Intended to be an internal document last week, the Centers for Disease Control and Prevention fully acknowledged: the highly contagious delta variant redraws the front line of the coronavirus pandemic and is new like the universal mask command. Needed public health measures. Or, as the agency put it in a document obtained by the New York Times, “The war has changed.. “
This news arrived when the first school district was preparing to reopen. Some children in Atlanta and its suburbs will return to the classroom this week.
Over the past year, there has been controversy over how many schools have contributed to the spread of the virus and when and when it should be closed. For some parents, teachers, and staff, keeping schools open during the epidemic of a new, poorly understood virus seemed like an unacceptable risk. But for others, it was the closure of schools that poses great risks of loss of learning, widening educational disparities and worsening mental health, not to mention the hardships of parents.
However, as the new school year begins, the CDC, the American Academy of Pediatrics, and many other professionals agree that reopening of school should be a priority.
Elizabeth Stuart, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said: “We have a very effective vaccine and we know a lot about how to open a school safely. We face some challenges when children are not directly in school. I think it raises awareness about. “
Only a few months ago, vaccinations over the age of 12 were steadily progressing, new cases were declining, and at least partially seemed ready to return to normal.
Delta doubts that.Many remain unknown variantIncludes whether it has more serious effects on children than previous forms of the virus. According to scientists, vaccination rates are very uneven and most decisions are left to local civil servants, so this variant introduces new uncertainty next year and when schools reopen. It is even more important to take safety measures.
Dr. William Schaffner, Medical Director of the National Infectious Diseases Foundation and Vaccine Specialist at Vanderbilt University, said: “This makes all these details even more important.”
Here are answers to some common questions.
What have we learned about the risk of infection at school?
Overall, studies show that infections within schools were generally low, at least last year, if schools took basic precautions.
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Dr. Yvonne Maldonado, a pediatric infectious disease specialist at Stanford University and chairman of the Infectious Diseases Commission of the American Academy of Pediatrics, said: illness. “There may be some transmissions, but they are quite rare.”
Study in North Carolina, Utah, Missouri When schools do several types of safety measures (masking, symptom screening, distance, improved ventilation, virus testing, hand washing, division of students into smaller groups, etc.), the school’s infection rate is even lower than its surroundings. Became clear. community.
Dr. Daniel Benjamin, Jr., an expert on pediatric infectious diseases at Duke University, said:
These low rates are, in part, Children under 10 years old It seems less likely to get the virus than older children and adults. But another factor is that the school may be in a controlled environment, may be controlled, and may have stricter security measures than the surrounding community, Dr. Benjamin said. Told.
However, outbreaks are occurring in schools that have reopened without proper mitigation measures. Israel’s first large school-based outbreak. Eventually infected 260 peopleIt came when the authorities temporarily lifted the mask obligation during the heat wave and the students were crowded in the air-conditioned classroom.
How does Delta complicate the equation?
Delta is about twice as prevalent as the original version of the virus, helping to increase infection and hospitalization, especially in regions of countries with low vaccination rates.Recent data suggests that people infected with Delta may carry 1000 times virus — As the person who caught the original version of the virus, it can make them more contagious and longer.
However, many questions about variants remain unanswered, including the exact risks it poses in a school environment. But what is clear is that Delta is already driving outbreaks in many American communities, which increases the risk of local schools.
“Schools are not islands, so if there is a lot of community expansion, part of that expansion will spread to schools,” said Dr. Westyn Branch-Elliman, an infectious disease specialist at Harvard Medical School.
of Studies conducted before the spread of DeltaResearchers in the United Kingdom found that the risk of school outbreaks increased by 72% for every 5 additional cases per 100,000 people across the community.
Fortunately, since the beginning of last year’s school year, the United States has licensed three highly effective vaccines for emergency use, which are widely available to people over the age of 12.
The vaccine is not perfect.Some fully vaccinated people will get Breakthrough infectious disease, Generally calm and rare. And vaccinated people infected with Delta Can carry high levels of virus With their nose and throat, that means they may be able to communicate it easily.
However, the vaccine provides strong protection against delta mutants. They reduce the chances of getting the virus and prevent the worst consequences, including hospitalization and death.
Schools with high vaccination rates can be infected with the virus and far fewer people can bring it to the classroom or infect it.
Justin Lessler, an epidemiologist at the University of North Carolina, said: “Even if it is imperfect, it has a significant impact on reducing infections and protecting people’s health.”
What does the CDC recommend?
Initially, the CDC guidelines recommended that unvaccinated people over the age of two wear masks at school. And they strongly suggested that vaccinated students do not need to be masked in the classroom.
But last week, Delta, due to concerns about the CDC Revised guidelinesRegardless of vaccination status, it is advisable to wear a mask at school this fall.
The agency recommends a hierarchical approach to Covid prophylaxis and suggests that schools combine several mitigations to encourage everyone who is eligible to be vaccinated to be vaccinated. increase.
However, the guidelines also leave many decisions to local officials who are told to make decisions about when to tighten or relax restrictions based on data on local incidents and immunization rates.
What about the states that ban masks require?
Some states, including some now I’m experiencing a big surge – include Florida, South Carolina and Texas — It makes it difficult for schools to take protective measures. These three states, and some others, have one of the following: Banned or significantly reduced Universal masks are mandatory.
That does not necessarily mean that all schools in these states are outbreaks, and even those schools may see almost mild or asymptomatic cases. However, districts that open without security measures are taking real risks, Dr. Benjamin said.
“This is another way of saying it,” he said. “When I grew up, I always escaped by riding behind the pickup truck, but that doesn’t make the kids behind the pickup truck a good national policy.”
Given the policy patchwork and uneven immunization rates across the country, experts said it would not be surprising if school safety changed significantly this fall. “If the school district decides not to follow the recommendations, I think there is a risk of infection,” said Dr. Maldonado.
As the pandemic continues to evolve, schools and authorities will need to make complex decisions based on local circumstances, such as when to claim certain precautions and when they can be safely lifted.
“We need to make subtle decisions about what to do at school,” said Dr. Branch Eliman. “But it’s a much more difficult public health message than a polarized” school is safe “or” school is not safe. ” “
How about unvaccinated elementary school students?
The exact schedule is unknown, but vaccines for some children under the age of 12 may be approved by the end of the year. However, until then, elementary schools are basically open without vaccination. (Children attending the trial may have received the shot.)
However, studies have shown that the virus is much less likely to cause serious illness in children. They are not completely protected.Although a few children may develop it rarely Severe inflammatory condition, And some children with mild infections may experience long-term symptoms.
There is still no definitive data on how Delta affects young children, but there is no evidence that Delta specifically targets children.
Still, many adults are vaccinated, which can increase the proportion of delta cases in children. The infectivity of a variant can also mean that more children are infected with the virus. There is also some new evidence that mutants cause more serious illness in adults.
According to experts, due to the lack of attention given to these observations, it is especially important to take other precautions, such as universal masking, in schools with unvaccinated young students.
According to Dr. Maldonado, in schools and districts where masks are not obligatory, parents can provide some protection by ensuring that their children wear masks at least at school.
And adults can help protect young children by being vaccinated on their own. “The only important thing a community can do to reduce risk at school is to vaccinate the entire community,” said Dr. Schaffner.
Covid Variant at School: What You Need to Know
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