How to assess Covid risk for young children?
January 31, 2022 1:50 PM   Subscribe

Our 4 year goes to an all-day creche (daycare) in Switzerland. It is not mandatory, but he likes it and it's great for him to learn French and to socialize with other kids his age. Two weeks ago, we decided to stop having him go in, as Switzerland (and our area) were and still are at peak number of Covid cases. Now we're wondering whether we're being overly cautious. Many of his classmates continue to attend and previously his pediatrician said that the social benefits of sending him to creche typically outweighed the downside of him getting covid. How do we think about the risks of Covid for him and our family?

We are both vaccinated and have gotten our boosters. Both he and his 10 month old sibling are too young to be vaccinated.

His particular group at the creche has about 15 kids. There have been intermittent cases of Covid in his group both with students and teachers. The teachers wear masks and do regular testing. The kids do not. When there were cases, no one seemed to be infected by the positive case.

There's news that Switzerland are considering declaring that Covid has become endemic and removing mask restrictions indoors. We think this is because the hospitalization to case ratio is decreasing.

We have three primary questions:
1. We've read that typically younger children do not get as severe cases of Covid. However, we've also seen there's some data suggesting higher heart and/or diabetes problems with those who've gotten Covid. If there was a high-risk for a long-term impact like that, keeping him at home for a month is well-worth it. Just how bad is the risk of these long-term impact is there for younger children?

2. Our 4 year old adores hugging and talking to his 10 month old sibling. On top of that, we live in an apartment where it's already difficult to quarantine effectively. We've read that children under 1 years old are at higher risk of severe disease. How do we access the risk for this?

3. If we should keep him home, is there a framework in which we can assess when it's safe for him to go back?
posted by comradechu to Health & Fitness (15 answers total) 1 user marked this as a favorite
Best answer: I can’t really help you with the science, but I can offer some anecdata. We are pretty much exactly where you are geographically and with kids. We send the kids to school because we came to the same conclusion as your pediatrician. It’s really important for them to be in school at that age, there’s so much socialization and pre-reading, and mine are just generally happier in school. We decided to privilege their mental health and ours.

Other people have come to different conclusions, but from what I can see in our town almost all the kids are in preschool. Either way I don’t think you’re making a crazy choice.
posted by ohio at 2:11 PM on January 31, 2022 [2 favorites]

To clarify, what you're considering is keeping him home for a few weeks until the current wave fades out, right? Or are you thinking about keeping him home longer-term?
posted by trig at 2:22 PM on January 31, 2022 [2 favorites]

Best answer: The primary reason for keeping kids in virtual school (or, in the case of younger kids, out of daycare) hasn't been danger to the kids, but danger from the kids -- a concern that schools would contribute to increased community transmission. It sounds like your kid is already in school, so has already been at risk for COVID, and quite possibly has already had and recovered from COVID (well, unless Swiss testing protocols require frequent enough testing to catch most cases, which would be pretty different from the US.) I think the stakes here are pretty low. If you want to keep him home for a couple of weeks while this wave dies down, and that works for you, I don't think his social life is going to be massively harmed by it. And if he doesn't stay home, I don't think he's taking on very much COVID risk over and above what you've already accepted in his life, and yours. So there's no real wrong answer here. I can only say that I didn't think twice about sending my kid back to in-person school when she was too young to be vaccinated.
posted by escabeche at 3:41 PM on January 31, 2022 [1 favorite]

Best answer: Covid becoming endemic means that everyone will get exposed to the virus sooner or later just from living normal life. That means that the level of cases at any given time is less relevant to your personal risk, since there's very little likelihood you'll miss it entirely -- it's just a question of earlier vs later (I say personal risk since there are still societal reasons why later might be better than now).

So for young children, I think the question of "how can I minimize the risk of them being exposed to covid" is the wrong question. You can't, realistically. Instead, ask "do I have a good reason why it would be better for them to get it later as opposed to earlier?"
posted by goingonit at 5:20 PM on January 31, 2022 [2 favorites]

Best answer: For me, the protection against hospitalization and death granted by vaccines is good reason to prefer a kid get infected later vs. now. Also in the future, hospitals might not be in critical shortages of people, beds, rooms, drugs, reagents, etc. the way they are now in many places.
posted by SaltySalticid at 6:21 PM on January 31, 2022 [1 favorite]

Best answer: Keeping the child home is not really to protect the kids. Omicron has been relatively "mild" on children, but the problem is while they may not suffer "much" from it, they can catch it from each other... and spread it to the rest of the school, take it home and spread it to the community, such as you. And doctors are seeing more long-term COVID symptoms in children so I'd recommend caution when sending him back to the creche.

I also find the idea of "COVID is going endemic" rather ludicrous. It's been shown that omicron is substantially different that if you have been infected by delta or earlier strains of COVID it offers VERY LITTLE immunity against omicron. (Booster on the other hand offers complete protection even against omicron) so the idea of "catching COVID to get it over with", IMHO, is a VERY DANGEROUS mindset. I believe a famous Czech folk singer tried that and died from COVID.
posted by kschang at 9:27 PM on January 31, 2022 [1 favorite]

Best answer: Here's one framework that may work for you: I'm not familiar with the statistics in Switzerland, but in the U.S. at least, one of most dangerous things we do on a regular basis is to get in a car. Society as a whole considers this an "acceptable risk." Someone might decide that additional covid precautions should be taken until the point where the risk of covid is less than or equal to the risk of getting in a car. Or perhaps there's an alternative metric that is more applicable to your family.

This is certainly easier said than done for sure. A lot of statistics we'd really like to have in order to make the best decisions for ourselves and our families don't exist. Moreover, when your pediatrician is advising you, she is giving you advice that is true for populations, but definitionally can't be true for all individuals. You know that your kid has a good home life, but advice for kids in general must consider all kids, including those who are not so fortunate. Moreover, the vast majority of under 5s who get covid are going to be fine in the long run. However, there are very real consequences to the children and their families who have long-term effects. There are also undeniable negative impacts of not sending kids to school. Plus no one has a magic eight ball. Pulling your kid out of for one month will have different consequences than pulling your kid out for longer. (In 2020, most of us thought this Covid thing would blow over in a few months).

A possible compromise might be to make sending your kid to school less risky. Will she where a mask (when her classmates won't). What about only sending her only part time? That being said, there's no reason you have to compromise. (It's just an alternative between all or nothing for the next month.)
posted by oceano at 10:16 PM on January 31, 2022

Best answer: Just to clarify, I am in the US, so most of my citings will be US news sources and the US CDC, which may not agree with its European equivalents or reach the same conclusions.

The CDC does have a page on "Science brief of COVID in K-12 Schools and Early Care and Education Programs", last updated December 15, 2021. This suggests it was NOT updated with any omicron-related information since.

TL;DR -- early childcare and education (ECE) place can be safe if they practice layered protection such as masking, frequent hand-washing and cleaning of surfaces, good ventilation, and if practical some social separation. They even cited a Swiss study, but I believe that's done in 2020 or 2021 about the Delta wave.

In contrast, some school districts in California have basically given up tracking and contact tracing in the midst of omicron surge. Palo Alto's school district superintendent basically stopped tracking altogether and told EVERY student and staff to assume they have been exposed, and test themselves weekly, and come to school unless they test positive or show symptoms. Marin school district went as far as not even recommend testing. While this vastly simplified paperwork for the school districts, it left the health departments wringing their hands because they now have no way of tracking COVID in schools. So the data about COVID in some schools may be more difficult to get regarding the omicron wave. Other school districts such as San Francisco are following the CDC protocol and still sending close-contact notifications of COVID cases.

Does this have any bearing on your decision? I have no idea, as I have no idea how closely are COVID tracked in your area. It may make you more anxious, or it may give you some comfort that situation is being tracked. I have no idea if finding out would help or hinder your decision process.
posted by kschang at 10:35 PM on January 31, 2022

Response by poster: > To clarify, what you're considering is keeping him home for a few weeks until the current wave fades out, right? Or are you thinking about keeping him home longer-term?

Correct, it was more concern over this latest wave. We've had him in creche throughout this entire school year.

Long-term, the benefits of the language / social interactions are quite clear.
posted by comradechu at 2:26 AM on February 1, 2022

Best answer: I’m very (maybe overly) cautious and we’ve managed to keep our young child home this whole time. We are only now getting part time in home childcare and will continue this way until we can get our young child vaccinated.

We’ve felt this approach worked especially well for omicron because everyone I know right now with a child under 5 in nursery school has had to have their kid stay home to quarantine or had to test their kid multiple times. Omicron has pretty much peaked now in our area and it took about a month to happen.

It’s really a decision you need to make together as a family. For us I’ve been surprised to see that despite not having met like more than 20 people in life and pretty much hanging out with only her parents, my social kid’s verbal is through the roof.
posted by donut_princess at 4:20 AM on February 1, 2022 [1 favorite]

Best answer: Nothing's certain except that there's likely to be some delay between US approval and approval in Switzerland, but some articles just came out today about an initial Pfizer vaccine hopefully being approved in the US this month for kids under 5.

In general, I think it's really hard to assess risk accurately since so much data (especially on long covid) isn't being measured, let alone reported. We're all being forced to gamble with insufficient information and it's terrible. That said, I think any developmental or social harms from being kept home are more of a (very) long-term issue than something to worry about on the scale of weeks or even months, especially if you're able to provide a fairly stimulating environment, so I personally wouldn't worry about that as a factor unless he actually seems stressed or unhappy. If you're able to keep him home without a severe cost to your own wellbeing and ability to work and function, then I think you're in the enviable position of being able to choose what path you're comfortable with, regardless of what other people (who might not be as well set up) are doing.

Do you have a good source for tracking infection and vaccination rates in your area? I've been making my own decisions based on sites that chart both the current situation and the statistics since the beginning of the pandemic, so that I have some context for how good or bad the current situation is, and also for how long a given wave is likely (though not certain, of course) to last based on precedent.

FWIW, I've also found this site useful for looking at what's going on in other countries with similar profiles to mine; even though no two countries are exactly alike, sometimes it's been helpful to see what the trends in other places are. (The interface is super unintuitive: if you click on the tab that says "chart" under the map, you'll get a graphed chart, and if you add countries using the box at the top of the page you'll be able to compare the data. The content menu on the left also lets you see a bunch of different statistics.)
posted by trig at 5:02 AM on February 1, 2022

It's anecdotal but Omicron has spread like wildfire through my friend's reception class (ie age 4-5) in the UK, but none of the kids has been ill for longer than a few hours and the experience has mainly been similar to other similar illnesses. Although this is anecdata, it does align with the hard evidence, which is that small children are exceedingly unlikely to have anything other than a very mild case of Covid. Small children entering nursery/school etc do tend to get sick more in their first year and bring everything home with them. Covid is no exception. If you can live with the idea that your kid will bring home Covid to your house, then I think it's fine. FWIW here in the UK, I don't know anyone who is keeping their kids out of school or nursery.
posted by plonkee at 8:10 AM on February 1, 2022

I think you may get very different answers here from a U.S. versus Europe perspective. In Northern Europe, where I live, absolutely no one is keeping (or has ever kept!) children home from preschools. Maybe only if they had a sibling who was very immuno-compromised and then only at the very beginning of COVID. So it is hard to say what the right answer is. Just to keep in mind that where I am from, people would look at this question very strangely... however, where many of the people on AskMe are from, keeping children home is very common.
posted by spisspisspis at 10:37 AM on February 1, 2022

Given that two weeks home is going to have very little impact on your kiddo's long-term development, in my opinion it's okay to also take your own well-being into consideration. If that option will result in you being significantly less stressed, you shouldn't feel guilty for keeping him home until the current wave has receded.
posted by coffeecat at 10:38 AM on February 1, 2022

Response by poster: Thanks all for your responses! Clearly given the lack of great information, there's a lot of differing opinions as to approaching this and I've tried to mark the responses showcasing this diversity accordingly.

As an FYI, the peak both in Geneva and Switzerland as a whole has started to drop and the Swiss government has started to loosen restrictions. Generally speaking, the parents here generally think that having them in school is more beneficial than keeping them at home. Furthermore, they don't think kids represent a risk for super-spreader events, so there are no mask requirements for those under 12 years old anywhere. Perhaps there's science that backs that up; however, at the same time, it feels like we're one of the few families in our network that haven't had a case of Covid yet and is still worried.

We're tracking the numbers and if the downward trend continues, we'll be sending him back soon.
posted by comradechu at 12:28 PM on February 7, 2022

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