What are the facts on coronavirus transmission in preschools?
March 15, 2020 9:37 AM   Subscribe

While all Seattle K-12 schools are closed, as are many preschools, my 3-year-old's preschool is still open, leaving the decision to me as to whether to pull him out or not. My understanding is that children of this age have not tested positively for the virus, making it unlikely for them to be carriers. That said, preschools are of course not kid-only, as there are numerous adults working on and visiting the premises, and we know that social distancing is key to "flattening the curve".

Is there some objective way to decide whether to pull my toddler out of preschool now? Do we know anything about virus presence or transmission in preschools? Appreciate any pointers!
posted by splitpeasoup to Health & Fitness (20 answers total) 1 user marked this as a favorite
How big is the preschool?

My child (2) is in a care center in a class of 6 with two staff, so 8 people total. The total census in the building is 12 kids 4 staff, and I'm ok with that. I'm also suspecting that they may be closed down eventually and wieghing my emotional health with extending the amount of time my child is at home with no outside support.

Our childcare center has a also strengthened cleaning protocols, and curbed outside visitors.

We keep going back and forth about it, but right now are keeping her engaged.

I haven't found any clear data, but I'm basing my decision that it's a small center. If it were larger i would be more concerned and it would tip me into pulling her out sooner .
posted by AlexiaSky at 9:45 AM on March 15, 2020 [2 favorites]

If your family is able to watch your child, I would pull her out. Young children do get infected; they just get it less severely.



posted by NotLost at 9:50 AM on March 15, 2020 [3 favorites]

Response by poster: How big: I don't have numbers, but there are multiple classrooms and ages, and if I had to take a wild guess I'd say 50 kids and 20 adults in the building.
posted by splitpeasoup at 9:50 AM on March 15, 2020

From the CDC: Information on COVID-19 and Pregnant Women and Children
Infections in children have been reported, including in very young children. There is an ongoing investigation to determine more about this outbreak.
Also from the CDC: Coronavirus Disease-2019 (COVID-19) and Children
Q: Are the symptoms of COVID-19 different in children than in adults?

A: No. The symptoms of COVID-19 are similar in children and adults. However, children with confirmed COVID-19 have generally presented with mild symptoms. Reported symptoms in children include cold-like symptoms, such as fever, runny nose, and cough. Vomiting and diarrhea have also been reported. It’s not known yet whether some children may be at higher risk for severe illness, for example, children with underlying medical conditions and special healthcare needs. There is much more to be learned about how the disease impacts children.
posted by katra at 9:51 AM on March 15, 2020 [2 favorites]

A newborn in the UK has been diagnosed with the virus.

Children's Hospital LA is treating a 6-9 year old for coronavirus.

I've pulled my 4 year old despite my daycare not closing, and having high confidence in the teachers and their cleaning standards because 1. I am privileged enough to be able to do so without much difficulty, 2. kids are fucking germ factories at the best of times. I would rather risk less exposure at this time.
posted by toastyk at 9:52 AM on March 15, 2020 [3 favorites]

Best answer: "We know children get infected with the virus, but they don't appear to get very sick or die," said Justin Lessler, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. "What we don't know is how much these asymptomatic or mildly symptomatic kids transmit," he told AFP. "This is key to understanding their role in the epidemic." (AFP, March 14, 2020, Children less sick from COVID-19, but still spread the virus)
posted by Iris Gambol at 9:52 AM on March 15, 2020 [1 favorite]

There are two publications out in the past several days looking at transmission in pediatric patients. I have not read them, only summaries. They show prolonged viral shedding in feces in kids, raising the possibility that fecal-oral transmission from children is a real concern. However, we don't know how infectious those shed viral particles are vs. those transmitted by droplet. Here's a link to the tweet where I first saw the data, with links to the publications. I would pull your kid out. In my opinion (just a molecular biologist, not an epidemiologist), the only childcare that should be open right now are for people who literally cannot take care of their kids at home because they can't stop working right now.
posted by deludingmyself at 9:56 AM on March 15, 2020 [1 favorite]

Yes, even very young children can get it.
The second study was a research letter published in JAMA and examined data on all hospitalized infants diagnosed with COVID-19 between December 8, 2019, and February 6, 2020, in China.2 Samples from nasopharyngeal swabs were collected during the infant’s hospitalization, and the specimen was tested using real-time polymerase chain reaction testing. Two positive test results indicated infection.

The researchers identified 9 infected infants, 7 of which were girls. They ranged in age from 1 month to 11 months. Fever was reported for 4 infants; mild upper respiratory tract symptoms were found in 2 infants; and 1 infant showed no symptoms but tested positive for COVID-19 in a designated screening because of exposure to infected family members. All 9 infants had at least 1 infected family member.
posted by Kirth Gerson at 9:57 AM on March 15, 2020 [1 favorite]

Coronavirus, kids and school closings: A public health expert answers 4 questions (Aubree Gordon, Professor of Public Health, University of Michigan, Yahoo News)
One of the best ways that we have to help control epidemics or pandemics of viruses like influenza is to close schools. This is because children tend to be very susceptible to common human respiratory viruses. They shed, or pass on, virus at higher levels and for longer than adults, which makes them more likely to transmit the disease. And they typically have poorer hygiene habits than adults.
posted by katra at 10:05 AM on March 15, 2020 [1 favorite]

Comprehensive Social Distancing Is Difficult And Necessary. Here's How To Keep Your Family Safe (Asaf Bitton, MD, MPH, WBUR, Mar. 14, 2020) (via Harvard T.H. Chan School of Public Health)
I know there is some confusion about what to do next in the midst of this unprecedented time of a pandemic, school closures and widespread social disruption. As a primary care physician and public health leader, I have been asked by a lot of people for my opinion, and I will provide it below based on the best information available to me today. [...]

We must move to pandemic mitigation through widespread, uncomfortable and comprehensive social distancing. That means not only shutting down schools, work (as much as possible), group gatherings, and public events, but also making daily choices to stay away from each other as much as possible to “flatten the curve,” detailed below. [...] The wisdom, and necessity, of this more aggressive, early, and extreme form of social distancing can be found here. I would urge you to take a minute to walk through the interactive graphs — they will drive home the point about what we need to do now to avoid a worse crisis later.

[...] Here are some steps you can start taking now to keep your family safe and do your part to avoid a worsening crisis.

1. We need to push our local, state and national leaders to close all schools and public spaces and cancel all events and public gatherings now. [...]

2. No kid playdates, parties, sleepovers or families/friends visiting each other’s houses and apartments. [...]

3. Take care of yourself and your family, but maintain social distance. [...]

4. Reduce the frequency of going to stores, restaurants, and coffee shops for the time being. [...]

5. If you are sick, isolate yourself, stay home and contact a medical professional.
posted by katra at 10:57 AM on March 15, 2020 [3 favorites]

I just watched one of the daily Canadian reports (I think it was PEI's) who has asked us to keep our kids out of daycare and self isolate for 14 days if parents or kids had any illness symptoms (covid or otherwise) or had travelled internationally (including the US). They talked about how parents cant socially isolate from their small children and therefore the kids should be considered an extension of themselves. They've been exposed to everything you've been exposed to and you're exposed to everything they are (and by extension, the other kids parents).

Oh - found the link, it's at the bottom under "third recommendation". Granted Canada isn't the US, but a lot of the same concerns apply.
posted by cgg at 10:58 AM on March 15, 2020 [3 favorites]

Best answer: We have two kids in a day care. My wife and I are now working fully remotely. Even though we were originally planning to keep our kids in day care until it closed, we've decided to not send them indefinitely.

My reasoning is that in the if we were going to get the virus so bad that both of us would require hospitalization (if ~10% require hospitalization, then ~1% chance both of us would), there's literally nobody who could watch our kids. It's not like we can hand two COVID infected toddlers to their uninfected grandparents for two weeks.

Sorry for not providing a fact based source like everyone else, but that's a concern that is on my mind. Even though it's admittedly a small chance, I think if you are capable of pulling your kids from day care, you should. If nothing else it lowers the risk for people who don't really have that option.

Mods, if this is too off topic, please delete. Thank you.
posted by cali59 at 11:40 AM on March 15, 2020 [2 favorites]

This is our health department’s guidance for childcare centers. This is my employer and I trust my colleagues, and I trust our preschool, so my kid is continuing to go as long as it’s open and safe. One consideration is that she is an extrovert whose favorite toy is other people and I’m working from home - she needs structure and peer contact, I’m not in a high risk group, and we’re social-distancing otherwise. This is well within my risk tolerance as a public health professional, but if there were people at high risk in my household or I couldn’t properly self-isolate if needed, I might make a different choice. YMMV.
posted by centrifugal at 1:13 PM on March 15, 2020 [1 favorite]

The risk is not that your child will be a Covid victim; rather it is that she will be a Covid vector.
posted by DarlingBri at 1:32 PM on March 15, 2020 [11 favorites]

My kids' Seattle area school isn't closed yet. I find this frankly unconscionable, to the point that I think it's permanently souring my feelings about the head of school. Kids can get it and transmit it, and they may not show symptoms. But I can't make the decision to close; all I can do is give them two fewer reasons to stay open. For that reason alone I'd say, if you can do it at low cost to you, please do take your kids out.
posted by potrzebie at 1:46 PM on March 15, 2020 [2 favorites]

Our preschool is still open (but I doubt it will be by ~Tuesday.) It has about 120 kids and 30 adults at any given time. We are pulling our kid out because we make physical or near-physical contact with SO many people when we go there. They are doing their best with hygiene, but kids are just petri dishes in the best of circumstances, and these are not the best of circumstances. On Friday, she went to school, and I was hugged/sat upon by 3 other kids during drop-off. If we're going to do social distancing, we have to REALLY do it.

One of my bigger concerns right now is lobbying the school to keep paying my kid's wonderful teachers during a shutdown, since they are all underpaid in the first place.
posted by juliapangolin at 1:51 PM on March 15, 2020 [3 favorites]

see also, for some pediatric cases in Wuhan.
posted by potrzebie at 1:53 PM on March 15, 2020

If you can pull her out, you should. It will make it safer for the kids and families who have fewer options.
posted by Salamandrous at 5:23 PM on March 15, 2020

Best answer: We’ve chosen to take our child out of preschool voluntarily. I appreciate that his school is open for those who truly need it, but we can figure it out with working from home, and maybe that means they can send some teachers home too and reduces the chances of infection for everyone.
posted by notheotherone at 8:16 PM on March 15, 2020 [2 favorites]

Children definitely catch it, at least 1% of confirmed cases in Italy are between the ages of 0-18 and the reason there are so few is that they are only testing severely symptomatic individuals at this point because of a lack of tests and children DO seem to have mild or asymptomatic cases on average.

They can get it and they can spread it, though thankfully they are incredibly unlikely to develop serious disease from it.
posted by lydhre at 7:01 AM on March 16, 2020

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