# Understanding COVID-19 Transmission Among Children
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Chapter 1: The Camp Dilemma
As summer approaches, my thoughts are consumed with the question of whether summer camp will be available in Rhode Island. I've been sending somewhat relentless emails to colleagues involved in virus response, inquiring about the situation. My curiosity has even led me to check out options in neighboring states, like Maine, which appears more hopeful. I find myself browsing Airbnb as if it were my new full-time job.
The challenges of reopening camps echo those of schools: If we gather many children, the concern is they may transmit the virus. Thus, I was intrigued to see headlines suggesting that children are unlikely to spread the coronavirus.
Yet, some researchers argue otherwise, stating that children can indeed transmit COVID-19, making school reopenings potentially hazardous. So, what is the truth?
Section 1.1: Children and COVID-19 Illness
I've previously discussed the relationship between children and COVID-19, noting that severe illness appears to be quite rare among younger populations. Studies from China, data from the CDC, and findings from the Netherlands and Italy affirm this. Essentially, it is becoming clear that serious COVID-related illnesses in children are extremely uncommon.
Section 1.2: Examining Viral Spread Among Kids
The more nuanced question lies in whether children act as carriers of the virus. One perspective suggests that while many children may be infected, they do not exhibit severe symptoms, yet they could still spread the virus to others. This idea can be referred to as the “asymptomatic viral bomb theory.”
Conversely, another viewpoint posits that children are less likely to contract the virus in the first place, and due to their mild symptoms, they may also have a lower likelihood of spreading it.
While data is limited, it is clear that children can transmit the virus. Research indicates that infected children have viral loads comparable to those in adults.
However, the accumulating evidence increasingly supports the notion that children are not significant sources of viral transmission, primarily because they are less likely to become infected.
Section 1.3: Assessing Infection Rates
To assess the likelihood of infection among children compared to adults, we need broad population studies. For instance, an early study in Iceland tested around 13,000 random individuals, including 848 children. The overall positive rate for COVID-19 was 0.8%, with no positive cases among those under 10. This discrepancy is statistically significant.
Data from a town in Italy, where extensive screening was conducted, yielded similar results: children are less likely to be infected than adults. Although not random, information from the Netherlands showed that of those visiting doctors with flu-like symptoms, 6.5% tested positive for COVID-19, with no cases found in individuals under 20.
These findings suggest that not only do children not suffer severe illness, but they are also less likely to be infected, countering the “walking virus bomb” theory.
Chapter 2: Investigating Transmission Dynamics
To evaluate whether children spread the virus, researchers can examine cases where a child was known to be infected and track any subsequent transmissions.
For example, early in the pandemic, a child in the French Alps who attended three schools and had 112 contacts did not transmit the virus to any of them. This contrasts sharply with numerous cases involving adults who spread the virus widely in social settings.
Similar findings from Australia indicated that among 18 confirmed COVID-19 cases (nine adults and nine children), there was very little transmission to other students and staff in schools.
Furthermore, data from the Netherlands tracking families showed no instances of children being the initial source of infection within their households.
The first video titled "A kid's guide to COVID: How is COVID spread?" explains how the virus can be transmitted, particularly among children, providing a child-friendly perspective on the issue.
The second video, "How To See Germs Spread Experiment (Coronavirus)," visually demonstrates how germs can spread, emphasizing the importance of hygiene and precautions.
Section 2.1: The Bottom Line
While some interpret the data to mean that children cannot transmit COVID-19, this is misleading. In theory, they can, as they carry viral loads similar to adults. If an infected child were to touch their mouth and then yours, transmission could occur.
However, in practice, it appears that children are generally not infected frequently. When they are, their mild symptoms may limit their ability to spread the virus.
What does this mean for policy and families? The complexities of reopening schools, daycares, and camps remain, particularly due to adult interactions. However, the data suggests that the primary concern should focus on adult-to-adult transmission, which may be more manageable.
For families, this information can be reassuring. While we should still exercise caution regarding potential virus transmission from children to grandparents, the data suggests that this risk may be lower than previously thought. Ultimately, the decision-making rests with each family, and I wish you all the best in navigating yours.
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