Is it necessary to test your kid for Covid-19 before school re-opening?

Many sectors including some within health sectors say that children need not be tested for Covid-19. Children’s Hospital of Los Angeles’ website tells parents about Covid-19 testing: “In the vast majority of cases, children still don’t need to be tested.” At Children’s Healthcare of Atlanta, a similar refrain:

“Most children with Covid-19 infections have mild symptoms, such as fever and cough, and do not require medical care,” the hospital network advises. “For most with mild symptoms, testing is not necessary and does not alter the course of clinical management or at-home supportive care.”

Early tests

But the experts say that even with less severe symptoms, lack of testing among children could make it more difficult to contact-trace infections and stop the spread of Covid-19, especially as many states are poised to reopen schools in some form. Earlier in the pandemic, when tests kits were scarcer than they are today, doctors and hospitals limited who could receive tests based on severity of symptoms. The availability has expanded since then, but children are still a lower priority.

“If you look across all of the tests that we’ve done… the portion that has been the lowest-tested portion is the under-10-year-olds,” Dr. Deborah Birx, the White House corona virus response coordinator, said at the July 8 White House Corona-virus Task Force briefing. “Earlier, we said: ‘Test if you have symptoms.’ And now we know that if you’re under 18, the majority of you don’t have symptoms. So, our data is skewed originally to people with symptoms and then skewed to adults over 18,” she said.

School re-opening

Unless testing capacity increases rapidly and more children are able to receive Covid-19 tests, schools may have difficulty staying open with students present even if they do reopen in just a few weeks.

“Lack of testing can affect the reopening of the schools because without knowing what the risk of Covid-19 is for the population, we cannot assess how bad a second wave might be,” Dr. Maria M. Molina, a pediatrician with Somos Network in New York, told the press. “Overall, a lack of testing puts everyone at higher risk, and schools are simply places where you have large numbers of people congregating,” she added.

School-based Covid-19 testing for children is a critical component to getting schools reopened safely, according to Dr. Benjamin P. Linas, an Associate Professor of Epidemiology and an infectious disease physician at Boston University School of Medicine in Massachusetts. “That seems straightforward, but it’s not,” he wrote in his blog. “The community does not yet have adequate testing, contact tracing, or isolation. Schools currently have nothing. It requires building new capacity in schools for testing and contact tracing. It requires a budget. It requires a formal plan”, he added.

What’s the hope?

If there’s a silver lining, it’s that some early research suggests that child-to-adult Covid-19 transmission might not be nearly as common as transmission among adults. That is, in part, possibly because children with their milder symptoms aren’t coughing and spreading the virus around as much. A summary of two studies in a pre-publication commentary in the journal Pediatrics suggests that children “do not appear to be significant drivers of the Covid-19 pandemic,” especially elementary school-aged children with the lowest infection risk.

That could have implications for how safe returning to school might be, although teachers would still have to be careful about viral exposure from each other.