The exemplar is Denmark, where the first children began returning in mid-April, when the country had just under 200 new cases a day. As of June 8, Denmark had just 14 daily new cases. And while the reproduction rate of the virus increased after the country began reopening, it has since dropped.
The head of experimental virology at Copenhagen University’s Faculty of Health and Medical Sciences, Allan Randrup Thomsen, was initially hesitant about the move. But now he notes that, since reopening, there “hasn’t been any effect that we can see.”
In fact, the statistical models predicted there would be more spreading than was actually observed, according to Søren Riis Paludan, professor in virology at Aarhus University. The puzzle is why that didn’t happen.
“Opening the schools has really not been translated into any imprint in the transmission numbers,” he said.
One factor could be the effective implementation of social distancing, Riis Paludan said. Another, according to Randrup Thomsen, is the lack of opportunities for the virus to transmit to a larger number of people than it usually would.
„Modeling experiments suggest that it’s particularly through what we call super spreading situations that this epidemic is maintained,“ he said. „Those situations have not been created.“
In Norway, where schools began reopening on April 20, the spread of infection has continued on a downward trend, even though cases keep on being detected through increased testing.
Similarly positive figures coming out of Austria could add evidence to emerging science indicating that children possibly don’t contract coronavirus as easily as adults, said Eva Schernhammer, head of the Department of Epidemiology at the Medical University of Vienna.
In Austria, senior-year students returned at the beginning of May, when new cases were hovering at around 50 per day, followed by more widespread returns in mid-May. In June, new daily cases have varied between two and 66.
“So far, so good,” said Schernhammer of the effects of reopening schools. She also noted these figures remain relatively low despite most lockdown measures being withdrawn, apart from social distancing and mask usage in some public spaces.
But in Austria, the reopening has taken place with baby steps.
“In every step there was monitoring to make sure that the number of newly infected cases wasn’t going up and that there were no adverse effects with the reopenings,” said Schernhammer.
Germany was similarly cautious in reopening. In fact, Ralf Reintjes, professor of epidemiology and surveillance at Hamburg University of Applied Sciences, said that schools haven’t truly reopened in the country, with many children still being taught online and having limited attendance in schools.
„It cannot be said they’ve reopened, they’ve opened the door a few centimeters,” he said, adding: “It’s very early to say what effects this will have.”
He’s also cautious that as Germany returns to a semblance of normality it “will become more and more risky.”
“We’re holding our breath at the moment, and we’re hoping that things go well, but we have our concerns,” he said.
While admitting that the reported figures look “quite promising” and that the approach in Germany has so far not been “too bad,” he argues that the pandemic is “more complicated.”
„It’s not just monocausal,“ he said. „There are lots of factors influencing it.“
Similarly, Karl Lauterbach, a politician from the Social Democratic Party of Germany and professor of health economics and epidemiology at the University of Cologne, is hesitant about making any assumptions at this stage.
Lauterbach said that in Germany, Austria and Denmark, one couldn’t make any inferences about the reproduction rate and the opening of schools.
“They reopened the schools in all of these countries where there was a very low baseline rate of infection,” he explained.
The reticence in Germany about making assumptions around the effect of reopening schools may be colored by a recent outbreak of the virus in Göttingen following a large celebration and the illegal opening of a shisha bar. Around 57 children were among the close contacts of those who tested positive.
The outbreak led to stricter infection control measures in 13 schools in the area, reported Der Spiegel on June 2.
While the virus may be waning in Europe, fears of a second wave are also increasing. Whether schools should be closed again if this happens is a matter up for debate.
“Based on the scientific evidence alone, I would say that’s not a good reason for closing the schools,” said Riis Paludan. Instead, he believes, the key is to protect the elderly.
Randrup Thomsen is similarly hopeful.
“If we came to a situation where we had to lock down again, because of research in the epidemic, we should very seriously consider whether closing the schools is actually necessary,“ he said.
The evidence is still murky here. A June 8 modeling study published in Nature was unable to disentangle the effects of school closures from other interventions such as the stopping of public events and self-isolation rules.
However, it found that together, these interventions had a substantial impact on transmission.
For Schernhammer, the evidence available indicates that case numbers need to be down to relatively low levels for it to be safe to lift any lockdown measures. And she believes there is still work to be done to figure out the “perfect moment” when these lockdown measures need to be reimplemented.
Reintjes, on the other hand, thinks that things are moving too fast as it is. “We’re letting [restrictions] go before we really know what the real risk factors are,” he said.
What’s needed are tools to monitor the virus and a better understanding of its epidemiology, he said.
These fears are shared by those opposing wider school reopenings in England. On June 8, the NASUWT teachers’ union in the U.K. welcomed a government U-turn on plans for all primary school children to return by the summer holidays.
“With the ‘R’ rate close to or above one in a number of areas of the country, decisions to reopen schools more widely could be extremely damaging to public health as well as to the health and safety of children and adults in schools,” said NASUWT’s General Secretary Patrick Roach.
„The overwhelming majority of teachers remain extremely worried that with schools opening to more children whilst safe social distancing and PPE continue to be major concerns, wider school reopening is simply not safe,“ he added.
And as Dorte Lange, Vice President of the Danish Union of Teachers, knows, having unions on board is essential.
Pointing to the U.K., Lange said that the situation in Denmark isn’t comparable.
“[In Denmark] we have this long tradition of cooperation, of making people feel safe. And there’s a great deal of trust in authorities because we know that we can always sit down and talk about things,” she said.
At the start, Danish parents were as anxious as their British counterparts, fearing that their children were being used as “guinea pigs,” said Lange. But these fears were assuaged when schools reopened and parents saw that all the precautionary measures were kept in place.
Smaller groups of children, social distancing and shorter school days are some of the measures being implemented.
“When society is able to make the teachers feel safe … then parents will also feel safe,” she said.
But for countries like the U.K. at least, it seems that teachers have a long way to go.
This article is part of POLITICO’s premium policy service: Pro Health Care. From drug pricing, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics driving the health care policy agenda. Email [email protected] for a complimentary trial.
Source: politico.com
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