COVID-19 Special Report

The Infectivity of Students, Not What We Thought

For better or for worse, most public schools around the world have resumed some manner of in-person education. The decisions were made months ago, when the world was seeing the tail end of the first waves of COVID-19, and multiple studies reported lower than expected transmission of the virus among children. At the time, after months of lockdowns and chorus of upset educators and parents, it seemed to be the logical choice.

Why then have school reopenings coincided with the greatest COVID-19 outbreaks in months?

Legislators and the scientific community have largely responded with a shrug, choosing to blame poor social distancing, not wearing masks or some other fault of the public. After all, the data was apparently robust: students were reported time and time again to be at a lower risk of contracting and transmitting COVID. However, it turns out that the science, when mixed with the real world, suddenly became much more complex than reported.

In general, it is not untrue to say that younger students generally have a lower rate of infection and transmission than adults from a comparable socioeconomic, racial, and geographic background. The multiple caveats and the double negative of that sentence should, however, begin to illustrate the degree of complexity and nuance surrounding that conclusion.
Most of the studies, along with numerous systematic reviews which synthesized the conclusion of multiple studies, observed that the infection rate was approximately half of comparable adults. This was broadly interpreted as meaning that students were half as likely to contract COVID and pass it on, meaning that the risk of reopening schools wouldn’t necessarily correspond to a relatively risk of infection and transmission. It was facts like these, among many other pressures, that motivated the legislative backroom deals that finally reopened brick and mortar schools, despite the fact that the pandemic was yet to be wrestled into controlled.

“We are just following the data” – remarked a now infamous legislator, prior to opening up their state’s school.

The unfortunate reality was that this is a classic example of science being stretched beyond the context for which it was intended. Any student of the Sciences will attest that there are multiple levels of evidence necessary before a scientific conclusion can be taken from the lab to the bedside. We’re seeing a classic example of this during the development of the purported COVID-19 vaccine. The multiple safeguards and the progressively larger trials maintain the standard of scientific evidence necessary to take a conclusion and apply it to a population.

The conclusions about the infectivity of students were largely obtained from epidemiological data collected haphazardly by public health organizations or theoretical models extrapolating from them. When studies reported that students tended to have a lower number of infections, it was because the reported data observed a lower prevalence of younger people within the cases of reported COVID-19. No study measured the true or objective infectious rate because this would entail the horrifying prospect of infecting people as mad scientists would do for lab rats. Many studies acknowledged this unfortunate reality, and with due scientific modesty understated their conclusions.

The difficulty arose when these conclusions became sensationalized and interpreted beyond their context. For one, even assuming a best case scenario of a moderate infectious rate among students, it does not mean that the infectious rate is zero, meaning that crowding students together will inevitably lead to a rise in cases. The real concern however, is that because the disease tends to be less than severe in younger people, possibly even being asymptomatic, the true rate of infection among students may be grossly underestimated. It is now increasingly apparent that the rate of infection may have been masked by the severity of the disease.

This alarming conclusion has been affirmed by recent testing data. In general, children and young adults are far less likely to have been tested for COVID-19. It is therefore unreasonable, perhaps even unethical to continue propagating known misinformation about the apparently low rate of infection. The short answer is we just do not know if children are any more or less likely to contract and spread COVID-19 than an adult. It is very likely that the symptoms they demonstrate are lower than a corresponding adult might feel, however science cannot make any definitive conclusions about the total infectious rate, at least for the moment.

Where do we go from here? Should all schools be immediately closed and all students be immediately returned to quarantine? The question is unfortunately far more complex then a simple yes or no. It is critical to balance the multiple nuances of students’ mental health as well as the detriments of quarantine along with the possible benefits of avoiding a broader public health catastrophe. However one thing is clear, stretching narrow scientific conclusions beyond their intended parameters was a very bad idea.