
Covid-19 in schoolchildren – A comparison between Finland and Sweden [pdf] - mrfusion
https://www.folkhalsomyndigheten.se/contentassets/c1b78bffbfde4a7899eb0d8ffdb57b09/covid-19-school-aged-children.pdf
======
salmon30salmon
Here is a big problem. The children need to go somewhere. Parents need to
work, bills need to be paid and tax incomes need to continue to flow. So what
to do with the kids?

Right now, the options are either send them to school, where there are (in the
US) government employees making sure they are safe. The workers are well
represented by a strong union, have good healthcare and reasonable wages. The
other option is to send them to private day care, where private citizens with
no oversight, very low pay and no worker protections are being asked to
shoulder the risk. It seems like we have no problem hoisting even more
responsibility upon the poor and least represented in society.

Teaches are essential workers, much like firefighters, DMV workers or court
clerks. We expect a girl making minimum wage at Kroger to accept that she is
an essential worker. Why do we not expect the same from school staff?

Disclosure: I have siblings and other close relatives that work for and in
school in the US. I am not externalizing the risk.

~~~
bpodgursky
The teachers don't expect the same, because they are still getting paid.

I'm not saying they don't have legitimate questions about how schools will
reopen safely, but to be frank, it's really easy to argue that it's "just not
safe enough", when you're still pulling a paycheck sitting at home and the
closing of schools is felt by working parents who are SOL -- not by yourself.

~~~
cheez
Ding ding ding.

I heard of teachers outright disappearing, claiming "technical issues" during
this time.

~~~
rurban
In my city all sports teachers were suddenly ill for several weeks. they had
the lowest risk, but apparently also the smallest brains.

~~~
cheez
Lol. Nice work if you can get it

------
all_blue_chucks
Case counts in children is irrelevant. For an infection to become a case it
has to be diagnosed, and that typically only happens with symptoms. But we
know young people rarely have symptoms, so obviously they rarely count as
cases.

INFECTIONS, however, matter a LOT. If you're infected you can pass a virus on
without ever being counted as a "case." And we have zero reason to think
children can't be infected. Hell, tigers and mink can be infected. Of course
children can be infected. This thing is crazy infectious.

Children will spread the infection to their teachers, school staff, and
families. There is no question about that, regardless of whether children's
infections count as "cases."

~~~
dragonwriter
> But we know young people rarely have symptoms

And we know that, while presymptomatic spread is an issue, _asymptomatic_
spread is between rare and nonexistent.

The fact that children tend not to be diagnosed because they tend much more
strongly than adults to be asymptomatic when infected is _not_ irrelevant to
their propensity to spread the disease.

~~~
enraged_camel
>>And we know that, while presymptomatic spread is an issue, asymptomatic
spread is between rare and nonexistent.

Our knowledge is not that precise yet.

What we do know, based on models, is that "silent" transmission accounts for
about 50% of covid-19 infections.

[https://abcnews.go.com/Health/asymptomatic-presymptomatic-
pe...](https://abcnews.go.com/Health/asymptomatic-presymptomatic-people-
transmit-covid-19-infections-study/story?id=71647268)

~~~
salmon30salmon
We don't know this. We would need full contact tracing and much faster testing
to know this. Plus, we now know antibodies may _not_ be the biggest
contributor to the immune response. It seems T-Cells are in some cases able to
fight the disease without ever mounting an antibody response Thus no
antibodies.

But the ol' maxim applies here: absence of evidence is not evidence of absence

~~~
notacoward
> absence of evidence is not evidence of absence

That applies to infection/transmission via schools _in general_. Precisely
because we don't have decent testing and tracing, we have a large number of
cases whose origin is unknown. Schools have to be considered as one
possibility, especially considering the several cases where reopening schools
_has_ been strongly correlated with spikes in infections. The precise
mechanism doesn't matter. It's a red herring. Whether it's kid to kid, parent
to teacher, cafeteria workers, whatever, it seems to happen some of the time.
Until we've _clearly ruled out_ a cause for those unknowns, we have to
consider it still operative.

------
pugworthy
The second bullet point of the conclusion states...

| Children are not a major risk group of the covid-19 disease and seem to play
a less important role from the transmission point of view, although more
active surveillance and special studies such as school and household
transmission studies are warranted.

I feel like that is probably the next most important question to answer.

~~~
vvanders
Or we could take a look at Israel where they opened up schools and saw a
significant spike[1].

[1] [https://www.npr.org/sections/coronavirus-live-
updates/2020/0...](https://www.npr.org/sections/coronavirus-live-
updates/2020/06/03/868507524/israel-orders-schools-to-close-when-
covid-19-cases-are-discovered)

~~~
BadCookie
Or South Africa where they tried to open up schools for only two grades (7th
and 12th).

"Since the first phase of the schools reopening last month, 968 schools have
had to close due to outbreaks and 2,400 teachers and 1,260 learners have
tested positive for COVID-19."

Source: [https://medicalxpress.com/news/2020-07-south-africa-phase-
re...](https://medicalxpress.com/news/2020-07-south-africa-phase-reopening-
schools.html)

Or the Georgia summer camp that had an outbreak involving 85 campers and
staff:

[https://www.wftv.com/news/trending/85-campers-staff-test-
pos...](https://www.wftv.com/news/trending/85-campers-staff-test-positive-
covid-19-ymca-summer-camp/OPSPVDSXRFCLZOD7SEMLCYN2OA/)

Or the Missouri summer camp that had an outbreak involving 82 kids and staff:

[https://www.foxnews.com/us/missouri-summer-camp-closes-
after...](https://www.foxnews.com/us/missouri-summer-camp-closes-
after-82-kids-staffers-infected-with-coronavirus-reports)

A lot of this is anecdotal, sure, but I find it hard to believe that kids
don't spread the virus if we're seeing large outbreaks like these already.

~~~
BadCookie
If you want an example involving younger kids, there was recently an outbreak
involving 12 staff and 8 kids at an Oregon daycare that serves kids ages 6 and
under [1].

It might be impossible to know whether the adults infected the kids or vice
versa (or both), but Coronavirus cases are growing fastest among kids younger
than 10 in Oregon right now [2], so ... to me, it makes sense to assume that
kids can spread it until it's proven otherwise.

Lastly, for those who don't know, the CDC internally lists reopening schools
as the "highest risk" for Coronavirus spread. [3]

[1] [https://www.wweek.com/news/state/2020/06/30/oregon-child-
car...](https://www.wweek.com/news/state/2020/06/30/oregon-child-care-
facility-reports-covid-19-outbreak-among-first-in-nation/)

[2]
[https://www.oregonlive.com/coronavirus/2020/07/coronavirus-i...](https://www.oregonlive.com/coronavirus/2020/07/coronavirus-
infections-rising-fastest-among-kids-younger-than-10-dimming-prospects-for-
oregons-school-reopening-plans.html)

[3] [https://www.cnn.com/2020/07/11/politics/cdc-documents-
warn-h...](https://www.cnn.com/2020/07/11/politics/cdc-documents-warn-high-
risk-schools-reopening/index.html)

------
nkurz
If you haven't read it yet, this short report seems to conclude that for
reasons that are not yet well understood, children are not very likely to
contract the disease, and if they do contract it, are not that likely to
spread it to others. As a result, school closings (or the lack thereof) do not
seem to have a major effect on the spread of the disease. Pulling some key
quotes:

 _" Outbreak investigations in Finland has not shown children to be
contributing much in terms of transmission and in Sweden a report comparing
risk of covid-19 in different professions, showed no increased risk for
teachers."_

 _" In conclusion, closure or not of schools had no measurable direct impact
on the number of laboratory confirmed cases in school-aged children in Finland
or Sweden"_

 _" In the contact tracings in primary schools in Finland, there has been
hardly any evidence of children infecting other persons. The Swedish
comparison of number of reported cases among staff in day care and primary
school to number of cases in other professions does not show any increased
risk for teachers. This also indicates that the role of children in
propagating this infection is likely to be small. Various papers on contact
tracing have also found that children rarely are the first case in family
clusters (4, 12, 13)."_

 _" Closing of schools had no measurable effect on the number of cases of
covid- 19 among children."_

 _" Children are not a major risk group of the covid-19 disease and seem to
play a less important role from the transmission point of view, although more
active surveillance and special studies such as school and household
transmission studies are warranted."_

Intriguing.

This Mercury News article from a couple days ago tells the same general story,
and offers some theories on how things might work biologically:

 _Coronavirus: Why kids aren’t the germbags, and grownups are._

 _As school districts sweat over reopening plans, a growing body of research
suggests young children are unlikely to transmit COVID-19 virus. They get it
from us._

[https://www.mercurynews.com/2020/07/10/coronavirus-why-
kids-...](https://www.mercurynews.com/2020/07/10/coronavirus-why-kids-arent-
the-germbags-and-grownups-are/)

------
mnm1
I don't see any data for adult infections. That's what we're concerned about
mostly when opening schools. That the kids will infect the adults who will
infect each other. I can't believe they have the audacity to publish this
paper and its conclusions which clearly cannot be drawn from the data
presented. This is pure and utter garbage, garbage that will be used by idiots
to make policy decisions that will kill people unnecessarily. The paper should
be retracted and peer reviewers should rip it up. What idiocy.

------
nikolay
6% of infected people in Orange County, California are children 0-17 - this is
after many restrictions. Even if the percentage stays at 6% after schools
reopen, we're talking about a huge ripple effect on the whole population.
Unlike adults, kids really can't follow strict measures - America is no
Finland, no Sweden, no Asia!

------
tmellon
Can anyone comment if this document 'Covid-19 in school children - A
comparison between Sweden & Finland' is an official report ? I'm unable to
find it by browsing or searching for it on the website.

~~~
TravelPiglet
[https://www.folkhalsomyndigheten.se/publicerat-
material/publ...](https://www.folkhalsomyndigheten.se/publicerat-
material/publikationsarkiv/c/covid-19-hos-forskole-och-skolbarn/)

It can be found at [https://www.folkhalsomyndigheten.se/smittskydd-
beredskap/utb...](https://www.folkhalsomyndigheten.se/smittskydd-
beredskap/utbrott/aktuella-utbrott/covid-19/statistik-och-analyser/analys-och-
prognoser/)

------
jonahbenton
Frustratingly unhelpful paper, for those looking for useful, applicable
measures and measurements.

No details around:

* distancing measures * space utilization * travel arrangements * coplay arrangements

~~~
SpicyLemonZest
The reason the comparison is interesting is that Sweden didn't really
implement such measures. Schools there have been operating pretty much as
normal.

~~~
jonahbenton
I understand and appreciate the Swedish strategy...and its failings for its
adult population. With respect to what may be claimed "success" in its
juvenile population, because of potential applicability (or not) to other
communities, details of "normal" are essential. Those are entirely absent from
this report.

More directly- as a parent in NYC, I am unhappily looking forward to people
citing this unhelpful paper and "the Swedish model" claiming return to school
will be safe. No and no is what I say to them.

Cheers.

