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Experts pan ‘fundamentally flawed’ ministry report that kids are superspreaders

Nine leading academics say Health Ministry research has it all wrong with assessment that children are drivers of infection – a conclusion that may slow down school reopening

Nathan Jeffay is The Times of Israel's health and science correspondent

Jerusalem's mayor meets with young Israeli twins going into first grade at a school in Jerusalem on September 1, 2020 (Noam Revkin Fenton/Flash90)
Jerusalem's mayor meets with young Israeli twins going into first grade at a school in Jerusalem on September 1, 2020 (Noam Revkin Fenton/Flash90)

Government research that said children are more likely than adults to contract the coronavirus is “fundamentally flawed,” nine influential health researchers have claimed.

Unleashing numerous criticisms against a report summing up the research, which was shown to ministers on Wednesday, the experts said its suggestion that the dramatic rise in coronavirus cases seen in September was due to schools reopening is deeply mistaken “from an epidemiological viewpoint.”

The Health Ministry document presented figures that were said to show high coronavirus rates among kids, and warned that sending children back to schools at a time of high COVID-19 morbidity “may accelerate the spread of the virus.”

The study reported that eight percent of the 678,000 COVID-19 tests conducted on children under age 17 between January 27 to September 24 came back positive. This was 2% higher than the rate from some 2.6 million tests conducted on adults during that same period.

It claimed that children can act as “superspreaders” since 51% to 70% of them do not show symptoms of the virus, and said that in 17 cases tracked by the Health Ministry, children managed to infect over 10 of their peers.

The critics, in contrast, believe that the children play a relatively small role in spreading the virus, and the September outbreak was actually propelled more by adults infecting kids during multi-generation family vacations than by kids infecting adults.

Israeli children wear face masks on their way to school in Moshav Yashresh, on May 3, 2020. (Yossi Aloni/Flash90)

The report made such an impact when presented to politicians ahead of the coronavirus cabinet meeting on Wednesday that Prime Minister Benjamin Netanyahu reportedly expressed surprise that health experts signed off on opening kindergartens and preschools last week.

The government had been expected to open elementary schools for the younger grades at the end of the month. But there is speculation that the new report, with its cautious approach and recommendation for “gradual” reopening, is one of the reasons for Wednesday’s coronavirus cabinet meeting ending without a decision on school reopening, and that it may slow the timeline when the issue is discussed again next week.

Prof. Ronit Calderon-Margalit (courtesy of Hebrew University)

According to epidemiologist Ronit Calderon-Margalit, the Health Ministry has arrived at completely the wrong conclusions from the statistics it gathered. She told The Times of Israel that the report “seems to misinterpret data in a way that blames children in the propagation of disease.”

Calderon-Margalit, an adviser to Israel’s coronavirus czar, Ronni Gamzu, said that the report loses credibility by drawing broad conclusions for children as a whole, while medical evidence suggests that under-10s, who rarely catch the virus and infect others, differ sharply from over-10s, who reflect adult-like patterns in relation to COVID-19.

The report reflects a misconception that schools are behind the latest outbreak, she said. “The reopening of schools on September 1 was not the vector for the outbreak, and you cannot assume that closing them on the 17th was the reason for the decline in morbidity.”

Calderon-Margalit is part of a research group from Hebrew University and Hadassah Medical Center that focuses on contagion among children and has submitted findings to the government.

It has issued a response to the Health Ministry report, signed by all nine members of the group, that argued: “The data presented in the report clearly demonstrates that children are less contagious, and they most often get infected from adults, not the other way around, and that they constitute a small percentage of the super-spreaders in the population, 9.4%.”

Illustrative: An Israeli school, closed due to the pandemic (Olivier Fitoussi/Flash90)

The experts claimed that many of the problems with the report were in the interpretation of data, not the data itself, but they took issue with the reliance in part on serological research, which involved health services testing the blood of supposedly random samples to see if they antibodies had been developed as a result of catching the coronavirus at some point.

According to the Health Ministry, of those children who were able to determine whom they contracted the virus from, they reported that they had been infected by an adult 80% of the time, while the remaining 20% said they had caught COVID from a fellow child.

The testing took place at clinics, for patients who went for non-coronavirus matters, which, according to the critics, is not a reliable way to build a picture of coronavirus rates among children.

Ora Paltiel, professor at the Braun School of Public Health and Department of Hematology at Hadassah-Hebrew University and one of the nine critics of the government report, told The Times of Israel: “The serological study was a non-representative sample of people who came to clinics. Children do not come unless they are sick and rarely have routine blood tests, if ever. Therefore the children in the survey were more likely to be sick and were not proportionately represented in the survey.”

Times of Israel staff contributed to this report 

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