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A letter from myself, @mugecevik and @AshaBowen about #COVID19 in children and #schoolsreopening in reply to an opinion piece in @theMJA
We've been following the literature since the beginning
Careful and weighted review is vital to inform policy
https://osf.io/49q5a/
1/8
We've been following the literature since the beginning
Careful and weighted review is vital to inform policy
https://osf.io/49q5a/
1/8
School closures were one of the first non-pharmaceutical closures around the world, leaving 1.6bil children out of education
https://en.unesco.org/covid19/educationresponse/consequences
Their reopening has been the source of intense debate
To suggest they are overlooked is erroneous
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https://en.unesco.org/covid19/educationresponse/consequences
Their reopening has been the source of intense debate
To suggest they are overlooked is erroneous
2/8
Interpreting the evidence means not bundling "children" together as one group
There is a clear difference between young children (<10y) as compare to older adolescents/young adults in regards to susceptibility and transmission
https://www.medrxiv.org/content/10.1101/2020.07.19.20157362v2
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There is a clear difference between young children (<10y) as compare to older adolescents/young adults in regards to susceptibility and transmission
https://www.medrxiv.org/content/10.1101/2020.07.19.20157362v2
3/8
Despite claims that school closures made past evidence unreliable, the main source of the evidence is household contact tracing studies which are unaffected by school closure
If anything it would increase SAR for children by increasing exposure
https://www.medrxiv.org/content/10.1101/2020.07.29.20164590v1
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If anything it would increase SAR for children by increasing exposure
https://www.medrxiv.org/content/10.1101/2020.07.29.20164590v1
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Opinions voiced in the original letter were supported by highly selective reporting of evidence, and do not represent the international consensus on this topic
https://www.ecdc.europa.eu/en/publications-data/children-and-school-settings-covid-19-transmission#:~:text=Investigations%20of%20cases%20identified%20in,in%20preschools%20and%20primary%20schools.
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https://www.ecdc.europa.eu/en/publications-data/children-and-school-settings-covid-19-transmission#:~:text=Investigations%20of%20cases%20identified%20in,in%20preschools%20and%20primary%20schools.
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Many peoples prior beliefs on childrens role in transmission are predicated on influenza
The clinical phenotype of COVID-19 in adults compared to children is completely different than flu
Their reduced role in transmission however was observed for both SARS and MERS
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The clinical phenotype of COVID-19 in adults compared to children is completely different than flu
Their reduced role in transmission however was observed for both SARS and MERS
6/8
Highlighting risks to children from the disease is misleading. In England only 4 children <15yrs died of COVID-19 despite >600,000 being infected
We see 15 - 20 deaths from flu annually for comparison
Harms of lack of education are far greater
https://adc.bmj.com/content/early/2020/07/28/archdischild-2020-320042
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We see 15 - 20 deaths from flu annually for comparison
Harms of lack of education are far greater
https://adc.bmj.com/content/early/2020/07/28/archdischild-2020-320042
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Discussion about schooling is complex and requires nuance, balance, and fair representation of the evidence
Importantly it must consider more than epidemiology
Public health, equality, wellbeing and social concerns must be addressed
https://osf.io/49q5a/
8/8
Importantly it must consider more than epidemiology
Public health, equality, wellbeing and social concerns must be addressed
https://osf.io/49q5a/
8/8
