Interview

Ari Bitnun


It is my strong opinion that schools should have never been closed and that they should be reopened immediately.

I’m going to discuss two aspects relevant to this topic. One is the direct risks of SARS-CoV-2 to children, and secondly, some of the evidence pertaining to school safety.

So with respect to the risk of SARS-CoV-2, children have not gotten severe disease:

  • At least a third if not 50 per cent of younger children have no symptoms at all. And if they do have symptoms, they tend to be mild.
  • It is only a small proportion of children that go on and develop severe disease either in the form of acute COVID-19, or, perhaps more commonly even, the post-infectious multi-system inflammatory syndrome in children.
  • There is a case fatality rate of less than 0.01 per cent. This is similar to the 2018/2019 influenza season, which was not a particularly bad year; there were 1300-odd admissions to hospital, 270 ICU admissions, and 10 deaths. So basically, they’re in the same ballpark as COVID-19 and over a shorter timeframe. 

Schools are safe because most transmission does not happen in schools:

  • There have been many, many studies so far looking at SARS-CoV-2 transmission in schools using different methodologies in different countries with different mitigation processes in place. There are limitations to all of these studies, but in aggregate, they strongly suggest that with appropriate precautions in place, schools are safe.
  • Community acquisition is the dominant form of transmission, not schools.  

Cross-examination:

Moderator Meera Dalal-Burns: Your report out of SickKids on reopening schools made some recommendations for safe reopenings: ventilation, handwashing. Unfortunately, our government has not taken up any of these recommendations. So in today’s realpolitik world, what is your approach: to open regardless of the safety measures that are in place, or just to wait until they’re in place? 

Ari Bitnun: Yes, it’s true that the mitigation efforts that have been put in place have not been fully implemented, and it varies from school to school. A good example of that is ventilation; this is one that needs to be much improved. But we already have safety data. So from my point of view, there’s no reason not to open schools. Vaccines are key. As we ramp up vaccines, especially in the adults, there should be even less reason to keep schools closed, because that’s probably the most important preventive measure.

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2 Comments
  • frankly says:

    My first visit. Huge fan of need for debate. Censuring experienced knowledgeable pros is absolutely damning of the motives of the authority censuring.

    It seems a clock visible to the person speaking would be much less disruptive than verbally counting down. Very glad I found this site and thanks to all who contributed.

    Must say the interchange between fauci and paul in the US is fascinating just for fauci’s Freudian slips. Today he said we are coming for you, well indeed that’s been obvious, but nice to here him admit it.

  • Marion Day says:

    (I am reposting this comment from Martha Fulford’s post in the hope that someone will see it and address the issue MD)

    This debate took place in June, 2021. I’m seeing it reposted on social media with the date Jan 4 2022, It’s posted on YouTube as “Jan 4”, with a creation date of Dec 31 2021.
    Even if some (or even all) of the participants’ views remain unchanged in the context of Omicron, that the debate predates Omicron by 6 months provides potentially important context. It might be important for a viewer to understand the debate occurred in June 2021, not several days ago. I hope anyone with posting privileges will add this clarification. Thanks.

Authors

Ari Bitnun

Contributor

Ari Bitnun is a professor in the Department of Pediatrics at the University of Toronto and an infectious disease specialist at the Hospital for Sick Children.

Cross-examiner

Meera Dalal-Burns

Contributor

Meera is a general internist, palliative care physician at St. Michael’s Hospital, and journalist with a penchant for the unusual and a love of untold stories.

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