On Feb. 14, mandatory masking will be removed for children and youth in schools and for kids under 12 in any situation.
That comes after recent comments made by Alberta’s premier and education minister suggested children with COVID-19 aren’t a threat to the health of teachers, vaccines can’t prevent transmission of the coronavirus and masks aren’t needed to stop the virus’ spread in classrooms.
Global News spoke with a pair of infectious disease specialists to check the claims.
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In a video posted to social media on Wednesday, Education Minister Adriana LaGrange intimated kids can’t pass along COVID-19 to teachers.
“Children pose absolutely no threat to teachers, and for the teachers’ union to say that they do is unscientific,” she said.
Dr. Chris Mody, head of the department of microbiology, immunology and infectious disease at the University of Calgary, said there’s no data to suggest children “pose absolutely no threat” as the education minister claimed.
However, Mody said the correlation between symptom severity and viral load taken with the observations that children tend to have less severe symptoms could mean children have less viral load with a COVID-19 infection, with a caveat.
“I would argue that children have more contact and less social distancing with daycare workers, teachers, parents, grandparents,” he said.
“It’s been shown for many different infections that children transmit the infection and are really the vector of subsequent transmission in a household.
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“And that’s actually predicted by studies that have been done now – not with Omicron, but with Delta – that the chance of a family member, a household member getting infected if a child becomes infected in the house is over 50 per cent. While the chance of getting infected when a household member gets infected with one of the earlier variants is about half that,” Mody said.
According to the provincial advice around the vaccine, asymptomatic children can still put others at risk.
“Children can spread the virus even if they don’t have symptoms, potentially risking vulnerable friends, family or community members.”
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“The science is clear that children are at a much lower risk of COVID-19 than adults, and forcing them to cover their faces while learning and playing simply cannot be justified any longer,” LaGrange also said in the video.
Dr. Cora Constantinescu, a pediatrician and infectious disease specialist at Alberta Children’s Hospital, said the numbers tell a different story.
“Right now, we are seeing the highest rates of hospitalization in kids in the shortest period of time than we have in this pandemic — from and with COVID,” she said. “And we have all these kids 12 and under — of them all, most are unimmunized.”
According to provincial data, only 46.3 per cent of children between the ages of five and 11 have received one dose of a COVID-19 vaccine and only 19 per cent have received a second dose. More than 200,000 children in that age range, as well as kids under five, are unvaccinated.
“It’s hard for me to see a comparison of adult death versus children death, because that’s not how we look at health outcomes in children,” Constantinescu said. “And when we do that, when we say that children are less likely to be infected than adults or have severe outcomes…. then we’re actually minimizing the burden of this disease on kids and on their parents.
“And we’re actually also negatively impacting the vaccination effort and ultimately leaving our kids unprotected.
“So it’s time we moved past this comparison to adults, because in pediatric health, we have different standards for children’s health, and preventing any hospitalizations from COVID in children is a very worthwhile cause.”
Since the beginning of the pandemic, 499 children under 10 years old with COVID-19 have been hospitalized, with 82 of them in intensive care. COVID-19 has claimed the lives of three children in the same age range.
Masks and COVID-19 transmission
Minutes before the education minister’s video was posted, Premier Jason Kenney posted a similar video criticizing concerns the Alberta Teachers’ Association had about the removal of mask mandates for children.
“They think that kids who are not wearing masks are somehow unsafe,” the premier said. “It’s looking at children, not as kids, but as vectors of viral transmission.”
“No, that doesn’t make any sense to me at all,” Mody said of Kenney’s comments. “I mean, if children are infected, they’re transmissible and they’re transmissible to teachers just the same as they are to anyone else.”
Constantinescu said the Omicron variant seemed to have changed the patterns of in-school transmission.
“(Previously), it seemed that the COVID in schools was brought in by adults and there was little transmission from student to student,” she said. “However, with Omicron, we’ve seen a different pattern.
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“We’ve seen much more student-to-student transmission in schools, and we’ve certainly anecdotally seen a lot of kids bring it back home to their parents when they’re unmasked. So it’s hard for me to believe that kids could not spread this to the teachers.”
Mody said masks have long played an important role in stopping the spread of diseases, citing the “classic paradigm” of tuberculosis.
“We put a mask on (infectious patients) in the hospital so that they don’t transmit to other health-care workers. And so if you say that removing a mask makes no difference, then I don’t agree with that statement.”
The idea that masks are impeding kids’ social or emotional development is unfounded, according to pediatrician and University of Alberta pediatrics professor Dr. Tehseen Ladha.
“There is no current evidence showing that masking has a negative impact on mental health, or for that matter on development,” Ladha told Global News.
LaGrange said she believed “children need to see the facial expressions of their classmates and hopefully, very soon, their teachers as well.”
“They need the freedom to be animated and joyful,” she said.
Ladha said the science disagrees with the idea that kids need to see others’ faces in order to learn.
“If we look at visually-impaired children, they actually develop speech and language at the same rate as their non-visually impaired peers, which tells us that looking at other people’s masked faces does not impair language development,” she said.
Kenney also said “kids have been paying an unfair share of the burden” through public health measures like masking.
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“What I’ve seen personally in my clinical experience is the opposite: that children have felt quite comfortable in masks, they felt quite reassured wearing masks,” Ladha said.
She added children’s anxiety around catching COVID-19, passing it on to loved ones, or missing school because of being sick or due to elevated cases in the community is greater than the anxiety around masking.
“I think it’s unmitigated COVID spread that has caused a lot of anxiety in children, because when COVID spread in society is unmitigated we get school closures, we get activity closures, we get interruptions, we get isolation of kids who are sick,” Ladha said.
The pediatrician said in some of the clinics she practises in, every other child has rapid test-confirmed COVID-19. Ongoing restricted access to PCR tests, which are the only tests the province reports, means the actual number of Albertans sick with the coronavirus is vastly underreported. That, combined with the efficacy of masking in preventing infection and transmission, has Ladha questioning the government’s decision to lift the mask mandates for children.
“There’s no scientific reason to be lifting the mask mandate in schools, which begs the question, you know, what is the reason based on?”
Vaccines’ effect on transmission
In an interview with Global News on Wednesday, Kenney claimed vaccines were ineffective at preventing transmission.
“With the more contagious version of COVID-19 – the Omicron variant – plus the waning protection of the vaccines against infection and transmission, we’re seeing that vaccinated people are just about as likely to transmit the virus as the unvaccinated,” he said, claiming justification for ending the province’s vaccine passport program.
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Mody said that is similar to advice from the U.S. Centers for Disease Control and Prevention.
“The CDC has come out with a clear statement that vaccines provide very minimal protection in terms of transmission or acquisition of infection,” the U of C department head said.
But he added that the viral loads produced in the bodies of vaccinated and unvaccinated individuals differ.
“If you get vaccinated, you’re likely to have less symptoms,” Mody said. “That correlates with less burden of the virus, and if there’s less virus, then you’re less likely to be transmissible.”
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Constantinescu said studies that came out from Delta variant-fuelled waves showed the same effect.
“And now we actually have evidence that it’s true with Omicron as well in some pre-print studies,” she said. “So vaccinated people have lower infectious viral loads and then they are less likely to spread it, and also for a shorter period of time than the unvaccinated.”
A preprint study from October 2021 comparing historic data of adults who were fully vaccinated and those who caught the coronavirus in England concluded “vaccination reduces transmission of Delta, but by less than the Alpha variant. The impact of vaccination decreased over time.”
An earlier preprint study looking at viral loads in Israel during its Delta wave showed lower viral loads in vaccinated individuals than in unvaccinated people. It found “breakthrough infections in recently vaccinated patients, still within two months post their second vaccine inoculation, do have lower viral loads compared to unvaccinated patients.”
Both of those studies are undergoing the peer-review process.
Provincial government officials and the doctors Global News spoke with agree that vaccination is effective at preventing severe symptoms, hospitalization and death, even with the highly-transmissible Omicron variant.
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“Two doses is still over 50 per cent protective against severity and death and three doses, that protection goes up to 90 to 95 per cent,” Constantinescu said. “And really, this is what we’re trying to prevent from a personal level to reduce the risk of severe outcomes and death, but also from a health systems perspective to prevent the overwhelming of the health-care system by preventing hospitalizations and death.
“This is why vaccination, especially the third dose, is so important.”
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