Earlier this year, South Korea released a study on contact tracing during the COVID-19 outbreak there. Researchers found that COVID-19 patients between the ages of 10 and 19 had high rates of transmission in their households.
The study’s findings combined with others are part of why the decisions whether or not to reopen school campuses have been so tricky. We talked with the head of the Infectious Diseases and Vaccinology department at U.C. Berkeley, Dr. Lee Riley, about why teens are more likely to spread COVID-19 and when it’ll be safe to return to in-person classes.
This interview has been edited for clarity and length.
Lucas Roque: So there was a recent study that showed that young people between the ages 10 to 19 spread COVID-19 faster than other age groups. What are your thoughts on this?
Dr. Lee Riley: Until this study came out from Korea, a lot of people thought that young kids were less likely to transmit the infection and less likely to be infected in the first place. Those thoughts were based on some early studies, but they were very small studies.
Due to this, many political leaders, as well as some public health people, were saying that since kids are less likely to be infected, that it was ok to reopen the schools with in-person classes. In the more recent studies, including this one, the new evidence suggests otherwise. So the idea of reopening schools is getting questioned.
Regarding why kids between the ages of 10 and 19 are more likely to transmit than kids younger than 10, we still don't really know.
LR: What are your thoughts on the rise of cases after schools have been opening?
Dr. Riley: So, we're sitting exactly where everybody predicted — at least what the public health people and scientists were predicting. When people start going back into these crowded settings, of course, they're going to have transmissions. Now some of these [school districts] are having to backtrack and close the schools.
This has already happened in some colleges. For example, there's one in North Carolina that opened and then immediately after they were closed. Now, that's such a waste, right? Because all these students were actually forced to come back to the campus from all over the country. These are large universities where people from all over the country, all over the world come. So they are on campus and then just a couple days after they open the school, they have to close it. What are they going to do? Are they going to go back home? Why do they have to pay rent and stay on campus when they can just do everything remotely from home?
So these are the issues that come up at the college level. And they should never have opened the place in the first place. That will go for elementary schools and high schools as well.
LR: What advice do you have for school authority figures who are grappling with the decision to reopen?
Dr. Riley: I'm sure there are many clever and innovative ways to do some sort of an in-person class. But you can only do that at a certain point. You know, you can do outdoor classes up to a certain point. If you have to close a place at some point anyways, why start the in-person class to begin with?
At some point, no matter what you do, if you have people gathering in any form, you are going to have transmissions. And it may not only be detrimental to people’s health, but to the learning process itself. I think it's really a waste of resources to come up with these other things. I think they need to be investing in the technical resources to improve remote learning.
LR: So would you even consider it safe to return in person learning at all?
Dr.Riley: At some point, yes. But not at this time. Not until we have everything under control. We need to wait at least three weeks after we reach the peak. If you look at the epidemic curve [right now], the curve keeps going up. Can we really go back to in-person class in California right now, as we’re still on the upswing? If we reopen schools, it's going to get even worse.
When we reach a point after that peak past about three weeks, then we can begin to think about reopening.
LR: So what precautions would you recommend for young people who are going to school in person?
Dr. Riley: Maintain your social distancing, wear a mask in public places, wash your hands regularly — follow the guidelines that are out there right now from the public health departments. You can communicate with your classmates or your friends in person as long as you're maintaining social distancing.
Don't gather in groups of more than 10 people. If you do have to congregate, make sure you wear masks. So there's some socializing you can do, but you have to be vigilant. And if you do develop any sort of symptoms, you need to get tested. And if you do end up testing positive, then you need to inform your close contacts that you had so they can be tested. Every effort has to be made to interrupt the transmission of the virus.
LR: A lot of teenagers started vaping and drinking at a young age. How much does that have an effect on COVID and how it impacts them?
Dr. Riley: Yeah, vaping is really bad. It's already been well-documented. People who vape, if they get infected, will actually develop severe outcomes. Severe clinical manifestations form because of vaping itself. If they get super infected with the coronavirus, they'll do worse. So vaping is really something that should not be done.
Alcohol to a limited extent, should be ok. But when people drink alcohol to a point where you get drunk, then they can aspirate, meaning that they can swallow their stomach contents back into the lungs. That can damage the lungs so that if they get infected with the coronavirus, they'll have really bad outcomes. And so alcohol use can be done in a limited fashion, but any excess use of alcohol and even smoking a cigarette or weed will contribute to lung damage.
LR: So there's a lot of misinformation going out — even from our president. He was saying that kids are “virtually immune” to COVID-19, which is not true. Does it worry you that false information can lead to young people making really poor decisions?
Dr. Riley: Now, this president says all kinds of things that are nonsensical. He doesn't serve as a good model for what really needs to be done.
This is really contributing to the problem that we're seeing now. The reason the U.S. leads the world in the number of cases and the number of deaths is precisely because of the lack of leadership for what needs to be done. If the leader was a reasonable type of person who uses common sense and follows the guidelines of the public health officials and the scientists, we would not be having this problem. And that's clearly demonstrated by what happened in East Asia and Europe, where they've been able to control the infection because their leaders reacted differently. And so right now, the epidemic is not because of the virus, but because of the poor leadership of this country.