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University of Calgary launches study to explore children’s experiences with COVID-19 and role in transmission

U of C launches study into children’s experience with COVID-19 and role in transmission
WATCH ABOVE: Researchers from the University of Calgary are hoping to answer some burning questions about COVID-19 and children. As Laurel Gregory reports, their findings could inform how Canada comes back to life in the coming months.

Researchers from the University of Calgary are launching a two-year investigation into the interplay between COVID-19 and children.

The 29-member team of scientists will study how the disease affects children’s bodies, whether they build short-term or long-term immunity after being infected and what role they play in transmitting the virus.

Dr. Jim Kellner, a professor and researcher at the university’s Cumming School of Medicine will lead the team and says he considers the task of studying COVID-19 an “important contribution” as the world copes with the pandemic. Global News’ Laurel Gregory spoke with Dr. Kellner about the scope of the study.

Laurel Gregory: What are the main questions that you hope to answer?

Dr. Jim Kellner: There are several main questions we want to look at answering. Really, there’s the three aims of the study. The first is to really understand what that clinical experience has been for children who have been affected. As it’s gone, we have come to realize that there are very few children who are severely affected, which is really great, but it is not small the number of children who have been diagnosed with COVID[-19]. That’s one of the advantages we have in Alberta because of the very extensive and assertive contact-tracing system. It actually identified [that] over 900 children in Alberta have been identified with COVID[-19], and on a per capita basis, that’s way more than any other province in Canada. It is not that I think that we have a different manifestation of COVID[-19] here, I just think we have looked harder for it.
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We are going to be able to contact and follow the clinical course of hundreds of children who had COVID-19 infections — most mild for sure. But how did those affect the children, their families, their interactions with the health-care system over time?

Especially because most of those kids who have been diagnosed were diagnosed because an adult in their world was diagnosed with COVID[-19] — a parent or a caregiver or something like that. So it’s going to be important to understand that.

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The second big aim is what the impact of COVID[-19] is on the bodies — biologic systems — how we respond, whether we have mild or severe disease and whether there are any particular genetic features between children… [that] have COVID[-19] and children who don’t have COVID[-19]. Then the third aim is to look at the long-term immune response to COVID-19. We want to test 1,000 children, many who have had COVID[-19] but some who are known not to have COVID[-19] so far,  follow them and do repeat measures of their antibodies against COVID[-19] over a couple of years and see how many of the ones who had COVID[-19] actually have the antibodies and continue to have them over that time period, and then how many who didn’t have COVID[-19] actually developed those antibodies over time because they’ve been exposed.
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LG: Often we think we have to protect the elderly and children but that doesn’t appear to be the case at this point.

JK: It’s a really good point because with many infections, especially like influenza which people are comparing COVID[-19] to a lot,  you tend to have two peaks of disease: in young children and then in elderly folks and then along the way, folks who have particular risk factors. So what’s missing here is there is disease that occurs in children, occasionally severe, and then there are these unusual manifestations.

For the most part, children have been relatively spared from the worst of it with COVID[-19] for sure.

But because children are so involved with contacts with each other, with family members and throughout our society, it is really important to understand that even if children are maybe less likely to get COVID[-19] and maybe less likely to transmit it, they are so busy in the early years of life interacting with each other and other adults that even if, on an individual basis, they may be less likely to transmit it, there’s still so many opportunities for transmission and interaction that we need to understand that better.
For sure the role of children needs to be understood from a scientific perspective and from a social perspective. I think we have to be careful not to get too satisfied and say, ‘You know it doesn’t look like children are that affected that often except for a handful of times where you get more serious disease or one of these post-infectious kind of situations.’ Children are going to be an important part of the whole story over time of COVID-19 and we need to understand that, so I think because of how we are organized in Alberta, [we are] in an ideal situation to study that.
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LG: How much does our high volume of testing play into that as well as our young population.

JK:  Hugely. We do. The territories are a bit younger, but of the provinces, we have the youngest average age population and highest birth rate, so it’s hugely important the approach to testing that we have had. In Canada, in general, testing has been good, but in Alberta in particular, we have tested at a rate far higher than almost any jurisdiction in the world. And it is not just the amount of tests but the contact tracing related to the testing, so that we have made very assertive efforts to follow up all the people who have been diagnosed with COVID-19 and all their contacts. And because so much of our testing has been in looking at contacts, we have identified far more children on a population basis in Alberta than any other province in Canada, and really, than anywhere in the world. Most of the studies to look at COVID-19 in children have looked at that as a percentage of the total population who have been sick with COVID-19 and typically it’s somewhere between one and five per cent.

Across all of Canada, all the testing that’s been done, about four per cent of cases are in children. However, in Alberta, almost 15 per cent of the cases that have been diagnosed have been diagnosed in children and adolescents.

Fortunately, most of those have been very mild cases that they don’t have to go to hospital for. But that gives you a flavour of how we have identified so many more children and this is where we have a great opportunity to discover how it’s gone for them.

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LG: How long is your research project?

JK: We definitely want to aim to get some good information out soon, so we would like to get a snapshot of what we understand about immunity out in the next few months — what we know about it now. But our plan is to run the study for two years at least, and with children where we are looking at their immune reponse, measure them every six months for a couple of years and see what we know at that time. So doing all the research and getting all the analysis is going to run over a couple years.

LG: When you talk about immune response, do you mean in the way of, if you are infected and recover, are you likely to get it again?

JK: If you get COVID 19, especially because we are dealing with children who have had mild disease, and you recover, do you have immunity at that time? And then do you continue to have immunity six months or 12 months or two years down the road? So, it’s, ‘Have you developed that immunity when we know you have it?’ And then do you continue to have it? Because we’ll be testing children who were tested for COVID[-19] but were negative, but… [they] were exposed somehow and had some symptoms, we’ll see how many of those might have developed immunity because maybe the test to see if they had COVID[-19] in the first place, from the test in the nose and throat, maybe it didn’t identify it when it was there. That’s an issue sometimes. And then we’ll also be testing children who apparently didn’t have COVID[-19] up until now, and see over time how many actually develop antibodies, because they have either had an illness that’s apparent, clinically, or because they’ve had an infection with no symptoms at all.
LG: Would it be a win to see this research inform public policy in our COVID[-19] response?
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JK: This is part of a huge global thing, a problem that has affected us like nothing in anybody’s living memory. So it’s a very big thing to try to find some useful information that can help inform public policy. And some of the things we think we can help inform policy around and thoughts around, will be things like freedom of movement in children, how assertively we can get back to opening up schools and activities that children take part in, how much do families have to worry, how much do we have to worry about young children having interactions with elderly grandparents or loved ones who have underlying disease? Do we have to work to keep them apart indefinitely? Or is there going to come a time when we don’t have to worry about that so much. So I think there are a lot of practical elements that can really inform how we deal with this.