Study Finds Kids 9 and Under are Unlikely to Spread Coronavirus at School

Study concludes that children demonstrate lower COVID-19 infection rates and lower transmission rates.

A new study published in the Journal of the American Medical Association examined the spread of COVID-19 in Israeli youths aged 0 to 9 years compared to other age groups. At the time of the study, the incidence of new cases of COVID-19 in Israel was one of the highest in the world.

Daily data was obtained of COVID-19 incidence, SARS-CoV-2 polymerase chain reaction (PCR) tests, and the rate of positive samples. SARS-CoV-2 age group–specific weekly incidence rates were calculated and adjusted for the number of tests performed for the following age groups: 0 to 9 years, 10 to 19 years, 20 to 39 years, 40 to 59 years, and 60 years and older.

Data was analyzed from 47,620 children aged 0 to 9 years. The data revealed that children in this age group had the lowest increase in incidence rate ratios and in positivity rate ratios during the school attendance periods (September through December 2020).

According to the study results, children ages 0 to 9 do not have substantial rates of COVID-19 infection during school attendance and they do not have a substantial role in COVID-19 spread, which is supported by previous data showing lower infection rates and lower transmission in children. As per the CDC, “Based on the data available, in-person learning in schools has not been associated with substantial community transmission.”

Children are Typically Asymptomatic or Have Mild Symptoms

Compared with adults, children and adolescents who have COVID-19 are more commonly asymptomatic or have mild, non-specific symptoms. Children are also less likely to develop severe illness or die from COVID-19. According to a study in The Lancet, deaths from children in the US, UK, Italy, Germany, Spain, France, and South Korea remained rare up to February 2021, at 0 to 17 per 100,000 population, comprising 0 to 48 percent of the estimated total mortality from all causes in a normal year.

Multisystem Inflammatory Syndrome in Children (MIS-C)

While most children with COVID-19 are asymptomatic or experience mild symptoms, there are some extreme cases. Some children with COVID-19 have developed multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS).

MIS-C typically occurs 2–6 weeks after COVID-19 infection. Symptoms include:

• Abdominal pain
• Vomiting or diarrhea
• Headache
• Cervicalgia (neck pain)
• Rash
• Conjunctivitis (pink eye)
• Fever
• Fatigue

Learn More: CDC Information for Healthcare Providers about MIS-C

Are Children Long Haulers?

Some children do become long haulers (Long COVID-19) who experience symptoms weeks or months after they have first contracted COVID-19. Although, data on Long COVID-19 in children has been lacking.

A pre-print on medRxiv analyzed a cohort of 129 children in Italy who were diagnosed with COVID-19. More than half reported at least one persisting symptom after 120 days since infection, with 42.6 percent being impaired by symptoms during daily activities. Symptoms included:

• Fatigue
• Muscle and joint pain
• Headache
• Insomnia
• Respiratory issues
• Palpitations

At this time, it is unknown why children or adults experience Long COVID-19. There is simply not enough research to ascertain the etiology.

In February 2021, the National Institutes of Health announced a $1.15 billion initiative to support research into the causes and ultimately the prevention and treatment of long-haul COVID. You can read more about this initiative here.

References:

1. JAMA Netw Open. 2021 April;4(4):e217105.
2. The Lancet Child & Adolescent Health. 2021 March;5(5):E12-E13.
3. Transmission of SARS-CoV-2 inn K-12 Schools retrieved from the CDC on April 30, 2021.
4. https://www.medrxiv.org/content/10.1101/2021.01.23.21250375v1