Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series!

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research, and help you understand what it really means.

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

Lewis: And we’re Scientific American’s senior health editors. This is our back-to-school special episode. We’ll talk about why COVID testing is about to become a school problem. 

Fischman: And then there’s some good news about kids’ risk for long COVID: its pretty low.

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Lewis: If you’ve got young kids, you’ve already started buying fresh notebooks and maybe a new backpack: its back-to-school time. And you’ve probably bought into some worry, too. 

Fischman: Schools are large group settings, and group settings are good places for COVID outbreaks with the infectious subvariant BA.5 running around. You probably got alert letters last spring saying someone in your kid’s class tested positive, and if your kid was a close contact get your child tested too.

Lewis:  Easy rapid testing is a good way to contain outbreaks. And we all want to keep kids and teachers safe, and keep schools open.

Fischman: True, but we’re beginning to see some problems coming up with this containment strategy.

Fischman:  Let me start with Ashish Jha, the physician who’s the White House COVID response coordinator. He got on Twitter this week to say he’s ready to send his kids back to school, and wanted to emphasize ways to do that safely.

Fischman: His first point was about vaccines. The shots lower infection rates in kids, and do a great job at blocking serious illness. But this is problem number one: Children are not getting their shots. The fully vaccinated rate for kids aged 5 through 11 is just 30 percent. For kids under 5, who recently became eligible for shots, its even worse: just about one percent.

Fischman: Things look better for kids 12 through 17. Their vaccination rate jumps to 60 percent.

Fischman: But for those younger kids, the low rates mean a lot are showing up in school without the first and best line of defense.

Lewis: So that raises the risk of outbreaks, doesn’t it?

Fischman: It does. Which brings up Jha’s second point. The best way to keep spread low and reduce outbreaks is testing. 

Fischman: And the US government has, up to now, bought tens of millions of tests and made them available to the public, and those purchases created a market that encouraged companies to make even more tests.

Fischman:  But that’s going to change. Jha–the same guy pushing the importance of testing–told CNN that sometime in the fall, the government is going to stop buying these things, and turn that over to the commercial sector. Not all at once, but in kind of a phased withdrawal.

Lewis: You’ll still be able to get tests, right?

Fischman: Yes, but less so at free clinics and more so at drugstores and doctors’ offices, the regular medical system. A rapid antigen test kit sells, retail, for about 20 to 30 bucks. The more elaborate PCR tests cost about 250 bucks. You’ll have to find out if your insurance company will pay for them, and submit claims, and wait for reimbursement. 

Lewis: And probably get into arguments with insurance about how much they’ll pay, because that’s how insurance works in this country.

Fischman: Then if you’re one of the 26 million Americans who don’t have health insurance? You’ll be paying for tests yourself.

Lewis: You’ll still be able to get free tests at schools. The White House says it will supply 5 million rapid antigen tests and 5 million PCR tests to schools that request them, and the schools should give them to you.

Fischman: But the shift to the regular health care system is going to make the testing landscape more complicated. With low child vaccination rates, you could be needing a bunch of tests, and have to do more running around to get them. New Jersey just announced that unvaccinated school workers and workers in child care no longer have to get tested routinely, and if other states follow suit that’ll make spotting outbreaks even tougher. 

Fischman: So along with those new school notebooks and pencils, it might be a good idea to stock up on a bunch of COVID tests now, while they’re still pretty easy to get.

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Fischman: There’s a lot of scary and conflicting info out there about long COVID—especially when it comes to children. What do the studies really show?

Lewis: Early in the pandemic, there was good reason to be worried. Some studies showed the risk of long COVID—lingering symptoms such as fatigue, depression or headaches that continue weeks or months after an infection—could affect as many as two out of three children who had COVID.

Fischman: That’s a lot. Have those findings held up over time?

Lewis: Well, more recent studies provide some reassurance that the risk of long COVID in kids is much lower. As SciAm contributor Shannon Hall reported this week, these studies had something many of the earlier studies lacked: a control group.

Fischman: That seems like a pretty big shortcoming. 

Lewis:  It is. When researchers compared the rate of long COVID symptoms in kids who had been infected to those who hadn’t, they found few to no differences between the two groups. For example, a large study in the U.K. published last year found that most of the kids who had COVID felt better within six days, and more than 98 percent were fully recovered by eight weeks. In contrast, kids who tested negative for COVID actually felt worse at the four-week mark than those who tested positive.

Fischman: That’s not what I would expect.

Lewis: Right. And a study earlier this year in Denmark, where school children were strongly encouraged to get tested for COVID twice a week, found that those who tested positive were slightly more likely than those who tested negative to report at least one long COVID symptom two months later. But the difference was small.

Fischman: Were there any other problems with the studies?

Lewis: Well, one issue is that different agencies use different definitions for long COVID. The CDC defines it as symptoms that begin a month after infection, whereas the World Health Organization describes it as anything that lasts at least two months.

Fischman: I can see why that would be confusing. Is there anything else that could explain the symptoms in COVID-negative kids, if not COVID itself?

Lewis: Yes, researchers suspect the children in the control groups might have simply been suffering from other respiratory viruses. But another possibility is the pandemic school shutdowns and other societal changes could be causing all sorts of physical symptoms. Another study in the U.K. found that a whopping 40 percent of children—including those who’d had COVID recently and those who hadn’t—reported feeling worried, sad or unhappy.

Fischman:  That’s sobering. But, stepping back, how worried should parents be about long COVID itself?

Lewis: The findings suggest that long COVID isn’t a huge risk to kids. But it can still be a real struggle for those who do develop it. And other research has shown that kids who’ve had COVID are at a higher risk of complications like diabetes and heart problems than kids who’ve never been infected.

Lewis: Scientists still have a lot to learn about long COVID, in both kids and adults. But recent findings are suggesting that it may not be as common as some had feared.

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Lewis: Now you’re up to speed. Thanks for joining us. Our show is edited by Jeff Delviscio and Tulika Bose.

Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out sciam.com for updated and in-depth COVID news.

[The above text is a transcript of this podcast.]