The Spanish Association of Pediatrics has had to reinforce its own recommendations for going back to school in the face of “the irruption” of the delta variant, whose viral load in those infected is up to 1,000 times higher than that of previous versions of the virus, according to a study preliminary in China. If a covid patient infected two or three people on average at the beginning of the pandemic, now he can infect five , more than the flu. Spanish pediatricians have asked to maintain the mandatory mask for children over six years of age, even during outdoor recess.
The fear is that the little ones will become a reservoir for the virus. 93% of those over 40 years of age in Spain are already vaccinated, but only 55% of children over 12 years of age have received the full schedule, as María José Mellado , head of Pediatrics at Hospital La Paz, in Madrid , recalls . There are still no authorized injections for those under 12 years of age, so none are vaccinated. “It is evident that, currently, the population most susceptible to becoming infected are children under 12 years of age and those older who have not yet completed the vaccination schedule,” warns Mellado, president until last June of the Spanish Association of Pediatrics.
The cumulative incidence at 14 days in adolescents is still soaring, with 193 cases per 100,000, more than double that of those in their sixties. However, coronavirus infection is usually asymptomatic or very mild in the very young. The data is relatively reassuring. Since June 20 there have been almost 315,000 cases in those under 19 years of age in Spain, with 1,900 hospitalized (0.6%), 91 admitted to the ICU (0.03%) and seven deaths (0.002%), according to the National Center for Epidemiology . Covid can strike healthy children, but above all it is a risk for those with previous illnesses and for unvaccinated adult relatives.
The Spanish Association of Pediatrics has regretted the decision of the Ministries of Health and Education to reduce the minimum distance between students from 1.5 meters to 1.2 meters, “which will lead to more children per class.” At the Nuestra Señora de Loreto school, distance was key. The teacher mainly infected the children closest to her, as shown by the comprehensive analysis of the outbreak, published on the website of the US Centers for Disease Control and Prevention.
Distance between students at school
where the outbreak occurred
Minimum distance between
students in Spain
In the first two rows, 8 out of 10 students were infected.
The contagion rate was 80%
In the last three rows, 4 out of 14 students were infected.
The contagion rate was 28%
Pediatrician Quique Bassat insists that it is still necessary to maintain these precautions in schools. “The worst thing that could happen to us is having some super contagious event like the ones in June in the Balearic Islands [with hundreds of infected young people on end-of-year trips]. If we maintain strict measures until we have a much lower incidence, we will minimize this risk and, instead of waves, at most we will have self-limited outbreaks ”, says Bassat, pediatrician at the Barcelona Institute of Global Health and coordinator of the team of the Spanish Association of Pediatrics that has advised the Government for the return to schools.
Bassat calls on all school workers to get vaccinated as soon as possible if they have not already done so. The percentage of vaccinated teachers in Spain is very high, as suggested by the data from the communities that have given figures to this newspaper ( 95% in Extremadura, 94% in Aragon and 92% in Catalonia) , but there are still thousands of teachers without immunization , like the teacher of Our Lady of Loreto.
The pediatrician believes that, to relax the measures, the accumulated incidence at 14 days should be less than 25 cases per 100,000 inhabitants, without notable outbreaks. Currently the incidence reaches 131 cases per 100,000, with outbreaks everywhere. Bassat would begin by eliminating rules such as staggered entry into classrooms, shifts in the dining room, “obsessive hand hygiene with gel” and the prohibition of parents from accessing schools. However, he would keep the mask indoors until vaccination coverage was even higher and the cumulative incidence was “very very low, certainly less than 25 cases per 100,000.”
Bassat has two nine-year-old twin sons. “I will vaccinate them in the first moment that I can,” he says. Data shows that Pfizer’s vaccine, the first licensed in the youngest, is very effective in those over 12 years of age in preventing serious cases. Covid hospitalization rates are 10 times higher among unvaccinated teens, according to the latest report from the US Centers for Disease Control and Prevention.
Pfizer is now testing its vaccine with 4,500 children between the ages of six months and 11 years – in Spain, the United States, Finland and Poland – and plans to request authorization for its use in the coming weeks. Other companies, such as Moderna and AstraZeneca , are also testing the effectiveness of their injections in minors. Some mathematical models calculate that group immunity to the delta variant will arrive when 85% of citizens are vaccinated, but children and adolescents under 15 years of age make up more than 25% of the world’s population. Vaccinating them could be essential to ending the pandemic.