cumulative incidence at 14 days should be less than 25 cases per 100,000 inhabitants, without notable outbreaks. Currently the incidence reaches 131 cases per 100,000, with sprouts everywhere. Bassat would begin by eliminating rules such as staggered entry into classrooms, shifts in the dining room, “obsessive hand hygiene with gel” and the prohibition of parents from accessing schools. However, he would keep the mask indoors until vaccination coverage was even higher and the cumulative incidence was “very very low, certainly less than 25 cases per 100,000.”

Bassat has two nine-year-old twins. “I will vaccinate them in the first moment that I can,” he says. The data show that Pfizer’s vaccine, the first licensed in the youngest, is very effective in those over 12 years of age in preventing serious cases. Covid hospitalization rates they are 10 times bigger among unvaccinated teens, according to the latest report from the US Centers for Disease Control and Prevention.

Pfizer is now testing its vaccine with 4,500 children between six months and 11 years – in Spain, the US, Finland and Poland – and in the coming weeks it plans to request authorization for its use. Other companies, how modern and AstraZenecaThey are also testing the effectiveness of their injections in minors. Some mathematical models calculate that group immunity to the delta variant will arrive when 85% of citizens are vaccinated, but children and adolescents under 15 years of age make up more than 25% of the world’s population. Vaccinating them could be essential to ending the pandemic.

* Investigators in the case do not detail the sex of the person who started the outbreak for privacy reasons, but the media national and locales in the US they have reported that she was a teacher.

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