Children rarely transmit COVID-19, doctors write in new commentary: Schools can reopen in fall, they say, if safety guidelines are observed and community transmission is low

A commentary published in the journal Pediatrics, the official peer-reviewed journal of the American Academy of Pediatrics, concludes that children infrequently transmit Covid-19 to each other or to adults and that many schools, provided they follow appropriate social distancing guidelines and take into account rates of transmission in their community, can and should reopen in the fall.

The authors, Benjamin Lee, M.D. and William V. Raszka, Jr., M.D., are both pediatric infectious disease specialists on the faculty of the University of Vermont’s Larner College of Medicine. Dr. Raszka is an associate editor of Pediatrics.

The authors of the commentary, titled “COVID-19 Transmission and Children: The Child Is Not to Blame,” base their conclusions on a new study published in the current issue of Pediatrics, “COVID-19 in Children and the Dynamics of Infection in Families,” and four other recent studies that examine Covid-19 transmission by and among children.

In the new Pediatrics study, Klara M. Posfay-Barbe, M.D., a faculty member at University of Geneva’s medical school, and her colleagues studied the households of 39 Swiss children infected with Covid-19. Contact tracing revealed that in only three (8%) was a child the suspected index case, with symptom onset preceding illness in adult household contacts.

In a recent study in China, contact tracing demonstrated that, of the 68 children with Covid-19 admitted to Qingdao Women’s and Children’s Hospital from January 20 to February 27, 2020, 96% were household contacts of previously infected adults. In another study of Chinese children, nine of 10 children admitted to several provincial hospitals outside Wuhan contracted Covid-19 from an adult, with only one possible child-to-child transmission, based on the timing of disease onset.

In a French study, a boy with Covid-19 exposed over 80 classmates at three schools to the disease. None contracted it. Transmission of other respiratory diseases, including influenza transmission, was common at the schools.

In a study in New South Wales, nine infected students and nine staff across 15 schools exposed a total of 735 students and 128 staff to Covid-19. Only two secondary infections resulted, one transmitted by an adult to a child.

“The data are striking,” said Dr. Raszka. “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.”