As more information about the new coronavirus variants comes to light, concerns continue regarding their effect on children. In particular, there are reports that the B.1.1.7. UK variant more readily infects children and young people. Meanwhile, this variant has prompted a spate of new research in an attempt to clarify its true impact. 

On one hand, the Royal College of Pediatrics and Child Health has put out information to clarify the impact of the B.1.1.17 on children, while the UK's New and Emerging Respiratory Virus Threats Group (NERVTAG) has attempted to present the available data, which paints a somewhat different picture. 

In January 2021, this variant was said to have accounted for 70 percent of new infections in London. According to the Royal College of Pediatrics and Child Health, who compared the first wave of SARS-CoV-2 infections to a second wave between November and January, the new strain did not appear to result in a significantly different clinical course compared to the first. Conversely, according to NERVTAG, various studies did in fact show that hospitalization data and mortality risk was significantly worse with the B.1.1.7 variant. While NERVTAG's report does not comment specifically on children and young people, it does call into question whether we can trust earlier data entirely. 

Nevertheless, all of these data have limitations, and there is still much information to be gleaned from the wave of new variant infections in the UK. No matter what, when cases of covid-19 in the community rise, children will get infected. The number of children who get hospitalized will go up, just as it does in adults.

Note: NAAT is an abbreviation for nucleic acid amplification test, and refers to tests that search for the genetic material of a microbe—in this case SARS-CoV-2.

On Friday the US Centers for Disease Control and Prevention (CDC) released updated guidelines on school reopenings. The opening statements stress the importance of these decisions being made on a local level, using community transmission information. A companion Operational Strategy for K-12 Schools through Phased Mitigation outlines the essential elements for safe in-person teaching—strategies to reduce transmission using community transmission indicators, and changes to instructional and testing modalities intended to limit SARS-CoV-2 spread. This strategy also addresses the inherent concerns of continued remote education and potential health inequities that this alternative use has created or worsened.

These community indicators serve as a modification to the Dynamic School Decision Making indicators, using new epidemiologic data and simplifying the criteria to create new risk-based thresholds hinging on total new cases per 100,000 people and the percentage of positive tests over the previous week (see the Table below). 

Over the past several days, criticism of the CDC's new guideline has come from all sides, despite the fact that it provides far more evidence-based policy than previous statements on the topic from the agency. On one extreme, some feel that any opening of schools before all teachers have been vaccinated is too soon. On the other end of the spectrum, some point to the fact that even in areas of high transmission, schools have not been shown to be drivers of community spread. These observers also note that the standards put forth by the CDC imply that school is unlikely to open for the remainder of the year, which they see as untenable. The Centers for Disease Control and Prevention.