harvard | LIPSITCH: One
of the most important unanswered questions is what role do children
play in transmission? The go-to intervention in flu pandemic planning is
closing schools, and that may be very effective or it may be totally
ineffective. It’s a costly and disruptive thing to do, especially in the
United States, because many people rely on school breakfast and lunch
for nutrition. So we really need evidence that closing schools would
help. We need detailed studies in households of children who are exposed
to an infected person. We need to find out if the children get
infected, if they shed virus, and if that virus is infectious. The
second issue that we should be trying to get ahead of is the extent of
infection in communities and in places that aren’t doing extensive
testing.
GAZETTE: What do we know about for sure about how children are affected by this virus?
LIPSITCH: We
know that the cases of children sick enough to get tested is much lower
per capita than those of adults. And we also know that, in China
outside of Hubei province, the difference between children and adults is
smaller. Children are still underrepresented, but they’re a larger part
of the total than inside Hubei province. That would suggest that part
of the equation is that they are getting infected but they’re not that
sick — it’s easier to identify less-severe cases in a system that’s not
overwhelmed as it is in Hubei. But we don’t know whether they’re
infected and not as sick or whether there are a lot of kids that aren’t
getting infected even when they’re exposed.
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