DeSantis: Kids' Coronavirus Risk 'Incredibly Low.' A Pediatric Infectious Disease Expert Weighs In
Governor Ron DeSantis on Saturday doubled down on his assertion that sending children back to school next month will be safe, reiterating that he would have no problem sending his own children to school if they were old enough.
WUSF asked pediatric infectious disease specialist Sunil Sood, of Northwell Health in New York -- where coronavirus cases surged early on in the pandemic -- for his view on the Florida governor’s statements and what is known among researchers about the risks to children and adults in school settings.
Governor DeSantis: “The risk of corona(virus), fortunately for students, is incredibly low. The CDC will show the statistics, under 18, much more likely to be hospitalized for seasonal influenza than for this, obviously, the fatality rate is much higher for seasonal influenza, amongst under 18. And this is proven to be. And so we're fortunate that they're low risk on this.
Dr. Sood: “We actually have seen children (infected with coronavirus) right from the beginning, which was in New York around March, but at a much lower number, than, of course, the adults. So, the proportion of children, surprisingly, was less than maybe 5% of all confirmed cases. That includes all the teenagers around the country.
“What made a lot of news obviously was the multi system inflammatory syndrome (MIS-C) in children, which is even more rare, but we started seeing it about four to six weeks after the peak, at least in New York.
“And we now see children who may have been tested for antibodies, or as part of bloodwork for something else. And we find that children, even when they were home in quarantine, may have gotten infected, but really didn't seem to get very sick with it.
“So it's not that we won't see cases, for example, when schools open up in the upcoming fall and winter, but we hope it'll continue to be a low number.
“We know almost nothing about immunity to virus yet, whether it's children or in adults, it just has not been long enough for us to say that a person infected once could or couldn't get it again. And so that applies to children as well. We do not know anything about that."
Governor DeSantis: “People say, well, kids may be the vectors in the community because that's what happens in an influenza outbreak. It's like a petri dish, they infect everybody, and then it spreads throughout the community.
“But I think it's been found over and over again, as people have looked at this and studied this particularly in Europe, that the school children actually aren't vectors for this, for whatever reason. They're usually infected by the parents. They usually aren't infecting adults, and places that have had schools open have not seen the schools contribute to increasing the prevalence of the virus.”
Dr. Sood: “There are very limited studies on this. But I think we can summarize so far in saying that children seem less likely to become infected, and less likely to spread infection than perhaps we're used to seeing with the influenza virus, where they definitely seem to be spreaders of the virus. Again, the data is limited. It's from a few studies in a few countries only. And we're cautiously optimistic in saying that they're less likely to spread it, but I don't think we can be 100% sure of that yet.
“Children, just like adults, can spread viruses. The speculation so far is that developmentally, children may not have those protein receptors in the lining of their respiratory tract that can carry a lot of the virus. Again, this is the hypothesis. And so, the the load of virus they carry may be less. Maybe it's lower than, say, in an adult who actually has the infection and is fully symptomatic. Many of the children actually have been asymptomatic.
“We know they will be able to spread it. But it's possible that there's something about their development and about their cells that may make them less likely to get sick and therefore less likely to spread it.”
Governor DeSantis: There's just not a lot of evidence that they (childen) are doing a lot with community transmission. So that's, I think, pretty clear in terms of the data and the facts. And if people have other facts that they can show me, I'm happy to look at it, but we've looked at this six ways.
Dr. Sood: “Children will spread this virus, to some degree. They will spread it perhaps to each other, but also to the adult staff. We know how this virus spreads. It's primarily by droplets that are coughed up. So the measures that have to be put in place are physical distancing in the classroom and in other group settings in the school or outside the school, face coverings even for young children, hand hygiene and importantly, providing ventilation and using the outdoors as much as possible in and outside the school building to minimize exposure to the adult staff as well. And these measures have been known now -- this distancing and face masks especially -- have been proven to work in this pandemic.
“There have been isolated instances (of outbreaks) in countries that have opened up schools. But I think we have to keep in mind that the vast majority of school openings have gone well, especially in countries that have been able to achieve countrywide control of the spread."
Governor DeSantis: “There's an achievement gap that's developed, there's no doubt about it. That will only be exacerbated as long as this happens. And so we know there are huge, huge costs for not providing the availability of in-person schooling for our students.”
Dr. Sood: “As the American Academy of Pediatrics has clearly stated this week, our main goal is to have children back in the school environment, but to do it as safely as possible. It's important to go back to school for several reasons in addition to obviously instruction, because there are risks at home of social isolation, of mental health challenges, even physical and sexual abuse. So there are many advantages of going back to school. But because the virus prevalence numbers are so variable by geography, and they change all the time, as we have seen, I think all decisions for reopening or the type of reopening should be made by local jurisdictions, guided by local public health and educational agencies. Some schools may have to employ hybrid models such as the one that Mayor (Bill) de Blasio of New York City just announced for this September."
Governor DeSantis: “On the schools, obviously the local counties are instrumental in this, are key. The school boards need to be involved with superintendents. It's got to be a collaborative effort.”
Dr. Sood: “I would say trust your local public health experts. Everything we do these days should be based on public health guidelines. They are the true frontline workers. They're the ones who are monitoring the data for us, day by day, hour by hour, and are hopefully advising the schools – and the schools are taking the advice of local public health authorities.
“And it's important to not forget about the other infectious diseases. The worst would be if we have outbreaks of other vaccine-preventable diseases at the same time as we have outbreaks of the coronavirus. So children absolutely must be up to date on all vaccines. And the American Academy of Pediatrics has recommended for years that all children should be vaccinated for influenza. We've had setbacks in measles, and mumps and whooping cough immunization, and we should just not take those diseases lightly, especially in the midst of this pandemic.
“Resources would have to be split and one investigational team would have to go chase down contact tracing for say a measles outbreak, and the other would be dealing with this coronavirus outbreak. But also the fact that if someone gets sick with two infections at once, that's like double hazard in certain diseases.”
Editor's note: Dr. Sood was asked questions about coronavirus by our reporter and was asked to comment broadly on statements the Florida governor has made, but was not given a transcript of DeSantis's remarks or asked to debate him.