School closings should always be the last resort – this phrase was heard more often from politicians in the past year. It just didn’t help. Schools in Bavaria have been largely closed since December 18, 2020, and when they open again is completely open. But is this measure justified? Do school closings actually cause a significant decrease in the incidence value?
The position of the Robert Koch Institute (RKI) is not clear: “The role of children and adolescents in the transmission of SARS-CoV-2 has not been conclusively clarified. Whether they are more often asymptomatic and have a lower exhalation volume are less infectious than adults cannot currently be said. ” In other words: Children and young people can become infected and pass the infection on. Younger children (up to 10, 12 or 14 years of age, depending on the data set) often show no or few symptoms and exhale fewer aerosols when they become infected. Transmission is less common here than in adults. In adolescents, it approaches adults.
“According to the assessment of the German Academy for Pediatric and Adolescent Medicine (DAKJ), there is a lower prevalence (ie: number of cases, editor’s note) of SARS-CoV-2 infections in children and adolescents compared to adults. At least younger ones Children (<14 years of age) are less likely to transmit the virus to other people than adults. " Epidemiological Bulletin of the Robert Koch Institute 2/2021 from January 14, 2021
Emergency care for children – mixed groups
Nevertheless, daycare centers and schools in Bavaria and Germany were closed in mid-December, as the incidence value had generally risen sharply. Unlike in spring 2020, this time emergency care will not only be offered for children whose parents belong to certain professional groups – but for everyone who needs it. The problem with this: the groups – because they were smaller – were usually mixed up.
Measures in lockdown – which one works?
Since many shops were closed at the same time as daycare centers and schools, contact restrictions were tightened and exit restrictions and bans were introduced in Bavaria, the effect of the individual measures is difficult to differentiate.
However, the RKI is certain: “The infection process in schools in children up to the age of approx. 14 follows the infection dynamics in the general population and does not precede them.” In autumn, the number of Covid 19 infections also rose sharply among 6 to 19 year olds. With the beginning of the partial lockdown in early November, the increase was stopped. It was only with the tougher measures and the school closings in mid-December that the number of infections fell.
“Overall, the proportion of Covid-19 school outbreaks in all Covid-19 outbreaks is small, and larger outbreaks in the school setting are still the exception.” RKI from February 2, 2021
Decline in student mobility
The Bavarian State Office for Health and Food Safety (LGL) underlines the fact that the exact effect of individual corona measures in lockdown cannot be quantified. However, it emphasizes that the closure of schools has led to a general decline in mobility. After all, students who are at home in distance classes do not take buses and trains to school. The LGL argues that this relieves the burden on local public transport and thus possibly the infection process. However, it has not yet been scientifically proven whether people in subways and buses will be infected.
A lack of face-to-face teaching with consequences
But not only children, but also parents are increasingly staying at home to ensure childcare. It is precisely these indirect effects of school closings, says Eva Rehfuess, Head of the Chair for Public Health and Health Services Research at the Ludwig Maximilians University in Munich, that could probably make a contribution to controlling the infection rate.
However, one should not forget the high “collateral damage” caused by the omission of face-to-face teaching. Primary school pupils who are not yet old enough to work independently and pupils who do not receive the necessary support at home, in particular, have a hard time fighting here, warns the Bavarian Parents’ Association, for example.
Where is SARS-CoV-2 infected?
And there is another aspect that is important when assessing whether students get infected during classroom teaching. In the cases recorded, the LGL is only informed whether a child is being cared for in a daycare center or school. This is what the Infection Protection Act (IfSG) provides.
Specifically, this means that the direct chains of infection on the basis of the IfSG reporting data cannot currently be traced. This means that it cannot be analyzed on this basis whether the infection occurred inside or outside the school. It is only recorded that the child is in care. However, the data does not provide any information about whether it was infected during a meeting with his school friend in the afternoon.
More contagious virus mutants emerged
On the basis of the available results, a return to school could possibly be possible for some of the pupils – with clear protection concepts and packages of measures that are implemented at all schools.
But there is another problem: In the recent past, infections with more contagious corona variants have surfaced, even if there is hardly any reliable data on infections in children with the new virus variants in Germany. However, there are confirmed cases in a Freiburg daycare center in Baden-Württemberg and Cologne.
Special case: the British variant B.1.1.7
More recent data from England on the age distribution of the new British virus variant compared to the other virus variants show that the transmission capacity of the new variant B.1.1.7 is increased by around 30 to 50 percent regardless of age.
Series tests in England showed that variant B.1.1.7 was initially more widespread among 11 to 18 year olds in November and December 2020. At the time, there were relatively tough policies on the general population, but schools in the country remained open. As a result, the distribution of the British variant was relatively more represented in this age group.
After the school closings, the number of young people fell. In this context, Eva Rehfuess points out that the then national measures in English schools were rather unsuitable to prevent transmissions: For example, there were no comprehensive recommendations on how to deal with suspected cases or how to wear a mask. The situation cannot easily be compared with Germany. The expert’s conclusion: In Germany, increased vigilance is required in view of the more contagious Corona variants – especially in secondary schools.
Schools could soon open under strict hygiene requirements
What does the current situation mean with regard to possible school openings from mid-February? On the one hand, there were some protests against returning to schools among schoolchildren in the final year who have been taking alternate classes since Monday – also because of the risk of infection. And the President of the German Teachers’ Association, Heinz-Peter Meidinger, showed understanding. On the other hand, another part of the pupils, but also the parents and teachers, longs for the opening of daycare centers and schools.
Under strict hygiene requirements and with a low incidence value, nothing would stand in the way from a scientific point of view – especially for primary school classes. Because following on from the Regensburg ad hoc analysis of November 23, 2020 and the current results of Munich virus guard study Pediatricians do not see school attendance as the main risk for the transmission of infections. As it became known today, the authors of the Munich study come to the conclusion that healthy, asymptomatic children who visit the respective facilities do not contribute significantly to the spread of the pandemic “if suitable measures are taken to control infection”.
Children can just as easily get infected outside of school. But whether and to what extent they pass the infection on to others, Ultimately, the studies on this are missing, according to the RKI.
Eva Rehfuess points out that active use of emergency care would thwart the idea of closing the school. This leads to a mix of the groups of children or schoolchildren that is hardly controllable. This speaks more in favor of a controlled opening of schools, especially primary schools. Provided that the gradual school openings go hand in hand with a strict package of measures that are well implemented, in her opinion, at least the younger ones can be able to return to class soon.
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