B3504 - The role of children and school closures in the transmission of COVID-19 - 30/04/2020

B number: 
B3504
Principal applicant name: 
Amy Thomas | University of Bristol, Bristol Veterinary School (UK)
Co-applicants: 
Dr Ellen Brooks Pollock, Professor Adam Finn , Dr Leon Danon, Dr Hannah Christensen, Dr Alice Halliday, Professor Mick Bailey, Dr Jane Metz, Dr Emily Nixon
Title of project: 
The role of children and school closures in the transmission of COVID-19
Proposal summary: 

School closures have been a central component of many countries’ response to contain COVID-19; however, we don’t know:
• What children do during unplanned school closures
• Whether children are infectious
• Whether other strategies could be equally effective.
Much of the policy is based on influenza, which does affect children more than SARS-CoV-2 [1].

Preliminary evidence suggests that children are able to become infected with SARS-CoV-2, but are either asymptomatic or show mild symptoms, with a minority of cases progressing to disease [2]. The role of healthy children in transmitting SARS-CoV-2 remains uncertain. It is of interest to define how many children do/don’t experience COVID-19 symptoms and have evidence of having had SARS-CoV-2 infection, this may have implications for transmission dynamics and policy decisions. Along with many European countries, the UK decided to close schools from March 23rd in an effort to slow SARS-CoV-2 transmission - only some vulnerable children and those of key workers remain in school. We do not know what children’s contact patterns are during this unplanned school closure, but there is evidence that contacts inside and outside the home might continue, especially for older children and where parents don’t agree with closures [3]. We propose to deploy a survey to G2 ALSPAC children to capture data on symptoms and contact patterns during the COVID-19 pandemic, as well determine evidence of SARS-CoV-2 infection through saliva antibody detection methods.

Impact of research: 
Understanding the role of children in transmission of SARS-CoV-2 is essential to inform the rapidly developing policies in response to the SARS-CoV-2 pandemic and for informing current and future policies in response to infectious disease outbreaks. Ellen Brooks-Pollock and Leon Danon are contributors to the UK Government pandemic modelling advisory group, so these results will have immediate impact. Linking antibody detection to the planned contact survey allows i) assessment of the contribution of children in transmitting SARS-CoV-2, and ii) enhances the accuracy of self-reported disease surveillance. This has immediate impact on transmission control. The adverse effects of school closures (secondary economic and societal) simply might outweigh the perceived benefit until we better understand the role of children in transmission of SARS-CoV-2. This study will offer insights into novel control strategies, possibly negating full school closures. Finally, this work is part of a larger rapid response of researchers at the University of Bristol (Bristol UNCOVER). Collection of paediatric saliva samples during the SARS-CoV-2 pandemic will be of high value to investigate the natural history of mucosal immune responses to SARS-CoV-2.
Date proposal received: 
Thursday, 9 April, 2020
Date proposal approved: 
Monday, 20 April, 2020
Keywords: 
Epidemiology, Infection, Computer simulations/modelling/algorithms, Qualitative study, Statistical methods, Biological samples -e.g. blood, cell lines, saliva, etc., Cohort studies - attrition, bias, participant engagement, ethics, Immunity