Our children are sitting ducks, says DAUK’s Dr Louise Hyde

Children are not meant to die, so when people say the risk of a child dying of Covid-19 is very small, then yes, it absolutely should be.

Unfortunately, we’ve been letting Covid spread quite freely in the UK, especially through schools. Children are now dying of Covid regularly, at a rate of about 2 or 3 per week. In fact, we’ve lost at least 133 children to Covid in the UK so far.

My child probably won’t die of Covid, and yours probably won’t either, but in the next few days, someone’s child will.

To put the numbers into context, in 2019 in England and Wales there were 907 deaths of children aged 1-15 in total.* We actively take precautions to prevent all of the commonest causes of child death, both as individuals and collectively.

Suffocation causes similar numbers of deaths to Covid, but no parent would leave plastic bags lying about, and almost all bags come with little holes punched in the bottom, and a written reminder to keep out of reach of children.

When it comes to Covid, though, the measures we had in place through the first two waves have largely been removed. Most adults in the UK are protected by at least two doses of vaccine, but most children are not. Masks stopped being required in English secondary schools in May, at roughly the same time that the Joint Committee on Vaccination and Immunisation (JCVI) were concluding that “there was a low risk of child-to-child transmission”. Measures such as bubbles, distancing and isolation of covid contacts have also been removed or weakened since then, with predictable results.

For most of last term school aged children had the highest prevalence of Covid, and whenever schools are open, the rates tend to rise.

With the arrival of Omicron in the lead up to Christmas, schoolchildren were overtaken by young adults, extending up to the middle aged. Now that the new term has started, older age groups seem to have peaked, but schoolchildren and preschoolers continue to rise.

It has become clear that JCVI guidance suggesting the vaccine would only have minimal benefits for children was based on false assumptions. Children can and do transmit the virus when basic mitigation measures are removed.

The rapid spread of Omicron has lead to an unprecedented acceleration in children being admitted to hospital, at more than double the rate of previous waves. Similar patterns were seen in South Africa and New York, but it is still too early to say whether this increase in hospitalisation will translate into increased child mortality rates. The rates of Long Covid from Omicron are also still unknown.

Currently the UK lags behind similar nations in vaccinating children. The JCVI was slow to authorise vaccination of 12-15 year olds, initially only permitting a single vaccine.

The MHRA has approved a reduced dose vaccine for 5-11 year olds, but the JCVI are currently limiting its use to children who are Clinically Extremely Vulnerable (CEV) or have CEV members in their household. Even these few are struggling to actually access the vaccine, with reports of some families taking their children abroad to receive it. In contrast to the original adult vaccination campaign, and the booster programme this winter, vaccination of children has remained painfully slow. If vaccines are to be our main defence against covid, we need to step up the pace.

With school transmission driving the pandemic during term time, the rates of covid in parents and grandparents also tend to rise. The vaccine is very effective for most people, but it has a small but significant failure rate and not everyone can or will have it. If we choose to rely on vaccines alone, with rates this high, the virus will find those who
are susceptible.

For children with a clinically vulnerable parent or grandparent, the worry that they might bring Covid into the home is often their biggest fear. Children naturally tend to assume that bad things happening in the adult world are their fault, even in situations where there is far less logic to suggest it. In the UK, there are already an estimated eight thousand children orphaned by Covid-19. Those who argue that being in school is the most important factor for our children’s mental health are neglecting to consider these children. There is a huge difference between children being safely in school with multiple layers of mitigation measures in place, and children being in school where they are exposed to the virus with no protection.

The measures we need to make schools safe are quite simple:

  • Fast vaccine roll-out for all children aged 5 and up.
  • Acceptance that airborne spread of the virus is significant, ventilation, FFP2 masks, CO2 monitors and HEPA filters.
  • Awareness that close contact also plays a part, with physical distancing where possible.
  • Awareness that the number of people you transmit to depends on how many people you share air with, bringing back bubbles, avoiding assemblies, and a return to fully isolating cases and contacts.
  • Acknowledging that children are connected to the rest of the community too, and a return to similar measures across the rest of society to get background Covid rates down.
  • Perhaps the most complex measure, the one we are least likely to achieve, is a change to the public messaging about Covid in the UK. Because infections really do matter. We are all connected, and we do have a responsibility towards each other, whether we like it or not. My choices and actions could have unknown consequences for you, or for someone else, somewhere.

Consequences may be unknown, but they are not unforeseen. And in the case of infectious diseases, even a small change can make a very big difference over time, so every little helps. The actions that are in our power are smaller and simpler than those our government could have chosen, but they are still significant.

Open a few windows, wear a mask, keep your distance, stay home when you’re ill. You’ll never find out, but your actions could save the life of a child.