Covid in children: between fake news and real doubts, by Professor Gilles Pialoux

There are signs that, after twenty months of the pandemic, they should have, if not cautionary value, at least an incentive for humility. Both for politicians and polemicists, experts, scientific societies and other observers. Regarding the direct impact of the Covid Delta on children in the context of a debate on the advisability, or not, of a vaccination in children under 12 years of age, we could only retain one figure: the incidence of new cases of Covid in children under 12 years of age. 10 years in Austria would be 4,500 for every 100,000 inhabitants! Even if, especially in children, contamination does not mean disease. And illness is not synonymous with seriousness.

Austria, it should be remembered, is the country in Europe that has undergone the most examinations in schools, instituting repeated examinations using saliva tests to enter school. In Vienna, screening is compulsory from 6 years old and for children between 12 and 15 years old, the “Ninja Pass” of Austrian schools applies. Turning his back on the dogma of “open school at all costs” so dear to the Minister of National Education. This same Austria that is suffering the full weight of a fifth wave of strong magnitude despite, contrary to certain political statements, the implementation as of May 19 of a “green health pass”. In France, where one of the ways of not closing schools was to do a small screening, the latest update from the Ministry of National Education reports 4,048 classes closed until Thursday, November 18, for at least one case. A partial and partial situation that Vittoria Colliza (Inserm), a specialist in modeling, summarizes perfectly in the JDD: “class closures only represent what we see, and we see little”.

The myth of “natural” immunity

Another idea – but we know the distance that separates the idea from the ideology – (re) is currently taking shape: that of the “natural” immunity of children as a way out for the expansion of vaccination of the youngest. The term “natural” is just the individual adaptation of “herd” immunity. Also prosaic: “you play in the sandbox with the others and you put on the gastro and it immunizes you …”. It is true that pediatric Covid vaccination is not yet current due to the lack of hindsight, preparation of public opinion and “to go towards” the 6.4 million “eligible” French who have not received the slightest dose of vaccine. But letting go of the idea of ​​herd immunity for the very young, the same one that plunged the Trump-era America into deadly chaos at the start of the first wave, raises questions.

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And this idea, between fake news and doubt as it is not based on any scientific evidence, is circulating in the highest circles of experts. Following the example of the French Pediatric Society (SFP): “Apart from specific cases (NDRL, the child’s pathologies constitute a risk factor for serious forms), SARS-Cov2 infection in children seems to be very often benign, even with the delta variant, which allows considering the benefits of natural immunity “(SFP press release and 4 associations dated 11/15/2021). Concept adopted by the National Academy of Medicine (ANM) with a Semantic convolution that presents “the speculative advantage of a strategy that allows natural immunity to develop in the population while allowing the virus to circulate in groups with less risk of severe forms of Covid-“. 19 ”(ANM Opinion 11/15/2021) The adjective “speculative” and population displacement clearly refer to the total absence of data to support this hypothesis.

The challenge of the “long Covid” in pediatrics

Another element of opinion circulates here and there. Following the example of the same SFP press release: “young children, even in France, are less infected and outside the family environment, less contagious than the rest of the population”. There too: fake news or scientific doubt? Nobody knows precisely. Therefore, there are no reliable data on the spread of the delta variant in children. According to several experts, “equal symptoms” contribute as much as adults, but are less often symptomatic. With the Delta variant, which is twice as contagious, even 50% less contagious in children, there are significant risks of transferability. And studies such as those carried out by Arnaud Fontanet’s team (Institut Pasteur), during the era of non-delta variants, clearly show that having a child in your entourage increases the risk of infection within the family (EpiCov 2020 study).

Finally, the last area of ​​doubt: the children of the infected France would only more or less develop a “long Covid” whose nosological framework remains quite vague. Notwithstanding the opinion issued by the Scientific Council and the Council for Strategic Orientation of Vaccines (COSV) on September 13 on the challenges of the beginning of the school year: “although the frequency is lower, the issue of the” long Covid “in pediatrics also is to take into account “. And even more so the statements of “Mr Covid” in the United States, Anthony Fauci, during the press conference to launch the pediatric vaccination campaign at the White House on November 3, which underlined the reality of this long-term impact, According to him, it could affect 4 to 6% of infected children.

As what the child is not just a miniature adult, which is the fundamental basis of pediatrics. But defending the best interests of children is not a prerequisite for any specialist, since it concerns the whole of society. And those who rely on a random circulation of the delta variant among the youngest – due to lack of screening and tracking / isolation of children – to justify the now legitimate wait for the vaccination of children under 12 years of age could have an appointment. come.

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Prof. Gilles Pialoux is Head of the Department of Infectious Diseases at the Tenon Hospital (AP-HP) in Paris. A member of the PandemIA collective and the Terra Nova health center, he is also the author of “We were not ready. Record book in times of coronavirus” (ed. JC Lattès).

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Frédéric Filloux is a columnist for L'Express and editor of Monday Note.Frédéric Filloux

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Rama Yade, Vice President of the Radical Party (PR), March 10, 2012.By Sylvain Fort



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