Coronaviruses in children : contaminated ? Contagious ? The situation has changed

CORONAVIRUS CHILD. It is established, or almost now : the coronavirus button bit and bit violently the younger. The children affected would be also somewhat con

Coronaviruses in children : contaminated ? Contagious ? The situation has changed

CORONAVIRUS CHILD. It is established, or almost now : the coronavirus button bit and bit violently the younger. The children affected would be also somewhat contagious indicates a recent French study...

Summary: The coronavirus in children immune Defenses of children not infected ? The children are really less exposed ? What symptoms in a child ? The children are they contagious ? Studies on the transmission by children Opinion of the doctors on the contagious and Debates on the opening of the schools

The children are beautiful and little sensitive to the coronavirus and little contagious. This is the conclusion of a study conducted in Ile-de-France with several hundred children, the results of which were released in pre-publication on the site MedRxiv this Thursday 4 June. This study, supported by the Association française de pédiatrie ambulatory and managed by the paediatrician and infectious diseases physician at the hospital of Créteil (Val-de-Marne) Robert Cohen, concluded in brief that "the children seem to be less contaminated and less contaminants". In detail, the analysis included 605 young patients under 15 years of age, followed by 27 pediatricians in the city, between the 14 April and 12 may. The study indicates that of 46.8% (283) of the patients had mild symptoms, ranging from a simple cough to fever, and from diarrhoea or loss of taste. Conversely, more than half (53.2 per cent or 322) were asymptomatic, even if a part (118 children) had experienced symptoms in the upstream tests.

The teams of Robert Cohen has established that only 11 children (less than 2%) were PCR positive, demonstrating that the SARS-CoV-2 was active among them. They were, however, 65 (10,7 %) to show a positive serological test, a sign this time they have developed antibodies against the coronavirus. "We had already found in a previous study that the PCR tests in children were three to five times more frequently negative than in the adult," explains Robert Cohen the World. Side contagion, the 65 children positive seem in majority to have been infected by an adult, 87,3% of them "have had a contact with confirmed or suspected" with an older person in their family affected by the coronavirus. The one who is also the vice-president of the French Society of pediatrics and who leads the Group of infectious diseases pediatric (GPIP) also says in Le Parisien that only 0.6% of children displaying a test PCR positive were truly contagious.

"children are little holders, little transmitters,"

"At the beginning of the crisis, it was believed, as for other respiratory viruses - that [the children] played an important role in the spread of the epidemic. This is not the case. The evidence has been piling up", slice Robert Cohen, interviewed by the newspaper, île-de-france. According to him, "this disease mainly affects adults, more severe forms and deaths occurring almost exclusively in elderly patients or those with comorbidities".

Robert Cohen had already brought the first conclusion of this study called "Coville" on BFMTV on Tuesday, 12 may, going so far as to call the Covid-19 of the "disease of adults". The specialist was then advanced that the risk of contracting the coronavirus was "extremely low" in the child, "you can say a thousand times lower than in adults". "Children are little holders, little transmitters, and when they are contaminated it is almost always adults in the family who have contaminated", was pounding then Robert Cohen, which also minimizes the potential for contamination of the children between them. The pediatrician indicated, finally, that these results "confirm completely the whole of the literature" in science on the subject. And he dared even : "If the epidemic starts again this is not by schools but by adults", confirming about the recent minister of Education Jean-Michel Blanquer, according to which "the children outside of school are more likely to be in danger inside the school."

"we need to reassure families,"

many other scientific evidence can be gathered to substantiate the thesis of the French researchers, as well as many opinions of the experts. Among the latter, Christèle Gras-Le Guen, Professor of the University in pediatrics, head of the department of general pediatrics and of pediatric emergencies at the university hospital Nantes, provided very recently in an interview with the website The Conversation, she also provides that"it is necessary to reassure the families." "This disease, which we know certainly not everything, has absolutely not shown worrisome among young people. In the vast majority of cases, there are no contra-indications to what these children, usually regarded as fragile, and that we keep in the shelter of viral infections, do not return to school," says the other vice-president of the French Society of paediatrics.

Robert Cohen and Christèle Gras-Le Guen are among the signatories to a forum of twenty pediatricians, published Wednesday, may 13 on the website of the Daily of the doctor, which called for the return of children to school, while "the quasi-totality of children who have been infected by the COVID-19 have been in contact with adults". Other officers of the French Society of Pediatrics, as chairman of the Pr Christophe Delacourt and president of its scientific council, professor Emmanuel Gonzales, are alsoi part of the drafters of this text.

What are the scientific studies on children, and the coronavirus ?

from the clinical observation, it has been known for several week already, the children seem to be less affected and suffer from the forms noticeably less severe disease. Very often, children are asymptomatic or "no symptom" enter into the substance of the various studies published on the subject. On 24 February, the scientific journal online JAMA (the Journal of the American Medical Association) informed that on the 72 314 first case of coronavirus listed while in China, only 2% were children and adolescents under 19 years of age and that there were no deaths in children under 9 years of age. Other studies published in the same journal (here or here), in the Lancet, the recognized Pediatric infectious didease, site Pediatrics, or even an israeli study indicate that the children seem to be rarely achieved by the Covid-19, and that, when they are, they are affected by forms little severe (from "asymptomatic" to "moderate").

This observation is shared by several other publications listed on the website of the French Society of pediatrics or even by studies more specifically on the infectiousness of children that we include even more below. In the world, "the critical forms of disease in children appear to be very rare (around 1% of the total)" and "only a handful of cases death has been reported", summed up the beginning of may the site Don t Forget The Bubbles (DTFB), specialized in pediatrics, and who has analysed all studies on the subject.

statistics also reassuring

The chinese data, Spanish, as the data of the higher institute of health in italy (Istituto Superiore di Sanità), seem to confirm this observation. At the global level, the proportion of pediatric cases of Covid-19 is estimated to be between 1 % and 5 % of all cases, recently told public Health France. The French statistics are to the rider. In its weekly newsletter of April 16, public Health France were, as well as a hundred young people aged 14 and under were hospitalized, including one thirty in the resuscitation. The number of severe cases recorded among children under the age of 15 years represented only 0.6% of the total in France between 16 march and 12 April, at the time of the epidemic was the highest, according to the agency.

Among these children, one third were babies of three months or less tells The World that says that these children were generally"a fever isolated, without a sign respiratory". "A non-negligible part has an underlying pathology, according to the data of pediatricians French", assured still the daily in the evening.

A series of studies conducted in France

For a comprehensive view of the impact of the coronavirus among children in France, the national network of paediatric clinical research Pedstart (a thematic network F-CRIN, carried out by the Inserm), has put in place in mid-April, "a Task Force that aims to consolidate all information relating to the pediatric population infected". It identifies since "in real time, clinical studies conducted in France on the Covid-19 in children" (some of which are mentioned on the website of the French Society of pediatrics), and studied "the impact of the Covid-19 on the paediatric clinical research in france and europe". "This is the Covid-19, we have listed to date 18 studies, of which some are still in design. The majority of these are observational studies, that is to say that one does not test for drugs", said Régis Hankard, co-ordinator of the research network of clinical pediatric Pedstart, may 10, in The Conversation. "A single study related to a project adult more wide, that of Didier Raoult in Marseille, is testing a drug, but it relates to only 5 children, and there was no control group", he said. "Other studies involve the reaction of the children victims of cancer or other infectious diseases, cardiomyopathies, congenital, those who are bearers of signs, dermatological, etc"

We can also cite the study conducted by Arnaud Fontanet from children of six primary schools of Crépy-en-Valois, French commune very touched at the beginning of the epidemic, to "know whether they have been infected during the epidemic period of February". This epidemiology of infectious and tropical diseases (Pasteur Institute) and member of the scientific Council on the Covid-19, speaking on 30 April at a parliamentary hearing, and was thus considered to have"a bundle of arguments that we suggests that in less than 10 years, the situation is probably less severe than in adults, namely that they are less likely to be susceptible to infection and less infectious. But we want to be able to the check out."

children have better immune defenses against the coronavirus ?

"Why do children have mild symptoms with little hospitalization ? I confess that today I have no answer", declared in AFP the epidemiologist Antoine Flahault, director of the Institute of global public health at the University of Geneva, in mid-April. On Sunday, 19 April, during a press conference of the government, Florence Ader, infectious diseases physician and pulmonologist at the hospital of the Croix-Rousse Hospices civils de Lyon (HCL), has also recognized doesn't know the exact causes of this relative innocuité of the virus on the young. Immunity is a first track of the explanation which seems to be followed by public Health, France. The agency official, the French issued may 5, on its website a summary of international studies on the subject. According to her, the children seem to be as subject to infection by SARS-CoV-2 as adults, but develop very largely of the forms "less serious" of the disease, or no symptoms at all, which makes them more difficult to detect.

According to Robert Cohen, the children are overall less susceptible to viruses and their effects on the body, as it can be observed for diseases such as measles, chicken pox or mumps, that adults can suffer in a way that is more consistent. Among the tracks of the explanation cited by the pediatrician it is the "receptor of the virus," which would be fewer "on their nasal mucosa", the "runny nose" more often and that would also play a role barrier, but also the so-called "cross immunity" provided by other coronaviruses mild... The children would be in sum more "trained" and therefore more resistant to infections, according to him. Etienne Javouhey, head of the department of emergencies and resuscitation in the paediatric university hospital of Lyon, suggests that the immune response of children would be different because they are generally more exposed to viral infections, which would make them "more willing to defend themselves in the face of a new virus". The children would be regularly affected by viruses of the coronavirus family, which could allow them to have their already immune defenses adapted. They would develop interferons (proteins of the immune system) that would allow them to defend themselves. Etienne Javouhey also cites in The World vaccinations and very regular that would protect them more than adults, by stimulating their immune system.

But this explanation of an immune response most suitable may be challenged. According to Christèle Gras-Le Guen, Professor of the University in pediatrics, head of the department of general pediatrics and of pediatric emergencies at the university hospital Nantes, the immune system of very young children "is not yet in a position to defend effectively against the bacteria, which, later, will do them neither hot nor cold". "You have an illness, which turns out to be serious for the elderly and who is not serious for the very young, it's never seen," she says, taking example on the flu that also affects severely the young children and the elderly.

children can-they are not infected ?

other experts believe that children, especially under 10 years of age, are less likely to catch the Covid-19 as adults, they would simply not infected, and that the immune defenses are not really for anything. On the site, Don't Forget The Bubbles, already mentioned above, two specialists in paediatrics, Alasdair Munro and Damian Roland, think is "increasingly likely that there will be fewer children affected by the Covid-19" that of adults. They are based on tests carried out massively in South Korea, in Iceland or in the Italian town of Vo, where the number of children positive was much lower than that of adults.

A number of explanations to the more hypothetical still come from studies conducted in particular in the United States. An american researcher has shown in the beginning of the year that the reason for the protection of the youngest against Covid-19 would be bound to a hemoglobin that is different in children, fetal hemoglobin, whose protective properties are well known, and which disappears gradually with the age. The track of the cellular receptor ACE2, or "angiotensin-converting enzyme 2", is also explored. This enzyme present in our lungs, our arteries, kidneys, digestive system and even the heart, would be a door of entry of the virus. It is, moreover, a serious track of progress on a potential treatment. The ACE2 would be particularly less present in the child, but scientists remain divided on this assumption. Other scientists, such as the immunologist Jean-Laurent Casanova in The World, believe that genetic factors are predominant.

These tracks suggest that the virus could find just the door closed in children, what suggests also the Pr Christèle Gras-Le Guen. It testified to its amazement at the topic of "the case of mothers positive for the virus, but the newborns were not infected, despite their close proximity". "For the moment we do not know how it is possible [...]. The available information appears to indicate that the SARS-CoV-2 does not "cling" not a lot in children", assures it in an interview for the website The Conversation.

The children have really less often the coronavirus ?

effective immune Response, or pure and simple absence of infection with the SARS-CoV-2 : so these are the two assumptions that it must, for the moment, the tiebreaker to determine why children seem to be less affected. And the results of the tests seem to favor the second option. A major study carried out in Iceland and reported in the New England Journal of Medicine, indicated that the mid-April that the positive tests in children were at least two times less numerous than in the adult. A particular confirmed and even strengthened since then, including in France. "According to the data collected in the network of pediatricians, approximately 12,000 children were tested on a suspicion of Covid-19, and 6.3 % of these tests proved positive. This makes a little over 700 cases", stated, for its part, Christèle Gras-Le Guen in The Conversation last may 10. It noted, however, that the distribution was "very different according to the regions."

Only a handful of studies compartmental seem to support the opposite hypothesis. The site specialized MedRxvid, for example, has published in march a study that had not yet been validated by a committee of scientific reading on the subject. Based on a sample of 1 286 persons in contact with sick people of Shenzhen, in China, between January and February, it believed that young people are not particularly protected against infection, the levels of contamination are similar at the age of 19 and that of the rest of the population. The study has since been challenged by several scientists.

The number of tests further strengthens the uncertainties

Su the issue of contamination, the question of the number of tests performed on the children arises however crudely. It is possible that children have not yet been massively linked to the virus simply because the tests conducted on this population are significantly less frequent. The president of the doctors Federation of France, Jean-Paul Hamon, warned in mid-April in The Point : "We have no certainty". The overall vision of the epidemic in children may indeed be biased by the fact that they are very little tested unlike other age classes. "The children are doing well and don't go to the hospital, so they are not tested", also said Sharon Nachman, professor of the school of medicine the Renaissance of the children's hospital, Stony Brooks, near New York city in the same period by France Info.

"We only have two objective data : there is less severe, and less of all positive tests among children who arrive at the hospital compared to adults", summarized most recently Isabelle Sermet-Gaudelus, pneumopédiatre at the parisian hospital Necker-sick Children, in the Figaro. But the question of why remains unanswered : "Is this the children develop a portage healthy which will make them immune to, or forms very little symptomatic - type mini-pharyngitis - which will go unnoticed ? Or is it that they are not infected at all ? There is, at this stage, no clear conclusion", she says.

Are there any specific symptoms of the coronavirus among children ?

Despite statistics and analysis reassuring, the coronavirus reaches yet in rare instances to pass between the meshes of the net. A few deaths of patients very young since the beginning of the epidemic have already created a lot of emotion in France and abroad. On April 9, Jerome Solomon, the director-general of Health, reported the death of a child of ten years in the Ile-de-France, reached by the coronavirus, but which showed "significant comorbidities". A few days earlier, on 24 march, a teenage girl of 16-year-old from the Essonne, succumbed to the Necker hospital, after a sudden worsening of his state of health. She suffered from no "particular disease before," according to his family. There are also the death of a young girl of 12 years in Belgium, a child of 5 years in the Uk and a baby of 9 months in the United States.

A mysterious infection, which are on the increase in Europe, has also started to install the doubt among doctors and scientists since the 27th of April. Between Kawasaki disease and toxic shock, she goes from digestive disorders to myocarditis and, therefore, with serious heart failures and has already killed a child of 9 years in Marseille. There were also three deaths in the State of New-York, in the United States. The link between these new suspect cases, and the coronavirus seems to be well established, and many experts believe that they may be related to an overreaction of the immune system in three to four weeks after infection by the Covid-19. If this new infection is still very rare, the increasing incidence in several countries of the globe, including France, where more than 150 sick children have been listed since the 1st of march, is heavily monitored.

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Less serious than these special cases, or that the shock toxic mentioned above, the quirks have also been found in children with specific symptoms. Dermatologists and podiatrists Spanish reported at the beginning of the month of April that of young patients, sometimes with symptoms of the Covid-19, also had lesions on the toes, or have had just before. Lesions that were described as "purple" or "bright colors", sometimes with"a skin bumpy and burning" and followed by "scabs" and a "slight discoloration" persistent, according to the document posted on 9 April on the website of the general Council of the chiropodists Spanish.

This phenomenon on the rise, and the concurrent pandemic of coronavirus, has been confirmed by the international Federation of paediatricians and from the Northwestern University Feinberg School of Medicine in the United States, including a doctor and was assured that "this does not seem to be a coincidence", even if the link is not formalpally set. These rashes have inherited a nickname, the "toes Covid-19". They go away usually after a week and would be without consequences.

The children are they really contagious ?

Concerning the spread of the virus via the children, it was based on studies on respiratory viruses and influenza in particular, for which the decline in medical is sufficient, and according to which the spread by means of children is increased. The school has even been presented as a "zone of amplification of the disease in a report of the High council of public health in 2012. Further in time, a model published in 2008 by a team of French researchers believed that closing schools could reduce approximately 15% of the total number of influenza cases in the event of a pandemic, and 40% of the height of the peak.

Many specialists vary, however this is an assumption that as one progresses in the knowledge on the Covid-19. "Contrary to what we know with influenza, where children are the main transmitters, it appears that with the coronavirus they excrete less virus," according to the Pr Odile Launay, infectious disease specialist at the hospital Cochin in Paris. Pascal Crépey, an epidemiologist at the Ecole des hautes études en santé publique (EHESP), has also assured France info mid-April that the "initial argument" according to which "the coronavirus was a bit like the flu" in children, presented as "high transmitters" was probably being called into question. "We see now that this coronavirus does not behave in exactly the same way," he said.

A virus in smaller quantities ?

"The virus exists in children, but probably in smaller amounts than in adults," assured for his part on BFMTV on April 19, Jean-François Delfraissy, president of the scientific Council, first in line for advising the government in this health crisis. "It has not been of great homes from schools, except in france, where the virus came from outside," he added. The risk of transmission by children is considered "possible, but not certain" by the specialist who recognized again on April 15 during a parliamentary hearing miss data on the capacity of transmission of the virus between children and of children to their family.

The logic of the low capacity of transmission has yet been taken by the minister of Health Olivier Véran on France 2 on 21 April. "The studies are in the process of stabilization", had indicated the latter. "One tends to think that the more the children are small, especially those under ten years of age, the greater the risk of transmission would be low," he added, claiming at the time to give that information out "in the conditional tense, because the evolution of scientific knowledge on this virus is constant".

What studies have been done on the contamination by the children ?

The study, conducted in the Ile-de-France on more than 600 children and detailed at the top of our article seems to put an end to doubts for weeks : the child would be beautiful and much less infectious in regards to the coronavirus. Another study, called the "Pandor", is supported by the Association of clinical and therapeutic infantile du Val-de-Marne (Activ) and the French Society of paediatrics. A third, more long term, is underway through a cooperation between the hôpital Necker in Paris and the Commissariat a l'energie atomique (CEA). 1000 children came to refer to all types of patterns are tested, as well as one of their parents. "By analyzing the antibody, we will know who contaminated who. We could get feedback quickly enough," said to Necker, indicating that the positive cases will be followed for one year.

The French Society of pediatrics cites also a dozen studies on its website, based generally on samples with extremely low. One of these studies, based on the cluster of les Contamines-Montjoie in the Alps, one of the first of the epidemic in France, has been published on the website of the Clinical Infection Diseases, April 11. It concludes that a 9 year-old child, presenting with the symptoms of the coronavirus and tested positive, has not transmitted the disease despite "close interactions within schools", the latter having attended "three schools and a ski class" before being placed in segregation with the other contaminated of the cottage where a British had spread the virus. In the same group, an "adult asymptomatic" was a "viral load similar to that of a symptomatic patient". The study suggests in conclusion a dynamic transmission potentially different in children".

A publication, released in march in the journal the Pediatric Infectious Disease Journal, is based on research of the universities of Fribourg in Switzerland and Melbourne in Australia, supported themselves on three studies carried out in China. They tend to show also that children contracting the coronavirus were first in contact with infected adults in their family. The conclusion at the time : "the importance of children in transmission of the virus remains uncertain." Another study conducted by the Institute of public health of the netherlands from the statistics of the disease in the country seems to show that "less than 20 years, play a far lesser role in the spread of the virus than adults, and the elderly." The institution Dutch recommmande, however, apply as far as possible, a safety distance of 1.5 metres between the students and their teacher.

studies were less optimistic about the infectiousness of children

It is also necessary to emphasize that other studies have shown less optimistic about the potential for contamination of the children. A study conducted by several doctors from the university hospitals of Geneva, and pre-published on the website MedRxiv on 27 April, showed that although they are under-represented in the number of cases, "the SARS-CoV-2 infected children of all age groups". Most importantly, she argues that "despite the high proportion of infections are mild or asymptomatic, it would be naive not to consider them as transmitters". Out of 23 neonates, children and adolescents symptomatic and positive for the coronavirus, the viral load proved to be comparable to those of adults.

"The children symptomatic of all ages to be excreting infectious virus at the beginning of the acute illness," it said even the study. "Therefore, the transmission of the Voc-2 of SARS in children is plausible. Given the relatively low frequency of children infected at the present time, biological factors or other unknown factors could reduce transmission in this population," reassured, however, to the researchers, calling for "extensive serological surveys and routine surveillance of acute respiratory diseases, to understand the role of the children in this new pandemic".

A study with disturbing news coming of the Berlin

The university hospital of the Charité Berlin published at the end of the month of April a wide-ranging study on the viral load of the sars coronavirus in 3712 of his patients with a positive Covid-19, dividing them in different age classes. The results, pre-published on the website of the institution, showed that while there was "no significant difference between age categories, including children, which tended to demonstrate that the coronavirus was just as powerful in children as in adults. "The data indicate that the viral loads in the very young children do not differ significantly from those of children of less than five years," it said furthermore to the study, which warned in black and white against a re-opening unlimited schools and kindergartens in Germany. "The children can be as contagious as adults", acted as the German doctors the signatories, who have worked under the guidance of Dr Christian Drosten, clinical virologist recognized in Germany, advisor of Angela Merkel on the virus and initiator of the very wide testing policy conducted in the country.

Several scientists, including Alasdair Munro, a researcher in infectious disease pediatric university hospital, Southampton, United Kingdom, and the epidemiologist, the swiss Leonhard Held, have challenged the methodology and the conclusion of the study. In réanalysant its results, they leaned rather to the counter-interpretation and a viral load less than adults.

What are the opinions of the doctors on the transmission of the sars coronavirus by the children ?

Among physicians and scientists, the specific issue of the dissemination of the Covid-19 by the children is extensively commented. And certainties have changed significantly on this issue. "On the contagiousness, we have a real shortage of data," admitted Etienne Javouhey in The World in mid-April. "But contrary to what was said at the beginning of the epidemic, children are not more infectious than adults. I think the same personally to the contrary". Robert Cohen seemed to already for his part look for of the infections more common of the adult to the child than the reverse : "Almost all cases reported are cases of contamination in the family of parents to children [...]. Eight times out of 10, there is a contaminator in the family sick before them [...]. Three weeks ago, I would have said the opposite"...

"everyone is gone, on the idea that children are frequently carriers of the virus, that they do not fall ill, but they pass. The first data do not go in this direction", explained yet dr. Robert Cohen at the microphone of Europe 1 on April 15. The controversial professor Didier Raoult is one of those who have called for calm about the coronavirus among children. Infectious diseases physician in marseille, it is already on the front of the stage for his tests challenged on chloroquine, has published also in the same period a study with his team which showed that children and adolescents do not have a virus concentration is particularly high and were a little contagious.

others question already for a long time as Isabelle Sermet-Gaudelus, Necker, in the Figaro : "We do not know if the fact of being asymptomatic is connected to a lower viral load and what are the type and duration of the immunity triggered by the encounter of the virus," believed the pediatrician. Pr Pierre-Yves Boëlle, a researcher at the Institute Pierre Louis of epidemiology and public health, was abundant also in le Figaro : "Is that it can result in a reduced ability to transmit it , in the absence of cough ? One can hope, but we don't have the answer". He has since refined his thinking, always in the Figaro : "It is possible that the fact of not coughing or running of the nose to reduce the likelihood of transmitting the virus". A track recovery by Arnaud Fontanet before the deputies on 30 April, the latter agreeing that the infectiousness of the ekids was limited "to the fact that they do not have symptoms and does not a cough, not".

Up to Geneva, it is the subject of debate. Professor of public health at the university Antoine Flahault ensured also in the month of April, there are few reports showing that the virus circulation is intense in children. "The data seem to suggest that students would play a weak role in the spread of the virus", let go of it in the Figaro a few weeks ago. He felt, however, "premature" the reopening of schools. "In the case of the flu, closing schools is the measure that showed the best efficacy on mortality of the elderly, a group to protect in the first place".

The scientific opinions are not followed up on the school and the discussions lively

The reopening of schools, even progressive, since may 11, has caused heated debate in France. The scientific Council has thrown a stone into the pond on Saturday, 25 April, confirming in a notice devoted to the déconfinement of the schools that he had recommended a re-opening of classes in September, "as a precaution", and not in the spring, as decided by the government. The scientific Council said, however, to have taken "note of the political decision" to re-open progressively from the month of may, "taking into account the health issues but also societal and economic". He advocated, therefore, as a result, a battery of measures including the mandatory wearing of a mask one anti-bumping granule in colleges and high schools, and the temperature at home by the parents, of strategies in schools to prevent the mixing of students... Of recommendations that are repeated in large part in the health protocol accompanying since the return class of students.

A notice of the researchers of the Inserm published in mid-April called for a resumption of the class at the beginning of September, it has not been taken into account. Result : the fear was quickly palpable. "On the sanitary plan, it is not a very good idea. There is a general principle which is of déconfiner in the reverse order of containment. The schools would have had to be the last to reopen their doors", went on The Pr Eric Caumes, service chief of infectious diseases at the hospital of the Pitié-Salpêtrière hospital in Paris. The president of the doctors Federation of France, Jean-Paul Hamon, believed that the resumption of classes was considered an "unnecessary risk" to "the entire population".

The College of physicians also opposed to the date of 11 may, by the voice of its president, Patrick Bouet, in the Figaro. "There is no medical explanation to déconfiner in the school environment first", stated Dr. Bouet at the end of April." We know that children are potential vectors without develop by themselves the infection, except in rare exceptions," he said then. On the other hand, he believed it was also "very difficult in a school setting to observe the gestures barriers". and feared that the measure "only leads us to experience a rebound of the virus".

Dismay among teachers

Among the parents and among elected officials, too, the reopening of classes has caused serious concerns, as reported by Ouest-France. But it is above all in the educational community that the consternation has been the most visible. "This is everything but serious (...). We know that it is a place of high-transmission, high-contamination. This seems to be in total contradiction with the rest," responded Francette Popineau, general secretary of the Snuipp-FSU, the first union of primary as early as April 14. We must "give us the conditions of health of this recovery," she added on RTL.

"The minister has given the hallmarks of a gradual recovery", had declared on his side, Stéphane Hook, by the SE-Unsa, questioned by the AFP on 22 April, then adding that "many questions charm of a tradi[ai]ent on the plan for health care". "You spoke rather of the month of June, simply to review the students and re-establish links", wondered about him, Philippe Vincent, head of the union of headteachers (Snpden-Unsa) in Paris. "No recovery without health guarantees", warned also the Snes-FSU, the first union high school when his side, another trade union of the secondary, the Snalc, regarded as "unacceptable" the assumption of 15 students per class.

A " re-opening "playable" according to some doctors,

Some physicians, however, thought from the start that a re-opening of classes on may 11 was "playable" see desirable. "The children are not super-transmitters of the Covid-19, it is time to go back to school, have pleaded Alasdair Munro and another specialist british of infectious diseases, Saul Faust, in a column published on may 6 by the medical journal Archives of Disease in Childhood.

"We'll see at the end of fifteen days to reopen if the impact is negative", indicated, in France this time, Pascal Crépey in The World Tuesday, April 14. He believed that, given the month and a half of class that was then before the big holiday, "the two options – re-open or keep closed until the start of the school – took the road". "I understand very well the concerns about the reopening of schools. We learn every day and things we believe we know now may change again at time T+1. It is necessary to be cautious and continue the search," he added on France Info. "To maintain the closed schools could also grow the parentalts to entrust their children to the grandparents, a group at much higher risk". "It is coherent enough. This is the population the less of a risk, it will be necessary that they provide immunity to protect the most vulnerable," confirmed Pierre Parneix, head of the support Centre for the prevention of healthcare-associated infections New-Aquitaine.

"according to evolution, everything is subject to revision at any time if ever there were surprises, particularly in the bad sense", abounded Professor Bouchaud du CHU Avicenne. His colleague, professor Frédéric Adnet, head of the emergency department of this establishment located in Bobigny, france, considered the same as "it is a very good thing that the kids go back to school." "The children are at no risk, they are affected by the coronavirus, but not in the severe forms. The deaths are insignificant", has already made the one who is also the director of the Samu 93. It was estimated that the contamination of the adults was even a risk "which can take", since "the parents of children at nursery or primary school, are rather young as well as teachers" who "are mostly fewer risk factors that could make the virus fatal".

Date Of Update: 05 June 2020, 09:57

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