Friday, March 13, 2020

Close the schools, organise small group child care

source ibtimes

Unwittingly, Johnson is carrying out a massive experiment on the English by refusing to close schools at this stage in the Covid19 pandemic.

Countries like Ireland and Denmark have closed their schools, although Ireland has had only one Covid19 death, and Denmark none at all.

So Denmark and Ireland are the early intervention group, and the English are the control group (no early intervention). Who will have a slower increase in cases, an easier  hill to climb?

All the smart money is on Ireland and Denmark.

Thanks to Johnson's choice, we are in for a rough ride.

This Covid-19 epidemic is ferociously difficult, but at the same time, it is simple:

The central aim is that we reduce the rate of increase in cases to avoid ending up like Italy, where doctors are having to decide daily who should receive the oxygen and who should die.

To reduce the rapid rise, we need to identify and isolate the spreaders  -  those who are walking around feeling perfectly well, but who are spreading virus to everyone they meet.

The problem is that, by definition, we cannot identify adult spreaders. They all look the same.

However, there is one group of spreaders that we can identify: school children. It is well known by GPs that infectious diseases shoot up a week after the school term starts. Kids spread viruses to each other.

We know that kids do not often show symptoms of Covid-19 - they are only 2.1% of the cases in Wuhan. There is no reason to believe that they cannot pass the virus on to others.

Therefore, to close schools is to close down a very important source of virus transmission in the community, and therefore will help to avoid a steep rise in the number of cases.

So why do we not do it?

The objection is all about child care.
Many parents would have to stay home from work to look after their kids.
They cannot ask grandparents to look after them, because grandparents are liable to die of the virus. Therefore they want to be able to still send their kids to school
This works fine until the child comes home and give Mum and Dad the virus, whereupon they spread it at work for a week or so, then take to their beds for a couple of weeks and stay off work until pronounced clear - maybe 4-6 weeks off work if they are lucky. And who looks after the kids while all this is happening? Granny?

So what to do? We have to organise small-group child care. Each carer would have a specified group of kids to look after - maybe 3, 4 or 5. Small as possible, the same kids in each group. They could be in specified classrooms at school, rooms at daycare, or in neighbors' houses. Child care could be provided - again in small groups - by workplaces, especially hospitals, where a high proportion of the staff are female (though there is no reason that the father should not leave work to look after the kids).

It is important to keep the children in their groups as they arrive and depart.

The kids can still pass the virus on, but statistically, the risk is lower. There is a far greater chance that a child will pick up a virus if it is in a group of 300, compared to the risk if it is in a group of 3.

So small group child care slows the virus spread.

Yes, this is all very inconvenient. But, in the end, disease and death is even more inconvenient.

We are a backward country, and it is probably politically impossible for us to organise small-group child care.

That being so, at very least, schools should not penalise parents who choose to keep their children out of school now.

Johnson will change his tune and close schools in a couple of weeks when we are in a situation as bad as Italy is now. Then will be too late. We need to close schools now. Instead, Johnson will have to carry out his great experiment.

[This post was updated in a minor way on 14/3/2020]

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