Explained: Are children strong spreaders of Covid-19?

Recent studies have suggested that children may spread the novel coronavirus at least as much as adults.

A child’s sample is collected for Covid-19 testing in New Delhi. (PTI Photo)

How effectively can children spread Covid-19? Until recently, it was widely believed that they are not strong spreaders. Recent studies, however, have suggested that children may spread the novel coronavirus at least as much as adults. We look at three such studies — and a fourth with contrary finings:

1. A study in the US, published last week in JAMA Pediatrics, assessed levels of virus genetic material in the nose, among 145 cases of mild to moderate Covid-19 within the first week of symptom onset. The viral load was compared in three age groups – children under 5, children aged 5-17, and adults.
Virus levels were much higher in children under 5 compared to the other two groups. The findings point to the possibility that the youngest children transmit the virus as much as other age groups, the Ann & Robert H Lurie Children’s Hospital of Chicago said in a statement.

While this study looked at viral load, the following two were based on contact tracing.

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2. Also last week, an Italian study put up on a preprint server suggested that although child contacts of positive cases were less likely to become cases themselves, children were more likely to infect household members.

This was based on contact tracing in Italy’s Trento province in March-April. From 2,812 Covid-9 cases, researchers identified 6,690 community contacts, of whom 890 (13%) developed symptoms. An analysis found that the greatest risk of transmission to contacts were 14 cases under age 15. Eight of the 14 (age 1-11) infected 11 of 49 contacts (22%).

3. This was a study of 59,073 contacts of 5,706 Covid cases in South Korea. Of 10,592 household contacts, 11.8% had Covid-19; of 48,481 non-household contacts, 1.9% had Covid-19, according to the study uploaded by South Korea’s Centre for Disease Control.

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In households with an index patient aged 10-19, it was found that 18.6% of the contacts got infected, compared to 11.8% among household contacts of index cases across all age groups. In effect, older children and teens may be strong spreaders.

Contrary findings

4. The American Academy of Pediatrics’ journal Pediatrics published a study from Switzerland in its August issue, along with a commentary declaring: ‘COVID-19 Transmission and Children: The Child Is Not to Blame’. The commentary also referred to similar findings in an earlier, Chinese study.

The Swiss study traced the household contacts of all children under age 16 diagnosed at Geneva General Hospital during March 10-April 10. Of 40 households, only in three was the child found to be the index case. In all other households, the child developed symptoms after or together with adults. This suggested, the researchers wrote, that children most frequently acquire Covid-19 from adults, rather than transmitting it to them.

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