Closing schools is not evidence based and harms children.
About: This article is published in BMJ.The article was published on 2021-02-23 and is currently open access. It has received 32 citations till now.
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29 citations
TL;DR: In this paper, the authors investigated whether pooling of samples for SARS-CoV-2 detection by RT-qPCR is a sensitive and feasible high-capacity diagnostic strategy for surveillance in schools.
20 citations
TL;DR: In this paper, it is argued that the harms from containment measures should be factored in a broader perspective on the good of the child, and a prudent and ethical scheme for gradual incorporation of minors in vaccination programs that includes a rigorous postvaccination monitoring.
Abstract: Nearly 400 million adults have been vaccinated against COVID-19. Children have been excluded from the vaccination programmes owing to their lower vulnerability to COVID-19 and to the special protections that apply to children's exposure to new biological products. WHO guidelines and national laws focus on medical safety in the process of vaccine approval, and on national security in the process of emergency authorisation. Because children suffer much from social distancing, it is argued that the harms from containment measures should be factored in a broader perspective on the good of the child. Considering the available knowledge on the disease, vaccine, and coping strategies, the decision about vaccine access to children is a public responsibility. The ultimate choice is a matter of paediatric informed consent. Moreover, jurisdictions that permit non-participation in established childhood vaccination programmes should also permit choice of vaccines outside of the approved programmes. Even if vaccine supply is too short to cover the paediatric population, the a priori exclusion of children is unjust. It may also exacerbate local and global inequalities. The second part of the paper delineates a prudent and ethical scheme for gradual incorporation of minors in vaccination programmes that includes a rigorous postvaccination monitoring. This is a theoretical paper in ethics that uses the Pfizer vaccine as a stock example, without discussing possible differences among existing vaccines. The key purpose is reflection on the good of the child in emergencies and vaccine policymaking.
16 citations
TL;DR: In this article, the authors investigated the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a vulnerable population of children and their household contacts.
Abstract: Objectives: To investigate the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a vulnerable population of children and their household contacts.
Methods: SARS-CoV-2 reverse transcription polymerase chain reaction assays and coronavirus disease 2019 (COVID-19) immunoglobulin G serology tests were performed in children and their household contacts after enrollment during primary health care clinic visits. Participants were followed prospectively with subsequent specimens collected through household visits in Manguinhos, an impoverished urban slum (a favela) in Rio de Janeiro at 1, 2, and 4 weeks and quarterly post study enrollment.
Results: Six hundred sixty-seven participants from 259 households were enrolled from May to September 2020. This included 323 children (0-13 years), 54 adolescents (14-19 years), and 290 adults. Forty-five (13.9%) children had positive test results for SARS-CoV-2 polymerase chain reaction. SARS-CoV-2 infection was most frequent in children aged <1 year (25%) and children aged 11 to 13 years (21%). No child had severe COVID-19 symptoms. Asymptomatic infection was more prevalent in children aged <14 years than in those aged ≥14 years (74.3% and 51.1%, respectively). All children (n = 45) diagnosed with SARS-CoV-2 infection had an adult contact with evidence of recent infection.
Conclusions: In our setting, children do not seem to be the source of SARS-CoV-2 infection and most frequently acquire the virus from adults. Our findings suggest that, in settings such as ours, schools and child care potentially may be reopened safely if adequate COVID-19 mitigation measures are in place and staff are appropriately immunized.
15 citations
TL;DR: In this paper, a qualitative study aimed to reflect on the experience of primary school staff (pupils aged 3-11) in Wales regarding school closures and the initial reopening of schools and to identify recommendations for the future.
Abstract: School closures due to the COVID-19 global pandemic are likely to have a range of negative consequences spanning the domains of child development, education and health, in addition to the widening of inequalities and inequities. Research is required to improve understanding of the impact of school closures on the education, health and wellbeing of pupils and school staff, the challenges posed during reopening and importantly to identify how countries can ensure a safe return to education and to inform policy. This qualitative study aimed to reflect on the experience of primary school staff (pupils aged 3-11) in Wales regarding school closures and the initial reopening of schools and to identify recommendations for the future. A total of 208 school staff completed a national online survey through the HAPPEN primary school network, consisting of questions about school closures, the phased reopening of schools and a return to full-time education. Thematic analysis of survey responses identified five recommendations; (i) prioritise the health and wellbeing of pupils and staff. This includes more focus on wellbeing activities and less focus on attainment/assessments and protecting staff breaks to promote workplace wellbeing; (ii) focus on enabling parental engagement and support. Introduce support sessions for parents and include regular check ins during periods of home learning; (iii) improve digital competence amongst pupils, teachers and parents. Ensure the provision of equipment and training in building digital skills. Offer a combination of paper-based and digital home learning activities; (iv) consider opportunities for smaller class sizes and additional staffing. Ensure support is directed to need whilst providing pastoral care; and (v) improve the mechanism of communication between schools and families, and between government and schools. Ensure that schools receive advance notice of local or national changes in guidance.
13 citations
References
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1,840 citations
TL;DR: The results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus, and a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools is proposed.
Abstract: Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, Rt, of COVID-19. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Using country-specific ‘what-if’ scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions. Analysing over 50,000 government interventions in more than 200 countries, Haug et al. find that combinations of softer measures, such as risk communication or those increasing healthcare capacity, can be almost as effective as disruptive lockdowns.
927 citations
TL;DR: A review of 39 studies indicated that achievement test scores decline over summer vacation as discussed by the authors, and the effect of summer break was more detrimental for math than for reading and most detrimental for computation and spelling.
Abstract: A review of 39 studies indicated that achievement test scores decline over summer vacation. The results of the 13 most recent studies were combined using meta-analytic procedures. The meta-analysis indicated that the summer loss equaled about one month on a grade-level equivalent scale, or one tenth of a standard deviation relative to spring test scores. The effect of summer break was more detrimental for math than for reading and most detrimental for math computation and spelling. Also, middle-class students appeared to gain on grade-level equivalent reading recognition tests over summer while lower-class students lost on them. There were no moderating effects for student gender or race, but the negative effect of summer did increase with increases in students’ grade levels. Suggested explanations for the findings include the differential availability of opportunities to practice different academic material over summer (with reading practice more available than math practice) and differences in the mater...
906 citations
TL;DR: SARS-CoV-2 transmission rates were low in NSW educational settings during the first COVID-19 epidemic wave, consistent with mild infrequent disease in the 1·8 million child population.
318 citations
TL;DR: Consistent evidence is found that remaining in school causally reduced the risk of diabetes and mortality in all specifications, using a large dataset from the UK Biobank.
Abstract: Educated people are generally healthier, have fewer comorbidities and live longer than people with less education1–3. Much of the evidence about the effects of education comes from observational studies, which can be affected by residual confounding. Natural experiments, such as laws that increase the minimum school leaving age, are a potentially more robust source of evidence about the causal effects of education. Previous studies have exploited this natural experiment using population-level administrative data to investigate mortality, and surveys to investigate the effect on morbidity1, 2,4. Here, we add to the evidence using data from a large sample from the UK Biobank
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. We exploit the raising of the minimum school leaving age in the UK in September 1972 as a natural experiment
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. We used a regression discontinuity design to investigate the causal effects of remaining in school. We found consistent evidence that remaining in school causally reduced the risk of diabetes and mortality in all specifications. The authors exploit a 1972 policy that increased the minimum school leaving age to investigate the causal effects of staying in school on health. Using a large dataset, they find that remaining in school reduces the risk of diabetes and mortality.
175 citations