When It Comes to the Delta Variant, the Kids Are All Right

With few exceptions, parents should send their children back to the classroom—despite a COVID-19 surge.

Parents are naturally worried about sending their children to school amid the Delta variant—especially those who have kids under 12, who are too young to be vaccinated. According to a survey updated in August by researchers at the University of Southern California, nearly one in five families (18 percent) were considering not sending or planning to not send their kids back to school because of COVID-19 fears. The numbers get even worse as family income goes down. A third of families making less than $25,000 a year reported that they were not sending their kids to school or are unsure about it, compared to just 4 percent of families making more than $150,000. As the Delta variant continues to spread, this fall may bring a new round of school closures.

Because parents and school administrators are understandably nervous, it’s crucial to weigh the risks of the virus against the downsides of keeping children out of school. Despite schools opening across the country, it’s too early to know if there’s been a drop-off in in-class attendance. But the USC survey and news reports suggest that parents could easily pull their kids out of the classroom, or school systems could shut down in-person learning. That would be a mistake in all but extreme circumstances.

Here’s the cost-benefit calculus parents need to consider—and it’s not a close call.

There’s little evidence that the Delta variant is more dangerous for kids than earlier versions of the virus. It spreads more easily, yes, but the minuscule death rate among infected children continues to drop compared with versions of the virus circulating last year.

By the end of July 2021, more than 80 percent of COVID-19 cases (adults and children) were caused by the Delta variant, according to data from the Centers for Disease Control and Prevention. That sounds like an alarming statistic, and in some ways, it is. But when it comes to children, the facts don’t merit panic. In July, eight children under age 15 died, compared with 17 in July 2020. Some of the decrease may be due to improved treatment and vaccination of children 12 years and older, but the case fatality rate for children too young for the vaccine is lower than last year.

Even older variants are not particularly dangerous for children. According to the CDC, of the 633,786 COVID-19 deaths since the pandemic began in February 2020, 470 were children under 18.

Any child’s death is tragic, but this number needs to be put into perspective. COVID-19 deaths among children last year are comparable to the number of children who die annually in automobile accidents (636 in 2018) and the estimated 480 deaths from flu among the same age group during the 2018–19 flu season. As Martin Kulldorff, professor of medicine at Harvard Medical School, put it, “We don’t shut down schools in flu season.”

We also don’t shut down schools or keep kids home for the respiratory syncytial virus, or RSV, another virus that most kids have had by the age of two—and that kills anywhere from 100 to 500 children under the age of five every year.

The media has recently been focused on intensive care units being overwhelmed by COVID-19 cases, leaving parents to worry that school is too dangerous. But first of all, the vast majority of kids with COVID-19 needing hospitalization—between 75 and 90 percent—have not needed to be put in the ICU. Second, the vast majority of people in the hospital with COVID-19 are unvaccinated adults. As of September 4, a total of 40,182 children and teenagers have been hospitalized since the beginning of the pandemic—out of 74 million children in the U.S. Having a child in the hospital can be terrifying. Still, the number of kids hospitalized for COVID-19 over the past 19 months is lower than the 58,000 kids under age five hospitalized with RSV every year.

That’s not to say that no parent needs to worry about COVID-19. Immune-compromised children and those with chronic illnesses such as diabetes might need to stay home during viral outbreaks at their schools. Parents, along with school administrators and public health officials—and, for that matter, doctors—need to balance the risk of COVID-19 infection for generally healthy children, which for the vast majority is either asymptomatic or no worse than a cold, against the harms of missing school.

Last year’s school closures should be instructive to any parent thinking of yanking their kids out of the classroom. Shutdowns led to children losing ground on everything from test scores to time spent reading. A study from the Netherlands, where schools were closed for only eight weeks, found that children’s performance on national exams fell an average of three percentage points compared with their performance before the pandemic. For kids from homes with lower education levels, the drop was 60 percent greater.

According to the U.S. Department of Education, 3 million students either have been consistently absent from remote learning or have not been actively participating in it since the beginning of the pandemic, and learning losses have been worst for Black and Hispanic children. A report from the NWEA, a nonprofit organization that provides academic assessments, and the consulting firm McKinsey & Company, found that Hispanic third graders’ scores in math were 17 points lower on NWEA tests in the spring of 2021 compared to 2020. Black third graders saw a drop of 15 points. Overall, kids were 10 points behind in math and nine points in reading.

It’s too early to know how many children are being kept home this fall, but if the survey from August is any indication, the fallout from lost learning could have a lasting effect on an entire generation. Studies of school days lost to other causes such as teacher strikes suggest that the impact can be felt for many years. A report by the Organisation for Economic Co-operation and Development in September 2020 predicted that children would suffer lifetime earning losses based on missed school attendance. Other studies have found that education is tightly linked to health in adulthood and longevity.

In the near term, children are being harmed in other ways. “Nobody has suffered more from lack of socializing than children,” Paul Offit, professor of pediatrics at the Children’s Hospital of Philadelphia, says. “Teen suicide is up, and many children depend on schools for meals.” While reports of child abuse have dropped dramatically during the pandemic, that may not reflect the reality, since cases are most often picked up in schools. Compared to years past, one trauma center saw a doubling in the number of severe injuries to children, including broken bones, brain hemorrhaging, and facial contusions.

Parents are now being swept up in the face mask wars, which are hard fought across the country. In Texas and Florida, Republican governors have vowed to override any local mask mandates. Many school districts remain defiant, and 60 percent of parents of school-age children want a mask mandate for unvaccinated teachers and students.

But do masks reduce the risk of COVID-19 for children? The CDC recommends masks not just for the unvaccinated but also for all students and teachers, advice based on contradictory evidence. The data on the effectiveness of masks in a community (versus a hospital) setting is mixed at best, and articles claiming randomized trials show that masks work against COVID-19 are often short on detail. One study, conducted in Bangladesh, found that wearing a surgical mask reduced 11 percent of infections that might have been COVID-19—a benefit seen only in older adults. In other words, masks failed to prevent approximately nine in 10 infections even among higher-risk, older individuals. There was no benefit seen for individuals aged 18 to 50, and children were not included in the study.

Without clear guidance from science, mask wearing should ultimately be decided by parents and school administrators, ignoring politicians’ edicts as much as they can. In Florida, at least, the courts are upholding schools’ decisions, and in a speech on September 9, President Joe Biden promised that the federal government would make up any pay that school employees might be docked by governors who have tried to block mask mandates. Parents who oppose mandates should not keep their kids out of school to make a political point. Likewise, parents who favor mandates should keep in mind that the risk of harm from the unmasked is extremely low.

Parents should also be aware that communities with low vaccination rates are seeing the highest numbers of children hospitalized with COVID-19. That suggests that schools are not the problem. It’s the adults kids encounter at home and in their neighborhoods. More vaccinated adults and teenagers mean fewer kids with COVID-19. And it should go without saying that teachers and other adults at schools should be vaccinated as well.

The chances are good that before too long, vaccinations will become available for children under 12, probably beginning around age 3 to 5. But the ultimate comfort for parents may lie in the likely long-term trajectory of COVID-19, which epidemiologists are hoping will follow the course of many viruses and become far less deadly. Even H1N1, the flu virus that caused the pandemic of 1918, still circulates but no longer kills large numbers of people.

One way or another, we will have to learn to live with COVID-19, because we aren’t going to eliminate it, says Jay Bhattacharya, a professor of medicine at Stanford University who supports vaccination. “If you adopt a strategy of stopping this disease, you will fail,” he says. In the meantime, a better approach is to protect the most vulnerable, including the elderly and those with chronic illnesses. Kids are the least vulnerable. In the latest survey, 65 percent of parents (and 83 percent of Democrats) support school closures if Delta cases continue to spike. That’s ill-advised. For most children, staying home from school is harmful, and a mistake.

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Shannon Brownlee and Jeanne Lenzer

Shannon Brownlee is a lecturer at George Washington University School of Public Health. Jeanne Lenzer is the author of The Danger Within Us; America's Untested, Unregulated Medical Device Industry and One Man's Battle to Survive It.