As children across the European Union are going back to school, the European Centre for Disease Prevention and Control (ECDC) is encouraging countries to “appropriately” balance children’s physical and mental health needs while ensuring COVID-19 prevention.
“As children and adolescents are returning to school after summer holidays, their role in the transmission of COVID-19 is again highly relevant,” said ECDC director Andrea Ammon.
People under 18 represent the age group with the lowest rate of COVID-19 vaccination coverage in the EU/EEA. Based on the ECDC data, only 6% of people under 18 are fully vaccinated, while the European Commission says 70% of adults in the EU are now fully vaccinated.
At the beginning of the year, children made up a small proportion of COVID-19 cases in the reported data. According to data from The European Surveillance System (TESSy), between 4 January and 20 June, children aged 1 to 11 years and 12 to 18 years represented 9% and 7% of cases, respectively.
However, increased transmissibility across all age groups has been reported recently for SARS-CoV-2 variants of concern, most notably the Delta variant.
“In regions where an increasing percentage of adults are fully vaccinated against COVID-19 but children are not vaccinated, it may be anticipated that in the coming months greater proportions of reported COVID-19 cases will be among children,” Ammon warned.
Children of all ages are susceptible to and can transmit COVID-19, but cases in younger children still appear to lead to onward transmission less frequently than cases in older children and adults.
Based on the second update of the ECDC publication COVID-19 in children and the role of school settings in transmission, released on 8 July, children aged between 1-18 years have much lower rates of hospitalisation, a severe disease requiring intensive hospital care, and death than all other age groups, according to surveillance data.
“Children tend to have a much lower risk of developing symptoms or severe disease than adults, and children only rarely suffer from severe COVID-19 with pneumonia and respiratory insufficiency,” said Ammon.
Schools need to be prepared, not closed
The ECDC publication stated that the decision to close schools to control the COVID-19 pandemic should be used “as a last resort.” The negative physical, mental and educational impacts of proactive school closures on children, as well as the economic impact on society more broadly, would likely outweigh the benefits.
But it was also highlighted that it is imperative that there is a high level of preparedness in the educational system for the 2021/2022 school year.
Ammon is encouraging countries to use “scientific evidence to develop approaches to appropriately balance the broader physical and mental health needs of children and adolescents while ensuring adequate COVID-19 prevention and control in this population.”
The report mentioned that combinations of non-pharmaceutical interventions in the form of physical distancing that prevent crowding as well as hygiene and other measures are essential to prevent transmission in school settings.
Additionally, testing strategies for educational settings aiming at timely testing of symptomatic cases need to be established to ensure isolation of cases and tracing and quarantine of their contacts.
That means that when positive cases are identified, the school should be informed, contact tracing should be initiated according to local guidelines, and communication to and the testing of close contacts, ideally with rapid diagnostic tests, should be considered.
[Edited by Josie Le Blond]