Too many children are being tested for coronavirus because of an understandable but misplaced concern about school outbreaks, a leading scientist has said, as a study shows they are about 40% less likely than adults to be infected.
Prof Russell Viner of UCL and Great Ormond Street children’s hospital, the study’s lead author, is calling for schools to be kept fully open in light of the findings, because of the serious harm done to children by classroom closures.
“I think we have a coherent policy about testing in schools, but we are probably being overcautious and testing too many children,” said Viner. “It was the right thing to start with, but it has had some unintended consequences.
“The key thing about this research is that it supports keeping schools open. Schools need to be open and be almost the last places to close. As part of learning to live with this virus, we need to be keeping schools open.”
Viner said many children were getting the usual winter colds, with sneezing and runny noses, at the start of the autumn term. Those symptoms are unlike those of Covid-19. He said only children with classic coronavirus symptoms – a persistent cough, high temperature and loss of taste and smell – should be tested.
“There is clearly limited capacity in testing at the moment,” he said. “We need to be thinking: ‘Are we testing too many children?’ because of our understandable but probably unscientific and misplaced concerns about children being infected in schools.”
The study, published in the leading medical journal Jama Pediatrics, showed that primary school children had the lowest rate of infections. The oldest group, about 17 or 18 to 20, have similar rates of infection to adults. There is too little data on the middle group of adolescents to be certain how they fare.
He stressed that this meta-analysis, pulling together a large number of studies from around the world with data on 41,640 children and young people up to the age of 20, was not about children’s ability to transmit the virus to other people, which will be the subject of a separate study.
But he said: “Susceptibility tells us a little about transmission. You have got to be able to catch the virus to transmit it.” The paper says the existing data does suggest that children and adolescents are much less likely to pass on Covid-19 than they were to pass on flu during the last pandemic.
Viner’s team began the work in spring and published an early pre-print on their initial limited findings. They have since been feeding their data to Sage, the government’s scientific advisory committee, updating advisers and ministers as the evidence has accumulated and contributing to the decisions over opening schools in the UK and overseas.
He thinks the debate over schools should end. “We need to stop some of the flip-flopping of schools opening and closing and recognise that we are probably testing too many children,” said Viner. “In the event of seemingly inevitable future waves of Covid-19, there is likely to be further pressures to close schools.
“There is now an evidence base on which to make decisions, and school closure should be undertaken with trepidation given the indirect harms that they incur. Pandemic mitigation measures that affect children’s wellbeing should only happen if evidence exists that they help, because there is plenty of evidence that they do harm.”