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I have seen some repeated assertions about the evidence on #COVID19, children and schools recently which sound convincing, but unfortunately are false
It is a sensitive and important topic, which is important to get right
Shall we bust some myths?
Let's go!
1/10
It is a sensitive and important topic, which is important to get right
Shall we bust some myths?
Let's go!
1/10
Myth 1. Evidence suggesting limited transmission within schools is based on flawed evidence as only children with symptoms were tested 
There are many studies drawn on symptom based testing, there are MANY which are not, and all find the same thing
Here's just a few...
2/10
There are many studies drawn on symptom based testing, there are MANY which are not, and all find the same thing
Here's just a few...
2/10
Australia
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30251-0/fulltext
Norway
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.26.1.2002011
Italy
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.49.2001911
Hong Kong
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.37.2001671?crawler=true
Germany
https://www.medrxiv.org/content/10.1101/2021.01.27.21250517v1
Switzerland
https://www.medrxiv.org/content/10.1101/2020.12.19.20248513v1.full.pdf
3/10
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30251-0/fulltext
Norway
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.26.1.2002011
Italy
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.49.2001911
Hong Kong
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.37.2001671?crawler=true
Germany
https://www.medrxiv.org/content/10.1101/2021.01.27.21250517v1
Switzerland
https://www.medrxiv.org/content/10.1101/2020.12.19.20248513v1.full.pdf
3/10
Myth 2. Long COVID affects 13% of infected children
This is based on an incorrect interpretation of some ONS based data on symptoms in children, with NO control group
For why this is a *major issue*, read this excellent article
https://www.bmj.com/content/372/bmj.n157/rr
4/10
This is based on an incorrect interpretation of some ONS based data on symptoms in children, with NO control group
For why this is a *major issue*, read this excellent article
https://www.bmj.com/content/372/bmj.n157/rr
4/10
We certainly need more data on long covid in children (studies are underway), but given infection in children is predominantly mild or asymptomatic, prolonged, severe symptoms are unlikely to be common
5/10
5/10
Myth 3. International modelling shows schools drive transmission, and are less biased
That was not the finding of this systematic review of these studies
6/10 https://twitter.com/apsmunro/status/1355939249334448130?s=20
That was not the finding of this systematic review of these studies
6/10 https://twitter.com/apsmunro/status/1355939249334448130?s=20
Nor was it the finding of this modelling study from the US which determined children played a relatively minor role and young adults were the driving factor (which is what has been observed internationally)
5/10 https://twitter.com/apsmunro/status/1357359671447805953?s=20
5/10 https://twitter.com/apsmunro/status/1357359671447805953?s=20
Models have their uses, but are subject to the limitations of the data and assumptions put into them
Modelling of school closures relies heavily on data from Spring 2020, when accompanied by near simultaneous implementation of other interventions. This bias is baked in.
6/10
Modelling of school closures relies heavily on data from Spring 2020, when accompanied by near simultaneous implementation of other interventions. This bias is baked in.
6/10
Myth 4. Primary schools play just as important a role in transmission as secondary
I've heard people quote the number of outbreaks being the same from PHE data as evidence
Not untrue, but ignores the fact there are nearly FIVE TIMES MORE primary than secondary schools
7/10
I've heard people quote the number of outbreaks being the same from PHE data as evidence
Not untrue, but ignores the fact there are nearly FIVE TIMES MORE primary than secondary schools
7/10
Not only this, but data from a survey from the first half term in autumn showed the *majority* of cases in primary school outbreaks were in staff, not children
Also, random, in school sampling by ONS found lower prevalence in primary than secondary schools
8/10
Also, random, in school sampling by ONS found lower prevalence in primary than secondary schools
8/10
Does this mean transmission doesn't happen in schools? No
Does it mean we can open schools willy nilly? No
Does it mean the consensus of the EU and US CDC that transmission within schools is relatively low and not the driving factor in community transmission is sound? Yes
9/10
Does it mean we can open schools willy nilly? No
Does it mean the consensus of the EU and US CDC that transmission within schools is relatively low and not the driving factor in community transmission is sound? Yes
9/10
For the excellent review document from @ECDC_EU see link
https://www.ecdc.europa.eu/en/publications-data/children-and-school-settings-covid-19-transmission
And from @CDCgov see link
https://jamanetwork.com/journals/jama/fullarticle/2775875
Myths busted!
10/10
https://www.ecdc.europa.eu/en/publications-data/children-and-school-settings-covid-19-transmission
And from @CDCgov see link
https://jamanetwork.com/journals/jama/fullarticle/2775875
Myths busted!
10/10
