As Donald Trump makes his relentlessly uninformed push to reopen schools at any cost, one of the biggest problems facing school communities and parents who will be making those decisions is the lack of "gold standard" research on how coronavirus affects kids.
As Jackie Flynn Mogensen of Mother Jones points out, a plethora of questions remain unanswered about kids' transmissibility of the virus (are they as easily infected and are they as infectious as adults?), how COVID-19 ultimately manifests in kids, and why a small number of children have developed a potentially deadly inflammatory disease after contracting the virus.
The reason so little is known really comes down to the short time span scientists have had to research COVID-19 and how very difficult it is to study kids, in particular. On top of that, certain data points have offered conflicting conclusions. For instance, countries such as Austria, Denmark, and Germany have reopened schools relatively successfully while others, such as Israel, Japan, and South Korea, opened their schools only to shutter them again following spikes in new infections.
In another instance, an early contact tracing study in China suggested that kids under 10 years old were just as likely to get infected with COVID-19 as adults but much less likely to show symptoms. But subsequent to that, other studies have suggested kids contract the virus less frequently than adults.
“It’s possible that our study is an outlier,” Justin Lessler, an associate professor of epidemiology at Johns Hopkins Bloomberg School of Public Health and co-author of the contact tracing study, told Mother Jones. “The numbers are small, so it’s perfectly possible that our result is not going to be borne out over time. And that’s the nature of science.”
The modeling studies have also been inconsistent, with some suggesting reopening schools could produce a spike in cases while others have concluded school reopenings wouldn't be a major factor.
Here are the basics on why it's so tough to study kids.
1. Many kids are asymptomatic
A study of 2,135 pediatric COVID patients in China, initially published in mid-March in Pediatrics, for instance, found that more than 90 percent had asymptomatic, mild, or moderate cases.
And in the U.S., a recent CDC report showed people age 19 and younger accounted for only about 5% of confirmed COVID-19 cases between January and May. That said, a relative shortage in U.S. tests has skewed toward testing both symptomatic people and people with lots of exposure, such as medical workers. So that 5% may be deceptively low since so many kids appear to exhibit mild symptoms or even none at all.
2. There are extra hurdles to studying kids
Since kids are a vulnerable population, researchers must get parental consent in order to include them in studies. Beyond that, a host of ethical considerations also come into play.
“When we conduct research on children, there are special levels of protection because children are more vulnerable,” says Dr. Cynthia Haq, a clinical professor and chair of the Department of Family Medicine at the University of California, Irvine. "We don’t like to conduct studies on children unless there’s clearly no evidence of harm from the study or definite evidence of benefit.”
3. Many of the studies aren't "gold standard" research
In short, it's very difficult to conduct randomized testing in a crisis, and especially of kids.
“There’s lots of things being published and lots of stuff coming out, but most of it is either retrospective or somewhat anecdotal," says Dr. Sheila Nolan, chief of pediatric infectious diseases at Boston Children’s Health Physicians. "And it’s not that gold standard of how to really do a research study, which is exceedingly difficult to do while you’re in the middle of a crisis.”
Mother Jones goes into a lot more detail, so if this topic interests you, read the full story here.