Without vaccination, delta’s arrival in classrooms brings great

Last August 19th the The Intercept Brazil published an interview conducted by journalist Nayara Felizardo with biologist Lucas Ferrante and data analyst Isaac Schrarstzhaupt. Both warn of the risk of increased mortality among children and adolescents caused by the arrival of the delta (Indian) variant, finding a scenario of return to classroom classes and a low vaccination rate among children and adolescents. In Pernambuco, hundreds of thousands are in classrooms without a vaccine.

The strain, which has already reached over 130 countries, is more transmissible than the others. For now, more than 90% of cases in Pernambuco are of the gamma (Brazilian) variant. But cases such as the United States and the state of Rio de Janeiro, where the delta variant is growing rapidly, point to the prevalence of the Indian variant over other strains. In the US, the number of cases in unvaccinated children (up to 12 years old) has grown at the same rate as cases in adults.

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In Pernambuco 10 cases of delta were detected by mid-August (or 5.5% of the 148 cases analyzed). Considering that the total number of new weekly cases in the period in question was around 2,400 cases, it can be estimated that in the first half of August there were already more than 140 cases of the delta variant circulating in the state, with chances of this number being considerably higher , as the cases detected (submitted to testing) are also a fraction of the total.

The pair of researchers criticizes that “governments are trying to normalize the number of one thousand daily deaths”. Ferrante and Schrarstzhaupt warn that, despite Brazil having witnessed a sharp drop in the number of new cases and deaths for a few weeks, this drop is “slowing down”, which points to stagnation, which – if restrictive measures are not taken – will be followed by a new case high.

With a prevalence of the gamma variant, which is less transmissible than delta, the state of Pernambuco has already recorded, from March 2020 to August 2021, a total of 607,000 cases of covid-19, of which 553.8 thousand (91.3%) of mild cases and 53.2 thousand (8.7%) severe cases (SRAG), which resulted in 19,370 deaths (3.2% of the total cases). These are the numbers for the general population.

When making the cut by age, we observed that among children the chances are lower of developing severe cases or resulting in death. Among teenagers it is even rarer. In children from zero to 9 years of age, 18,948 cases were registered, 95.9% of which were mild and 785 (4.1%) were severe cases, which resulted in 70 deaths (0.4% of the total cases in this age group).

In the range of 10 to 19 years, 34,834 cases of covid-19 were registered, 98.8% of which were mild and 408 (1.2%) were severe cases, which resulted in 43 deaths (0.1%). In Brazil, more than 2,500 deaths of children and adolescents have been registered by covid-19.

These numbers, however, refer to a one-year period with schools closed. But since April, private schools (both for kindergarten, elementary and high school) have returned to activities. In the same month, the public network resumed classes for high school. In July, the return of in-person classes in the municipal networks (early childhood and elementary education) was released. The reopening coincides with the arrival of the Delta variant in the state, first detected in July.

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Despite having less risk of developing severe cases, children and adolescents have the same transmission potential as adults, which can lead to an outbreak of the Delta variant, the most transmissible. The larger the outbreak, the greater the number of deaths. The state education network has 544,600 enrolled teenagers. There are still hundreds of thousands enrolled in municipal networks. In Recife alone, there are 92,000 students and 5,400 teachers spread across 320 schools.

The vaccines used in Brazil, if taken in two doses, all considerably reduce the risk of developing severe cases of covid-19, even from Delta. But vaccines are not yet released for children under 12 years of age. Laboratories are still carrying out tests to measure the safety of vaccination for this audience. Results can take months to be published.

Until August 30, Pernambuco counted 2.25 million people (23.3% of the population) fully vaccinated, in addition to 3.22 million (33.3%) vaccinated only with the 1st dose. As the Ministry of Health has not yet released vaccination for children, the total number of people from Pernambuco eligible for the vaccine is 7.28 million (75.3% of the total population of the state).

Among those not immunized, most are children and adolescents. By the end of August there were only 27.9 thousand teenagers (12 to 17 years old) vaccinated, all in the group that took only one dose. No teenagers in the state completed the vaccination schedule. Of the 9.67 million residents in the state, there are still 4.2 million (43.4%) without any dose of vaccine. Of these, about 2.39 million are aged up to 12 years (24.7% of the population) and are not expected to be vaccinated. Without a vaccine, transmission must be controlled by other means.

The researchers highlight the example of Australia, a country with a slower vaccination rate than Brazil, but which has managed to contain the number of transmissions and deaths through restrictive measures. The pair mentions a study published in the journal Science pointing to closing schools as the second most effective measure to contain transmission (the most effective of all is to restrict meetings to a maximum of 10 people).

They believe that the solution is not to send children and adolescents to school at this time, but to wait a little longer for the advance of vaccination and the consolidation of a low level of local transmission. Schrarstzhaupt and Ferrante also warn that we are still learning about the sequelae of covid, so that “allowing a high number of infected children is to run the risk of producing a generation with sequelae.”

Source: BoF Pernambuco

Edition: Vanessa Gonzaga

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