Martin Kadai: No reason for Covid testing in schools this fall

Martin Kadai.
Martin Kadai. Source: Priit Mürk/ERR

Advisor to the justice chancellor, molecular biologist Martin Kadai said there is no reason to talk about wide-ranging restrictions this fall as the situation has changed fundamentally. Kadai told ERR that there is little sense also in testing for the coronavirus in schools as chasing the virus is no longer necessary, nor does he support ordering people to wear masks.

The coronavirus continues to spread in the world and Estonia, it is not going anywhere. A milder strain is currently making the rounds, while most people in Estonia have already recovered from Covid and/or been vaccinated. Whereas vaccination remains widely available. Is there any cause in this situation to look to last winters' Covid rules and restrictions?

The viral infection has been doing the rounds for two and a half years. Many have recovered from the disease it causes, many have been vaccinated and many have both recovered and been inoculated. In other words, there is relatively comprehensive immunity.

This is the main factor altering the pandemic and its effect on people. Pandemics develop when human populations lack sufficient immunity against pathogens.

The virus continues to spread and has the ability to dodge previously created immunity. But the consequences cannot be compared to what we saw with the Alfa and Delta variants of COVID-19.

And this begs clear conclusions. It has been suggested in scientific circles since this spring that the acute phase of the pandemic has passed. We do not yet dare declare the pandemic over or say that the virus has disappeared. It likely never will completely. But the situation and what needs to be done about it are completely different today.

What could prompt special regulations this fall? Based on what would we conclude the situation is now serious? Weekly infection statistics doesn't really compare to previous periods as we aren't ordering nearly as much laboratory testing. Are we left only with the workload of hospitals in terms of metrics?

There is no point in monitoring how extensively and intensively the virus is spreading today. The situation cannot be compared to earlier phases of the pandemic. Today, the chief or primary thing we need to be watching is what the disease causes. That can help us answer the question of the problem we're trying to solve. We do not necessarily have to stop the virus from spreading. We have plenty of seasonal viral infections that we are not purposefully combating because such a fight would be lost before it begins. Nor is there any great sense in it. We need to fight viral infections if they have severe consequences.

The coronavirus no longer does, to suggest that we do not need to combat its spread. What we need to monitor is illness. That is the main indicator.

But looking at hospitalization is also less than informative. The Omicron strain also changed the situation in hospitals, and while many people with Covid are hospitalized, they are not there because of the virus. It is an important change. People do not need to be treated for Covid, while they might need to be isolated to keep the disease from spreading in hospitals.

It needs to be analyzed whether hunting for the virus and isolating people inside medical facilities is justified in a situation where Covid symptoms are no more severe than those of other seasonal viral infections. An extremely complicated question. Communicable diseases and infection control experts should decide something and keep monitoring the situation.

Efforts to look for the coronavirus and isolate patients can only be made at the expense of planned treatment. This might no longer be balanced, as postponing planned treatments also causes major problems. We should be measuring it as a whole, in number of healthy years, instead of preferring to treat one disease at the expense of others. But it is a difficult matter.

People can be divided into many categories based on recovery and vaccination. Some have been ill several times, following several jabs of vaccine, some have recovered after not being vaccinated. Some got Omicron last winter, while some have it now. How could it be possible to create a credible Covid passport system in such a situation? Even if we do not think about it in Estonia, some countries are bound to react to the infection rate spiking by requiring Covid certificates.

Covid passports could be issued to people who want to prove how many times they've been vaccinated or when they were diagnosed. But the relevant question is what would be the point of such a certificate? Covid passports tell us nothing about immunity because we cannot measure immunity created as the result of vaccination or recovery. The passport cannot tell us whether and when the person could be infected again, and, in that fact, loses its point.

It also does not tell us whether the person is infectious as we know that vaccination and recovery offer no protection from infection. Vaccination lowers the risk of severe illness and death. Being both vaccinated and having recovered from Covid can improve immunity. But this still means that a Covid passport is completely useless in terms of proving immunity. It would be very difficult to justify in the current situation. Some countries might do it, and there is nothing we can do about that, while I see no real reason to reintroduce Covid passports in Estonia.

Do we need to return to wearing masks if the situation deteriorates? We can, of course, recommend people wear masks, but what about obligating them to?

It is crucial to tell recommendations apart from something that is mandatory. We cannot hold it against capable agencies when they recommend wearing a mask as protection against infectious diseases. No one should have anything against that. But we should also understand people who decide not to take this advice or follow it differently.

Laying down mandatory rules requires a lot more proof of the measure serving its purpose. Failure to comply must be followed by a punishment, and it needs to be possible to offer proof of necessity. We do not currently have consistent and convincing proof that wearing a mask indoors in public places has any considerable effect on the spread of the virus. There is no such proof. That is where the problem starts. That is why we should not obligate people to wear a mask in the current situation.

If we recommend it, we should not tolerate people frowning on others either wearing or not wearing masks. This kind of scornfulness caused a lot of conflict during past viral seasons.

Absolutely. It mustn't be ridiculed or resented in any way. It was disgusting to see people not wearing masks wrestling with supermarket security staff. That is not sensible either.

Children will be returning to school next week. Should schools avoid switching to distance learning as we know the illness is usually very mild in children? How should we weigh Covid against our children's education and socializing opportunities?

I believe schools should stick to the main rule where healthy children are expected to go to school. A child who is ill should definitely stay home both for their own health and so as not to infect and endanger others. This simple rule says it all. Doing much more than that would not be sensible. Children can continue learning if we observe this rule.

We also do not have to go looking for children who test positive for Covid. It is important to realize that a positive test result does not equal illness. That is why it is not sensible to screen for positive test results among children. As I suggested before, we are no longer in a phase of the pandemic where we need to be desperately chasing after the virus.

The problem is created when the person becomes ill. Once that happens, we can decide whether we need to find out what has caused it or whether it is not important.

It's as if the coronavirus pandemic has been turned upside down: we are looking for the virus first and trying to understand whether it's a problem second. Searching for the virus and isolating those potentially infected, including keeping children home from school, is no longer necessary. As long as healthy children are sent to school and sick children stay home, everything is just fine.

As concerns universal measures, I completely agree with Professor Irja Lutsar in that general remote learning shouldn't even be considered today. It has repeatedly been suggested in scientific papers and international organizations find that putting kids on remote learning should be a last-ditch measure.

The Ministry of Education and Research has spent millions on rapid tests for schools. What should be done with them?

That is a difficult question. I could not explain why they are needed because, as I've suggested, there is no good reason to go looking for the virus in society. For example, if my kid tests positive for Covid, how should that affect my decision? Will I do anything differently? A sick child will still stay home and a healthy one should go to school.

Does it affect treatment when a kid tests positive for Covid? You still buy over-the-counter drugs to alleviate fever, cough and other cold symptoms. Nor are there any prescription medicines that work specifically for Covid. Home treatment also does not depend on the test result, neither for children nor adults. We also do not recover any faster if we know we have the coronavirus. It boils down to curiosity in the end.

Local governments approached remote learning in different ways. For example, Tallinn was quite eager to introduce remote learning. I believe that as the virus makes its way back to schools and illness goes up among children, we will once again see vocal parents, principals and local politicians for whom the only solution is sending the kids home.

Let us also recall the situation before the pandemic. Viral infections have been with us always, and it has happened before that many teachers and students are ill at the same time. It will also happen in the future. I believe it is a familiar situation for schools. And they will find solutions in different situations. I see no need for local or central government intervention in terms of remote learning. All such situations can be solved on the level of the school or even class.

Considering recommendations in scientific literature and from international organizations on closing schools and distance learning, I cannot imagine how we could justify something like that today.

I remain less optimistic. I have seen official risk scenarios that suggest we might have 450-600 people hospitalized with Covid by the time of the first school break in October. Pressure from hospitals and a part of the population will mount and there will be demands for rapid solutions. Back to what we have been told for the last three years.

It will come down to what is legal and possible. The Health Board has not clearly stated whether COVID-19 continues to be an acutely dangerous novel infectious disease. The board has remained somewhat vague in its comments.

This will determine whether any restrictions can be laid down. Professor Lutsar has suggested we have not closed schools because of the flu, adenovirus or other viruses. And we hopefully won't in the future, more so as the law does nor provide for such action.

It is very important we understand this new situation. I would also recall what happened earlier in the year. The Omicron wave brought mass infection, and it happened in spite of all the restrictions that had been laid down to prevent or mitigate it. This clearly showed that restrictions cannot effectively fight the spread of the virus.

Preventing or alleviating illness that follows infection is possible to some extent. But the solutions required are quite different. We must concentrate on vaccinating risk groups to prevent death and severe illness.

Closing schools or ordering universal social restrictions are not quantifiable solutions on this road.


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Editor: Marcus Turovski

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