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Covid-19: the role of schools still debated in the face of the circulation of the virus



Schools, “Achilles heel assumed from the current device” ? This is the image used by the epidemiologist Arnaud Fontanet in the Sunday newspaper March 21. In the ten days that followed, the Covid-19 epidemic outbreak in establishments was accompanied by a multitude of forums and positions, from doctors and politicians, calling for the establishments to be closed.

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Despite the adoption of a new reinforced protocol, on March 29, the question was at the heart of Emmanuel Macron’s speech on Wednesday evening. “Yes, the virus is circulating in schools but no more than elsewhere and the education of our children is not negotiable, school is not negotiable. (…) We must take our responsibilities, yes we must curb the virus ”. Thus, nurseries, schools, colleges and high schools will be closed for three weeks and the spring school holidays unified throughout France from April 12 to curb the epidemic.

→ PRACTICAL. Covid-19: the new school calendar facing the third wave

In session at the Assembly, Tuesday 30, Olivier Véran had for his part affirmed that “The school is not an infectious center, but a place where, like all collective places, the virus can circulate”.

Variations according to age

In a press release dated March 29, the French Pediatric Society (SFP) stressed that“At a time when the circulation of the virus is increasing in the general population, the increase observed also in children is only the reflection and not the cause”. And added that children remain proportionately less infected than adults, even since the arrival of the variants.

“School plays a minor role in the transmission of the virus”, thus advance the pediatricians on the basis of the preliminary results of the “Vigil” study carried out on 4,000 children aged 12 years and under, followed since June 2020. Over the period, and despite the arrival of variants, “Our conclusion is that the family is the main vector of contamination”says Robert Cohen, a pediatrician who oversaw the study. Out of ten contaminations, “Adults are involved seven to eight times out of ten, he adds, which does not mean that contamination by children does not exist, but that it is less frequent ”. And if the incidence rate among 0-14 year olds increased by 30% in the space of a week, the explanation lies in the increase in the number of tests, “With a positivity rate that has changed little”, says Robert Cohen.

A discourse against other returns from the field: in the Nièvre, recently placed in confinement, doctors have reported a clear increase in the proportion of positive tests in children.

→ REACTIONS. Confinement: the closure of schools, “a stop to the rising concern”

For other epidemiologists, including Antoine Flahault, schools are thus a “Major places of contamination , because of overcrowding, insufficiently ventilated rooms and more complicated barrier gestures to implement. A position shared by the signatories of a forum published in The world March 30, signed by the epidemiologist Dominique Costagliola and the head of the infectious diseases department at Tenon hospital, Gilles Pialoux, among others: “Children and adolescents are likely to become infected, and then pass on, when they are exposed. Exposed, they are, at school, despite wearing a mask. The canteens, of course, but also the classes in our schools are places at risk. “

Act differently depending on the region?

“The analysis is more complicated for middle and high schools”, adds Robert Cohen, the curves are in fact not similar according to the age groups. As of March 27, the incidence rate was 209 (per 100,000) among 0-9 year olds, but 518 among 10-19 year olds. Colleges and high schools thus find themselves at the forefront of the educational issue. This explains why the SFP recommends closing middle and high schools as a priority, and “If this measure is taken in the territories most affected by the epidemic, more tests as well as a massive vaccination of teachers and childcare professionals”.

As for the relevance of maintaining a territorial approach rather than a national one, the situation remains varied, with an incidence rate which remains six times higher in Seine-Saint-Denis than in Finistère. A uniform measure could therefore seem inappropriate or even unfair by part of the population. “Given the spread of the virus over a majority of territories, maintaining an approach by regions seems difficult”, however, believes the Forgotten Schools and Families collective.

Above all, measures limited to schools seem insufficient to all: “The anticipation of school holidays could be acceptable if they are accompanied by real confinement of the rest of the population”, writes the SFP. “A school closure would not make sense without additional measures for adults”, judge for its part the collective Forgotten schools and families.

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