Relaxation of infection control measures – they must also apply to children! : www.kinderaerzte-im-netz.de

03/04/2022

In the recommendations from DGKJ / DGPI with support from BVKJ, children should be given perspectives. The relaxation of infection control measures should also apply to children.

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The peak of the omicron wave has passed in most federal states. At the Prime Minister’s Conference on February 16, 2022, the federal and state governments agreed to reduce state infection control measures. Children and young people have suffered in a special way during the changes during the pandemic and the associated interventions in their social participation. In its 7th declaration, the Federal Government’s Expert Council explicitly warned that the best interests of the child should be a priority during the pandemic. The relaxation of measures for children and young people should be at least analogous to the relaxation of the overall social framework.

The goal is now primarily targeted protection against serious disease progression, no longer protection against each individual infection. This particularly affects vulnerable groups with risk factors that are now well defined. Children and young people are only included in very rare exceptional cases.

SARS-CoV2 vaccination

Vaccination against SARS-CoV-2 makes a significant contribution to preventing the serious course of a COVID-19 infection. However, it can not reliably prevent any infection.

We explicitly support STIKO’s vaccination recommendations. We encourage vaccinations, especially in the pediatric environment. The benefit of vaccination is obvious, serious complications are extremely rare, even in the age group of children and adolescents. Vaccination of all adults also protects those under 5 years of age for whom an approved vaccine is not yet available. In the age group 5 to 11 years, basic immunization with two vaccinations corresponds to complete vaccination protection.

masks

Wearing a medical mouth and nose protector (MNS) or in special cases also an FFP-2 mask plays a major role among the measures used to limit the SARS-CoV-2 pandemic. In addition to other hygiene measures, wearing an MNS also reduces the risk of infection in schools. Analogous to the AWMF Guideline “Measures for the Prevention and Control of SARS-CoV-2 Transmission in Schools”, we recommend wearing an MNS when attending high school, depending on the infection process and the general rules that also apply without for the school. In situations, it is also recommended to wear a mask, but it should not be mandatory. Mask breaks should be allowed, physical education should take place without masks. We refer here to our updated information. Young children should be regularly excluded from wearing masks. Between the waves of infection, when the children’s disease burden is low, for example measured by hospitalization rates, masks should not be worn in educational institutions. Carrying a medical MNS should not be made dependent on vaccination or recovery status or the performance of SARS-CoV-2 tests for no reason.

SARS-CoV-2 antigen rapid test / PCR pool test

The age group that has previously been followed most consistently, ie without reason, with rapid antigen tests or PCR pool tests, are children and young people in day care institutions and schools, some of whom have daily tests. This had and has far-reaching consequences that went beyond what was in demand and implemented outside of school operations. For example, if the test results were positive, isolation and quarantine measures were initiated, which were maintained at least until confirmation / non-confirmation by a PCR test.

Unprovoked antigen tests with subsequent PCR tests with positive result do not make sense due to the high pre-analytical and analytical errors The test results are unreliable, especially in younger children. Experience has shown that even if a PCR test is subsequently performed, the evaluation and transfer of information is significantly delayed.

PCR pool tests are also not useful in cases of high prevalence, as they result in a high percentage of individual PCR tests, which are currently not available in sufficient numbers, bind resources unnecessarily and also only make it possible to identify infected persons with a certain amount of latency.

Rapid rapid antigen testing / PCR pool testing should therefore be discontinued with immediate effect. For COVID-19 symptoms, on the other hand, rapid antigen tests should be used, as well as if children and adolescents or parents so wish, eg if there is a person with risk factors (illness or poor vaccination response) in the same household.

If the test result is negative but the symptoms persist, this can be repeated daily if necessary. Isolation in the home and a confirmation test with PCR should only be performed if the antigen test is positive.

quarantine

In the case of day care and school children, quarantine should no longer be imposed if they come into contact with a child in the day care group or the school class with a positive SARS-CoV-2 test. They should have the opportunity to stay at the facility. Their infection status can be checked with sufficient certainty using an antigen (or PCR) test in the days after the contact.

Recommendations from DGKJ, DGPI and BVKJ in PDF format for download

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