New study documents effective transmission of COVID-19 from infected children and adolescents to household contacts

A much debated question is how effective is the transmission of COVID-19 from children and adolescents to household contacts. This question has immediate resonance as we plan to reopen schools for children of all ages, especially those 12 and under who will not be vaccinated at the start of the school year. A recent study provides an answer to this question: Children and adolescents effectively transmit SARS-CoV-2 to family contacts, and some of these contacts require hospitalization. The study, carried out last year, was completed before the advent of the even more contagious and dangerous Delta variant. The study was published by the New England Journal of Medicine in July 2021.

Children infected with SARS-CoV-2 who returned from the camp – 88% of whom had symptoms – had 526 family contacts, mostly parents and siblings. Twelve percent of family contracts that agreed to be tested were infected. Ten percent of those infected had to be hospitalized. Hospital stays ranged from five to eleven days. No one under the age of eighteen had to be hospitalized. Although none of the family contacts have died, many have underlying health issues that put them at risk.

The tests were voluntary and the participants reported the results themselves. For this reason, secondary attack rates are probably underestimated. Another confounding effect on this study includes one-third of index patients who started showing symptoms while still at camp. These campers may have been less contagious by the time they returned home, compared to those whose symptoms started after their return. While two-thirds of campers adopted social distancing measures upon their return home, transmission has likely been reduced throughout the household.

Children with COVID-19 pose a particular risk to parents and caregivers. They should try to minimize their exposure and that of other household members, especially those who could pose a risk. Dr Victoria Chu, principal investigator involved in the study, suggests that “the child should be cared for and supervised using the appropriate combination of physical distancing, seclusion when possible, and the use of masks to prevent as much as home transmission possible “. Without clear advice, most parents don’t know what to do to follow this wise advice.

A mother of two young schoolchildren with whom I spoke summed up the challenge for parents and children: “This study gives me shivers. With schools reopening this fall and distance learning options much more limited than they were last year, this study is a reminder of how risky indoor activities are for our children and their families. . I can only hope that our government, community leaders and school administrators will ensure that children are properly protected with masks, social distancing and ventilation – all of the things that can keep them safe inside. , especially for those who are too young to be vaccinated. Imagine the burden a child would have to carry if they brought home a fatal illness from just going to school or camp, this year has already taken unimaginable havoc on our children. We should do everything we can to ease their burden this fall if we can. “

The study is a revealing glimpse of what fall might look like with schools reopening and children reuniting without proper social distancing measures. With the increase of the more infectious and dangerous Delta variant, it is more important than ever to limit the spread and to vaccinate eligible children over the age of twelve. We also need to take steps to mentally prepare children for their return to school by teaching them the precautions necessary to keep their families safe during a global pandemic. While no mother or father wants to see their child sick, government and school districts must take steps to keep our children safe, while parents must also be educated to do what is best for them. child because COVID-19 is a continuous risk to the health of the nation.