Kvandermeer wrote:Hello, we're Americans living in the UK and as of today, the school's plan is a full on-campus return, complete with clubs, sports and indoor swimming. We have three kids ages 7, 8, and 10. Our 10 yo is APOE4/4 and "recovered" (it's ongoing; he still struggles to mount a proper immune response and a variety of vestibular malfunctions) from vaccine damage. ...What would you do and why? Thank you.
Welcome, Kvandermeer! The decisions you face are painfully difficult, and obviously don't end with simply deciding "go/no go", since either leads to further decisions.(Stay home how long? Do what if a child in another class tests positive?)
There are no right answers here, and you're right: the UK Biobank Study was of senior citizens and the numbers are probably not sufficient to make conclusions for young children, particularly since the data had not been updated since 2017 to include any recent diagnosis of dementia--a known risk factor for severe disease.
FWIW, my 5 year old grandson was exposed for up to two days to two difference classmates later diagnosed with confirmed COVID-19 in his preschool program in early March. No children, to my knowledge, caught it from them at preschool--a setting not known for social distance, no bodily contact or un-runny noses! I can't rule out the possibility that he or others were completely asymptomatic; if so, it doesn't seem they infected others at school or home. (Given the connections between families at this small school, word would have gotten out.)
I'm also the parent of a son who had surgery on his esophagus at birth and heart surgery at age 5, who had significant asthma and frequent bronchitis and pneumonia as a child. Like you and your spouse, my husband and I learned early on that there are no easy answers. We chose what we thought was our best (or most reasonable option) in many situations and didn't worry about what others would have done. Luckily, he is now a healthy, happy adult, and has managed to get through a week in hospital isolation in 2009 due to H1N1 influenza. It didn't help my anxiety that it was a 24 hour flight away, and he hadn't told us until he was getting better, but it taught me that he was careful (he took himself to the hospital at the first sign of breathing difficulty) and resilient. Do I still worry about him? Absolutely--and also glad that we listened to a doctor who encouraged us to never treat him as fragile.
If I were in your situation, I would look at the local positivity rate for testing and the incidence rate (how many cases per 100,000) to see if the virus is rampant. In a situation like we have had in some US cities, I would be leery; in other US cities, I would be much more ready to gingerly try it. BUT, I would also want to hear in great detail the school's plans for mask-wearing, for not having kids play contact sports in PE or on the playground, for not singing in chorus or sharing food at lunch. I'd also want to hear what the plans are for keeping kids in "pods" so that a group of 15 or so might be in the fifth grade class with one or two teachers coming in during the day. If a child in his class got sick, I would want the school (or local contact tracer) to notify me if he was within 6 feet of that child for more than 10 minutes in the 48 hours before symptoms started, or the positive test was taken.
If so, I would quarantine my son at home and try to have him and the family wear a mask and avoid hugs and kisses for 5-7 days (data suggest 90% of symptoms start within 5-7 days after exposure and that the infectious period is about 2 days before symptoms appear and about 3 days afterwards). I'd ask for a test within 2-4 days, to be able to tell early if he is positive, assuming you can get results back quickly.
But that's just me and I'm neither an epidemiologist nor an infectious disease doctor! You need to be able to sleep at night and know that he will be okay no matter what. If he's home from school, it won't be for the next 8 years; if he goes back; you can always change your mind. Don't worry about ApoE 4 in this equation--it's enormously unlikely to be a factor, IMHO.
Hugs from a 4/4 grandmother.