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Comment by all_blue_chucks | Hacker News Reader

Case counts in children is irrelevant. For an infection to become a case it has to be diagnosed, and that typically only happens with symptoms. But we know young people rarely have symptoms, so obviously they rarely count as cases.

INFECTIONS, however, matter a LOT. If you're infected you can pass a virus on without ever being counted as a "case." And we have zero reason to think children can't be infected. Hell, tigers and mink can be infected. Of course children can be infected. This thing is crazy infectious.

Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases."

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The report mentions this and for Sweden there was a study that found that school staff had no increased risk of exposure.

In that report (see reference 6) for example taxi drivers had 4 times the increased risk of exposure compared to teachers of primary school.

And yet, in other cases (e.g. Israel) infections have spiked after school reopenings. The evidence is highly mixed, so it's very important not to cherry-pick cases that only support one's hoped-for policy outcome.

> Children will spread the infection to their teachers, school staff, and families. There is no question about that, regardless of whether children's infections count as "cases."

Actually this is exactly the big question right now -- ignoring "cases", are children as infectious as adults?

We don't know, signs point to "not as infectious, but probably nonzero".

So in a classroom with 15 kids breathing in and out, talking etc, for hours, with an airborne virus, seems the teachers will catch it.

We don't know this either. May be age-dependent.

Ever caught a cold from your kid, who didn't have it bad? I have. It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception.

> Ever caught a cold from your kid, who didn't have it bad? I have.

Of course, and so has every parent -- what, exactly, are you implying, that the people studying this haven't had this experience? And are therefore not considering that kids can have mild symptoms but still be contagious?

If so, that's an awful lot of ignorance that you are ascribing to everyone studying this with an opinion that doesn't match your lived experience with other viruses.

If not, please enlighten me.

> It's highly likely this is the same, and the burden of proof is on those who want to say this coronavirus is the exception.

Yes. You are literally commenting in a thread about a paper that is trying to provide evidence ("burden of proof") by looking at differential rates of illness, and not simply drawing inferences from general facts about viruses -- which is what you are doing here.

> But we know young people rarely have symptoms

And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent.

The fact that children tend not to be diagnosed because they tend much more strongly than adults to be asymptomatic when infected is not irrelevant to their propensity to spread the disease.

>>And we know that, while presymptomatic spread is an issue, asymptomatic spread is between rare and nonexistent.

Our knowledge is not that precise yet.

What we do know, based on models, is that "silent" transmission accounts for about 50% of covid-19 infections.

https://abcnews.go.com/Health/asymptomatic-presymptomatic-pe...

We don't know this. We would need full contact tracing and much faster testing to know this. Plus, we now know antibodies may _not_ be the biggest contributor to the immune response. It seems T-Cells are in some cases able to fight the disease without ever mounting an antibody response Thus no antibodies.

But the ol' maxim applies here: absence of evidence is not evidence of absence

> absence of evidence is not evidence of absence

That applies to infection/transmission via schools in general. Precisely because we don't have decent testing and tracing, we have a large number of cases whose origin is unknown. Schools have to be considered as one possibility, especially considering the several cases where reopening schools has been strongly correlated with spikes in infections. The precise mechanism doesn't matter. It's a red herring. Whether it's kid to kid, parent to teacher, cafeteria workers, whatever, it seems to happen some of the time. Until we've clearly ruled out a cause for those unknowns, we have to consider it still operative.

Asymptomatic spread nonexistent?

"Our results indicate that silent disease transmission during the presymptomatic and asymptomatic stages are responsible for more than 50% of the overall attack rate in COVID-19 outbreaks."

https://www.pnas.org/content/early/2020/07/02/2008373117

Sure, if you add presymptomatic and asymptomatic spread you get a large number (because the most infectious period is the presymptomatic period right before symptoms develop.) That doesn't even begin to contradict asymptomatic spread, distinguished from presymptomatic spread, being rare to nonexistent. Usually, this makes little difference because you can individually distinguish the two only in retrospect, but when you have a population (like children) that demonstrably has a much lower propensity to develop disease symptoms when infected and a much higher propensity to remain asymptomatic, it makes a big difference.

You should publish your findings showing it is "rare to nonexistant" so that these researchers no longer waste time studying asymptomatic spread...

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