Can children spread the coronavirus? It’s complicated.

Source: Public News Update
May 3 2020

The raging debate over how infectious children with the coronavirus are, explained.

As most of the world continues to socially distance because of the coronavirus, Switzerland’s infectious disease chief wants to loosen restrictions for children — so they can hug their grandparents.

It’s a poignant move, as it was made in part to benefit older people’s mental health. But it’s also very risky, as it’s unclear whether or not young children, who generally seem to get mild cases of Covid-19, transmit the disease to others at similar rates as adults.

As that scientific debate rages, Daniel Koch, the Swiss infectious disease chief, firmly planted his flag on one side of it Wednesday. “Young children are not infected and do not transmit the virus,” he told reporters, referring to a study released this month as well as his conversations with Swiss health experts.

The Swiss Federal Office of Public Health, where Koch works, says children under 10 years old rarely get the virus. “When they get sick, they often have only light symptoms,” spokesperson Yann Hulmann told me in an email. “They are apparently not big spreaders and are often infected by adults. So reopening schools does not seem to be a major problem.”

The risk of such a hug “is very low compared to the benefit for the mental health of the grandparents,” Hulmann added.

The views of Swiss officials didn’t come out of nowhere. They come amid a growing number of released reports from public health and infectious disease experts suggesting children spread the virus far less than adults. They form part of the justification for why Denmark reopened its schools earlier this month and why Spain this week allowed children 13 years old or younger to play outside.

But the science is far from settled. The US Centers for Disease Control and Prevention says kids “can still pass this virus onto others who may be at higher risk, including older adults and people who have serious underlying medical conditions.” And other studies show children continue to display similar transmission abilities as adults, leading experts to caution against trusting kids not to spread the disease.

“What we don’t know yet is the degree to which children can transmit the virus,” Dr. Danielle Zerr, an infectious disease expert at Seattle Children’s Hospital, told me.

This isn’t some trivial debate. World leaders face hard choices over which parts of society to reopen, when, and how quickly. Plus, staying home from school could curb children’s educational progress, while disrupting the work-life balance for adults. If children can head back to school with minimal health risks, then that could prove a major benefit for the child, their parents, and society at large.

But at the moment, the only thing that’s clear is that there’s no real clarity on this issue. Still, it’s worth looking into the science for each case, and what the data does and doesn’t say about coronavirus transmissibility from young children.

The evidence for why kids rarely transmit the coronavirus

It’s not entirely clear why, but so far, children don’t seem to be getting Covid-19 as often as adults. As Business Insider pointed out on Thursday:

According to the US Centers for Disease Control and Prevention, 1.7% of 150,000 American COVID-19 cases affected people under the age of 18. Globally the amount of children with COVID-19 is under 2% of all cases, from Korea to Spain to Italy.

And there is a growing body of scientific literature showing young children may not be as likely to spread the virus to others as older people.

Take this April 22 study from the government of New South Wales, the Australian state that contains one-third of the country’s population and the city of Sydney. Researchers looked at five primary schools, with kindergarten through seventh grade (in US terms), from March to mid-April of this year. Schools prove a valuable testing case, not only because there are many children to observe, but also because they allow experts to gauge when the right time to restart normal schooling might be.

As the chart below shows, they found that only one person out of 168 in close contact with an infected person got sick with the virus.

Which led to the following conclusion: Covid-19 “transmission in children in schools appears considerably less than seen for other respiratory viruses, such as influenza.”

NSW Government

Top Australian officials, including Chief Medical Officer Brendan Murphy, are now citing this report to say social distancing measures don’t need to be followed in schools as the country considers reopening them fully in the near future.

But Dr. Kristine Macartney, the study’s lead author, pushed back on such conclusions. “We did see low transmission, we didn’t see no transmission,” she told me. “I think children can still transmit coronavirus. That’s certainly the case. We’ve seen that.”

Macartney also noted the study is still a preliminary finding — it will go through the peer review process soon — and that more research is required. Her team “didn’t actually evaluate” whether the observed schools followed social distancing guidelines or not, and class attendance dropped considerably in April, meaning new cases of community spread among her study’s population could have emerged after its conclusion. “I don’t think our findings should be used as a single piece of evidence in anybody’s policy,” she said.

What she does emphasize is: “It’s not that transmission can’t happen, it’s just that evidence is suggesting … that [transmission among children] happens at a lower rate than does transmission between adults.”

Other evidence for that claim includes a March non-peer-reviewed study from experts in China and Australia. Between December 2019 and March 2020, researchers looked at 31 households with coronavirus infections in China, South Korea, Singapore, Japan, and Iran.

What they found was someone 18 years or younger brought the disease into the home in just under 10 percent of cases. That’s remarkable, since previous studies had shown children were responsible for infecting their families with H5N1 bird flu in about 50 percent of cases.

The preliminary evidence for the claim that children don’t transmit the coronavirus at high rates also led the European Center for Disease Control and Prevention (ECDC) to be optimistic about kids and transmission on their website: “Data from population-based and cross-sectional studies indicate that children are unlikely to be primary source cases.”

However, when I followed up with the ECDC, spokesperson Alexandru Niculae told me in an email these and other studies “cannot be considered as ‘enough evidence’, this is still considered limited data; so we need to take this with a pinch of salt for the time being.”

Remain skeptical of low child transmission claims, at least for now

Despite all those studies, multiple experts told me it’s still completely possible that kids could be significant spreaders of the disease. Seattle Children’s Zerr is one of them. “If we document high levels of virus in their nose, I don’t know why they would be less likely to transmit,” she told me.

In other words, a child doesn’t necessarily have to be very ill to spread the virus. As long as a kid is near others with a load of virus in the nose or mouth — symptomatic or not — they could be a carrier and a transmitter.

A study released by Germany’s chief virologist Christian Drosten and others this week backs Zerr’s skepticism. Here’s what they found: “Analysis of variance of viral loads in patients of different age categories found no significant difference between any pair of age categories including children,” the researchers wrote. “In particular, these data indicate that viral loads in the very young do not differ significantly from those of adults.”

“Based on these results, we have to caution against an unlimited re-opening of schools and kindergartens in the present situation,” they concluded. “Children may be as infectious as adults.”

You can see a chart from the report below, which Drosten tweeted out Wednesday. What it makes clear, though, is the study looked at fewer cases of infected children than other age groups, which may have skewed the results. The paper also hasn’t yet been peer reviewed.

Viral loads by PCR as seen in our laboratories. No significant difference between children and adults. Age categories: Kindergarten (KG), Grade school (GS), Highschool (HS), etc. with age ranges and (counts). https://t.co/xunzyHEi47 pic.twitter.com/je73hsKrZb
— Christian Drosten (@c_drosten) April 29, 2020

All this means there’s no scientific consensus on the infectiousness of children — and that has many health officials urging caution.

The US CDC’s website, for example, says:

Because persons with asymptomatic and mild disease, including children, are likely playing a role in transmission and spread of COVID-19 in the community, social distancing and everyday preventive behaviors are recommended for persons of all ages to slow the spread of the virus, protect the health care system from being overloaded, and protect older adults and persons of any age with serious underlying medical conditions.

And Beth Riggs, a spokesperson for the Children’s National Hospital in Washington, DC, told me they continue to ask visitors — including young people — to follow “universal masking policies in place to help limit the potential spread of the virus and protect our patients, their families and our staff.”

Which makes the Swiss case — allowing health children to hug their grandparents — all the more troubling. It’s not that the country’s health officials say kids can roam free, but suggesting they effectively pose no risk is too absolute for experts like Zerr. “We have so much evidence of children with infections,” she told me after I read her the Swiss infection disease chief’s statement to the press. Koch’s statement, she told me, is “just not true.”

Covid-19 is a new disease, and as such, scientists have a lot more replicable research to do before the world can begin to even come close to understanding how children may spread it. And this uncertainty has many still taking necessary precautions until there’s more and confirmed evidence about whether children are actually rare spreaders of the disease.

In times like these, then, the cautious approach might be the best one.

Nato accused of killing family in botched bombing raid

Πηγή: Telegraph
By Damien McElroy, Zlitan
11:00PM BST 04 Aug 2011

Nato's mission to protect civilian lives in Libya has been called into question after it admitted carrying out an air strike in a coastal town where a mother and two children were killed.

The alleged strike on a two-storey home in the suburbs of the town of Zlitan, 160 miles east of Tripoli, killed the wife and two children of Mustafa Naji, a physics teacher and sparked an eruption of local anger against the bombing campaign.

The regime of Libyan leader Col Muammar Gaddafi seized on the attack to press claims innocent locals have been killed by Nato's bombs.

Nato's efforts to assist advances by rebels from central Misurata have embroiled the alliance in an urban war for control of Zlitan. Bombed schools and flattened food warehouses are now in evidence in the town and they are being used by Gaddafi loyalists as staging grounds for continued attacks on the rebel enclave.

Despite the use of fixed wing aircraft and helicopter gunships and despite rebel claims that the town had fallen earlier this week, fighting raged yesterday on Zlitan's eastern fringes. A handful of loud explosions were accompanied by the whine of jet engines on Nato aircraft.

The Naji home stood ten miles from the front line in the apparently quiet suburb of Kaim. Regime officials said the family were ordinary people who had feasted just hours before to celebrate the Muslim holy month of Ramadan.

Its concrete floors had collapsed and the rooms were destroyed. By midmorning it was impossible to tell if the building had ever been used by Gaddafi's military unlike the nearby Law College and school where the bombed buildings were littered with military paraphernalia including combat fatigues and log books.

Ibtisam, the mother of two children, Mohammad 5 and Muttasim, 3, were buried within hours at an emotional funeral ceremony next to a local mosque.

"These people were not fighters, there is no military in this neighbourhood," said Ali Adil, a lawyer and neighbour. "Nato say they are protecting civilians but they are turning their weapons on us. The UN Security Council should investigate this." A nephew pulled off the funerary shrouds to reveal the bloodied faces of the dead.

"Those that are fighting with Nato are traitors against their country," said Mohammad Ali Berber, a cousin of the victim. "We should volunteer to go to the front line and finish it. We will never forgive." Nato bore the brunt of the blame for the attack.

Mr Adil said that he had seen helicopters in action attacking areas where there were no soldiers deployed. "It's an unfair war using this technology against us."

A Nato spokesman said the organisation had struck a target at 6.30am in Zlitan and that it was investigating the allegations of civilian casualties.

The UN Security Council resolution authorising the Nato campaign to use military air power to stop Col Gaddafi's regime killing his own people to crush a nationwide uprising.

Moussa Ibrahim, the Gaddafi regime spokesman, said the attack on Zlitan was one of many Nato atrocities. "Yet another crime of Nato against Libyan civilians has taken place," he said. "No one is safe from Nato." Despite Misurata rebels claims that they had taken the centre of Zlitan there has not yet been heavy downtown fighting.

But as the fighting has encroached, locals have fled elsewhere. Apartment blocks along the main boulevard, Sahili Rd, are deserted. Only a handful of shops remain open.

However the main impediment to the fall of the town is the hatred of local tribes towards Misuratans. The proximity of the two towns belies a deep-rooted antipathy.

Many local families are the descendants of slaves captured by the pirates that operated from Misurata in the 19th century.

"I have no friends or acquaintances from Misurata, I know nobody from there," said Khalifa Misha, a schools inspector. "They have no right to come here. We will resist this conquest until the last drop of blood."

U.S.: 29,000 Somali kids have died in last 90 days

Πηγή: CBSNEWS
August 4, 2011 8:52 AM

(CBS/AP) NAIROBI, Kenya - A U.S. official says the famine in Somalia has killed more than 29,000 children under the age of 5.

The United Nations has said that tens of thousands of people have died in the Horn of Africa's drought and famine, but the U.S. estimate is the first precise death toll offered in the crisis.

Nancy Lindborg, an official with the U.S. government aid arm, told a congressional committee in Washington on Wednesday that the U.S. estimates that more than 29,000 children under age 5 have died in the last 90 days in southern Somalia.

The U.N. on Wednesday declared three new regions in Somalia famine zones. Out of a population of roughly 7.5 million, the U.N. says 3.2 million Somalis are in need of immediate lifesaving assistance.

Getting aid to the country has been difficult because al Qaeda-linked group al-Shabab controls much of the country's most desperate areas.

Even before Somalia's worst drought in 60 years, many of the country's children have only known strife during their lives.

At a government rehabilitation facility in Mogadishu last week, The Associated Press obtained rare access to former al-Shabab child soldiers, providing a unique view into the workings of the group whose presence in much of Somalia is stymieing international efforts to provide emergency aid.

The former fighters assigned to a drab cement housing bloc are young -- too young. One is only 9, yet they were enforcers of harsh edicts from Islamist militants who are preventing thousands of Somalis from escaping famine.

The hardline militant group routinely recruits young teenagers, kidnapping them from schools and forcibly removing them from homes. Last week three teenage fighters surrendered to the African Union military force during a military offensive.

The most recent arrival at the rehab center, 17-year-old Abshir Mohammed Abdi, said "there was no life, no prospects" inside al-Shabab, which he belonged to for 1½ years before escaping to the camp last week. Abdi is from the country's south -- Kismayo -- where Somalia's famine is hitting hardest.

Abdi said many there are suffering, with al-Shabab fighters trying to stop the flow of refugees toward food, an outflow that threatens to diminish the population from which al-Shabab draws its conscripts and collects its taxes. Al-Shabab has denied a famine is taking place.

"Even with women and children suffering from drought, al-Shabab would stop them, stop them, stop them until they couldn't stop them anymore," Abdi said, suggesting that the wave of famine refugees was too much for the militants to stanch.

Faces of famine

Somalis who have fled the famine zones and reached Mogadishu told AP that militants are threatening refugees who leave the south and often stopping -- and sometimes killing -- the men, leading to a disproportionate number of women and children in displaced-persons camps in the capital. One of the young former fighters, who spoke to AP through an interpreter while standing under a shade tree at the rehabilitation facility, said al-Shabab also uses threats to keep Somali men within the famine zones.

"What they would tell the men is that your women and children would be killed if you leave," said Ali Hassan, who like many of the former teen fighters wore a colorful track suit that looked like it was made by Nike but instead said "Nile Sports."

The two dozen young men, mostly teens, said there were killers among them, though no one dared specify who. One bearded fighter in his 20s suggested that he had carried out beheadings.

What is striking about the former al-Shabab members is how young they are. The youngest at the center is Liban Mohammed, a shy boy of 9. Al-Shabab used him as a spy.

Most children recruited by armed groups in Somalia appear to be between 12 and 18, though some are as young as 8, Amnesty International said in a report last month. Conscripting or enlisting children under the age of 15 is a war crime, the group noted.

"This is a never-ending conflict, where children are experiencing unimaginable horrors on a daily basis," said Amnesty's Michelle Kagari. "They risk becoming a lost generation if the world continues to ignore the war crimes affecting so many of them."

The children, who come from a desperately poor region where government can't function, are lured into joining al-Shabab through the promises of phones and money. Forcible recruitment and kidnapping are common. The government also stands accused of using child soldiers.

One official who is helping watch after the former child soldiers said executions were a part of al-Shabab's recruitment process, in order to instill fear. Many saw their friends die, he said.

"What they were promised was riches, and as the drought kicked in they were given handfuls of rice as payment," said the man, who did not give his name.

(CBS/AP) There are more than 160 former al-Shabab fighters in the government rehabilitation program. Many here say they hope to get an education, though some, knowing little but war during their young lives, profess that they want to join Somalia's military and fight back against al-Shabab.

Hassan said he had fought alongside Arab militants and fighters from Kenya, and that he had seen Omar Hammami, an American al-Shabab leader known as Abu Mansur al-Amriki. Hassan and many of the other teens said al-Shabab treats their youngest soldiers very poorly.

"We don't matter. We're taught how to load and unload a gun. I want a future for myself," Hassan said, explaining why he left.

Al-Shabab is split into about three main factions, the former fighters said. One top leader, often referred to as al-Shabab's No. 2, is Sheik Mukhtar Robow, who is seen by the international community as a more moderate al-Shabab leader, one that aid groups have been able to work with in the past.

A leader like Robow could be a way for aid groups banned from southern Somalia to find a way in to distribute food aid. But one former fighter, 24-year-old Abdullahi Dahir, said aid groups shouldn't trust Robow's word, even if he tells them that they can enter.

The teens seem content at the government-run facility, if not a little bored. There is little for them to do and rehabilitation programs are not yet up to full speed, despite the program being more than six months old.

Government spokesman Abdirahman Omar Osman said that more than 50 al-Shabab fighters have defected and joined government forces since the drought began. He said the government needs more money to cover the needs of the program.

For the former fighters, once they're in, it is their only way forward. Marked men -- or boys, in many cases -- they must stay in government-controlled territory.

"If I walk out of here I'll be killed," said one former fighter who didn't give his name. "Where can I go?"