Hundreds of thousands of pupils are returning to classrooms this week, with experts predicting a surge in COVID-19 cases linked to schools reopening in England and Wales.
Headteachers’ unions have voiced concerns as many safety measures to combat the spread of the virus in schools have been eased since the end of the last term.
It has prompted the government to face claims it is implementing a “hit and hope” strategy over the return of pupils.
Amid fears that more children will catch COVID as schools reopen, how much of a danger is the virus to youngsters and could vaccinating those as young as 12 curb serious infections?
Are children more likely to contract COVID as schools reopen?
The simple answer is yes, says Dr David Strain, senior clinical lecturer at the University of Exeter Medical School.
“The summer holiday acted exactly as a firebreak would,” he told Sky News.
“What we’re now expecting is the rates to pick up and the R number to jump to about 1.7 – basically doubling in case numbers on a weekly basis.”
England’s current coronavirus reproduction number – or R value – is between 1 and 1.1, according to the latest official data.
In Scotland, COVID cases among young people have risen sharply since schools reopened and restrictions were dropped two weeks ago.
Experts have warned that it is “highly likely” there will be large levels of infection in UK schools by the end of September.
The government’s scientific advisers have said the vaccine rollout will have made “almost no difference” to many pupils as it currently only extends to 16 and 17-year-olds, along with some younger children at higher risk from the virus.
What risk does COVID pose to children?
Most children who contract COVID will face a “very, very mild disease” that is little more than a bad cold, according to Dr Strain.
But he added: “They can pass it to parents, so there is a risk to any unvaccinated parent from their children catching it, but really that’s where the risk lies.”
Fewer than 30 people under the age of 18 died due to COVID in England between February 2020 and March this year, according to the Joint Committee on Vaccination and Immunisation (JCVI).
Professor Tim Spector, lead scientist at the ZOE COVID Study, has said it is “still very, very unlikely that if your child does get COVID that they’re going to end up in hospital”.
Dr Michael Absoud, a consultant in paediatric neurodisability, said most children admitted to hospital with the virus “do thankfully have a good recovery”.
“Twenty-four children sadly passed away in the first wave of the pandemic, but many of them had comorbidities that put them at much higher risk,” he added.
Those high-risk health conditions include neurological conditions, severe learning disabilities, and some genetic disorders such as Down’s syndrome.
Children who are immunosuppressed – meaning they have a weakened immune system – either as a result of a health condition or due to medication, are also at increased risk from COVID.
What are the most common symptoms of COVID in children?
The NHS says the main symptoms of COVID in children are a high temperature; a new, continuous cough; and a loss or change to sense of smell or taste.
But Emma Duncan, professor of clinical endocrinology at King’s College London, has said asymptomatic infections among children are common.
“On average, of those who catch the virus, somewhere between 40% and 70% of kids don’t have any symptoms at all,” she said.
Symptoms can vary depending on a child’s age, with stomach pain more common in younger children, while older children are more likely to suffer loss of sense of smell, Prof Duncan said.
The length of illness can also indicate whether a child has COVID.
Children with confirmed symptomatic COVID are ill for around six days, whereas those sick with another illness are poorly for an average of three days, Prof Duncan said.
What is the risk of long COVID to children?
As many as one in seven children who get coronavirus could have symptoms almost four months later, according to the world’s largest study on long COVID.
Researchers looked at almost 7,000 children, including those who had a positive COVID test between January and March and a group who tested negative in the same period.
The study’s lead author, Professor Sir Terence Stephenson, said there was “consistent evidence that some teenagers will have persisting symptoms” after contracting COVID.
“Our study supports this evidence, with headaches and unusual tiredness the most common complaints,” he said.
Dr Strain said he had concerns about the effect of long COVID on pupils.
“Children are effectively sponges,” he told Sky News.
“If children are missing out on school because of fatigue and brain fog, that would have an overall effect on their well-being.”
Should children be vaccinated against COVID?
COVID vaccines have been offered to all 16 and 17-year-olds in the UK and those who are younger with serious underlying health conditions, or if they live with someone at high risk.
The JCVI has yet to decide whether to extend the rollout to all 12 to 15-year-olds.
A study carried out by Dr Strain and other experts found that giving the jab to adolescents and children “has the potential to play a vital role” in reducing coronavirus infections and deaths.
They predicted that vaccinating all 12 to 15-year-olds in the UK could cut all COVID deaths by 18% and reduce hospital cases by 21% up to December.
“The majority of lives saved would be in the parent and grandparent age,” Dr Strain told Sky News.
“That’s the ethical argument. We’d be predominantly vaccinating children to save the lives of their parents and grandparents.”
Dr Strain said rare cases of myocarditis – inflammation of the heart – had been reported with both Pfizer and Moderna vaccines, and he believed the JCVI were being “cautious” over their decision in order to determine that risk.
His study, which has not been peer reviewed, was funded by Moderna, but he insisted the company had no influence over the findings.
Do the newer COVID variants pose a greater risk to children?
The Delta variant still causes a much milder illness in children than it causes in adults, but it is a “more serious infection” when compared to other variants, according to Dr Strain.
“We know children can catch the Delta variant and get sick from the Delta variant and make enough copies of the Delta variant to infect other people,” he said.
“With the Alpha variant, there were very few recorded cases of transmission from child to adult.
“With the Delta variant, we are definitely seeing cases going in both directions, so we know it’s more infectious.
“Anything that is more infectious between you and another person is also more infectious within your body.”
Follow the Daily podcast on Apple Podcasts, Google Podcasts, Spotify, Spreaker
Dr Strain also voiced fears that if cases “rise hugely” then new mutations could emerge.
He said the emergence of a new variant that can be transmitted easily outdoors would have a huge effect on schoolchildren.
“If children suddenly can’t take their masks off in a playground as well as not take them off in the classroom, that would have a major impact on the psychological development of children,” he said.
What can children do to protect themselves from COVID at school?
Schools and colleges in England no longer have to keep pupils in year group “bubbles” to reduce mixing, and face coverings are no longer advised.
Children do not have to isolate if they come into contact with a positive case of COVID. Instead, they will need to get a PCR test and isolate only if positive.
But all secondary school pupils are being invited to take two lateral flow device tests at school – three to five days apart – in England on their return to class.
Dr Strain said parents who are worried about children catching COVID at school should encourage them to continue to wear face masks when appropriate and socially distance.
Children who test positive should rest and “take as much time as it takes to get better”, adding: “Getting back up and pushing themselves appears to be one of the risk factors for long COVID.”