A recent commentary published in the Journal of Pediatrics encourages schools to reopen, citing that children rarely transmit COVID-19 to each other or to adults.
The commentary, authored by two pediatric infectious disease specialists at the University of Vermont, builds on evidence that children contract the virus at much lower rates than adults and when infected, generally have mild symptoms. The specialists, Benjamin Lee, M.D. and William V. Raszka, Jr., M.D., wanted to know to what extent children are responsible for transmission, a key consideration for reopening schools.
The two base their conclusions on five recent studies examining COVID-19 transmission among children.
A Pediatrics study performed contact tracing among a group of infected children in Switzerland to identify infected household contacts. Of the 39 households, children were the index case in only 3. All other children were infected at the same time as or after adults in their homes, suggesting “that the child was not the source of infection.”
A study of infected children at Qingdao Women’s and Children’s Hospital replicates this finding. In this case, 96 percent of children with COVID-19 were household contacts of previously infected adults.
Both studies suggest that children most frequently acquire COVID-19 from adults, rather than transmitting it to them. This finding may alleviate concerns that children returning to school will infect teachers and parents, whose older age puts them at greater risk.
Studies cited in the commentary show that child-to-child transmission out of household settings is also rare. In a French study, a 9-year-old boy infected with COVID-19 exposed more than 80 classmates across three schools to the virus; however, none contracted it, despite transmission of other respiratory diseases.
Additionally, a study in New South Wales, Australia examined 9 students and 9 staff infected with COVID-19 across 15 schools. Though the infected individuals had close contact with 735 students and 128 staff, only two secondary infections were identified.
“The data are striking,” Dr. Raszka said. “The key takeaway is that children are not driving the pandemic. After six months, we have a wealth of accumulating data showing that children are less likely to become infected and seem less infectious; it is congregating adults who aren’t following safety protocols who are responsible for driving the upward curve.”
The report concludes that “researchers provide early reassurance that school-based transmission could be a manageable problem, and school closures may not have to be a foregone conclusion, particularly for elementary school–aged children who appear to be at the lowest risk of infection.”
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