Why are people starting to think that kids are spreading SARS-CoV-2, the virus that causing COVID-19, in school and daycare centers?
Probably because we are seeing more and more cases in kids, especially kids in daycare centers and schools in states with spiking cases.
SARS-CoV-2 in School and Daycare Centers
For example, let’s take a look at what’s going on in Texas…
“As of Friday, 410 total cases of coronavirus — 267 staff members and 143 children — had been reported at 318 licensed child care operations across the state, according to the Texas Health and Human Services Commission.”Texas child care centers see sharp increase in coronavirus cases after months of relative calm
So far in Texas, 83% of child care centers (12,196 facilities are open) haven’t reported a COVID-19 case.
But 17% have…
Either in a child or adult.
Altogether, since March, there have been 1,271 cases in children and 2,416 cases in adults in 2,034 different daycare centers in Texas.
So far the largest cluster was in a Houston daycare, in which 17 adult staff members and 6 kids tested positive.
In another large cluster, in Pleasanton, 11 kids, but only 2 adult staff members tested positive.
COVID-19 has also already led to several school closures in Texas, just weeks after the start of the fall semester.
In one high school in East Texas, the number of active COVID-19 cases has already reached 3%. The school was only open for about three and a half weeks before having to move to online only education.
Are Kids Spreading SARS-CoV-2 in School and Daycare Centers?
A rise in cases in daycare centers doesn’t necessarily mean that it is the kids that are doing the spreading though.
Are staff members getting exposed and bringing SARS-CoV-2 to work with them, exposing the children? Or are the children acting as the spreaders?
A new study, Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020, provides some answers.
These outbreaks all started with an infected staff member, but quickly spread to other staff members and children.
“Analysis of contact tracing data in Salt Lake County, Utah, identified outbreaks of COVID-19 in three small to large child care facilities linked to index cases in adults and associated with transmission from children to household and nonhousehold contacts. In these three outbreaks, 54% of the cases linked to the facilities occurred in children. Transmission likely occurred from children with confirmed COVID-19 in a child care facility to 25% of their nonfacility contacts.”Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020
Not surprisingly, cases then spread outside the daycare centers, to some of the parents of these children and other family members at home.
Of course, that this study found evidence that children can spread SARS-CoV-2 isn’t surprising because it isn’t the first to make this claim.
“These findings demonstrate that SARS-CoV-2 spread efficiently in a youth-centric overnight setting, resulting in high attack rates among persons in all age groups, despite efforts by camp officials to implement most recommended strategies to prevent transmission. Asymptomatic infection was common and potentially contributed to undetected transmission, as has been previously reported.”SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020.
There is also the report about children at the overnight camp in Georgia in June, which found an overall attack rate of 44% among the campers.
And the report about the Rhode Island COVID-19 daycare outbreaks.
“A total of 101 possible child care–associated COVID-19 cases were reported during June 1–July 31. Among them, 49 (49%) symptomatic persons were excluded after receiving negative laboratory test results, 33 persons (33%) had confirmed cases, and 19 (19%) were classified as having probable cases.”Limited Secondary Transmission of SARS-CoV-2 in Child Care Programs — Rhode Island, June 1–July 31, 2020
Fortunately, community transmission of SARS-CoV-2 was lower in Rhode Island than many other states at the time, which is likely why “possible secondary transmission was identified in four of the 666 programs that had been allowed to reopen,” and not more.
Of course, these results stand in contrast to early reports in other countries which found that children didn’t seem to be spreading SARS-CoV-2.
“These data all suggest that children are not significant drivers of the COVID-19 pandemic. It is unclear why documented SARS-CoV-2 transmission from children to other children or adults is so infrequent.”COVID-19 Transmission and Children: The Child Is Not to Blame
Early reports that were maybe flawed because children simply weren’t being exposed to SARS-CoV-2 at the time because of school closures and other factors.
“Here, we report that replication of SARS-CoV-2 in older children leads to similar levels of viral nucleic acid as adults, but significantly greater amounts of viral nucleic acid are detected in children younger than 5 years.”Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19)
So with conflicting reports, what are we to believe?
What to Know About Kids Spreading SARS-CoV-2
We will have to see more research, but with cases continuing to increase in daycare centers, schools, and colleges, it is very hard to believe that kids aren’t spreaders of SARS-CoV-2.
Not that they have to be…
There is an easy way to keep kids from spreading SARS-CoV-2 at daycare, school, and college.
Even easier than making them wear masks.
Yes, that’s keeping the COVID-19 case count down in your community!
More on Kids Spreading COVID-19
- Are Kids Dying With COVID-19?
- Going Back to School During the COVID-19 Pandemic
- What to Do if You Have Been Exposed to COVID-19
- What to Do if You Have Been Diagnosed with COVID-19
- Why Are Social Distancing Kids Still Getting Sick?
- What is the COVID-19 Multi-System Inflammatory State?
- Why There is Still So Much COVID-19 Confusion
- What to Know About Face Masks and COVID-19
- Returning to Sports After Having COVID-19
- The role of children in transmission of SARS-CoV-2
- AAP – Children and COVID-19: State-Level Data Report
- More than 300 children in Texas day cares have caught COVID-19, and the numbers are rising
- Texas COVID-19 Case Data
- In shift, Texas begins publishing some data on coronavirus cases at child care centers
- AAP – Is it safe to send my child to child care during COVID-19?
- State-Based Covid-19 Child Care Information
- CDC – COVID-19 Guidance for Schools and Childcare Programs
- CDC – Stop the Spread in Children
- Texas child care centers see sharp increase in coronavirus cases after months of relative calm
- MMWR – Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020
- MMWR – SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp – Georgia, June 2020
- MMWR – Limited Secondary Transmission of SARS-CoV-2 in Child Care Programs — Rhode Island, June 1–July 31, 2020
- AAP – COVID-19 Transmission and Children: The Child Is Not to Blame
- Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19)
- Kids with COVID have more viral RNA in their airways than adults do
- The role of children in transmission of SARS-CoV-2: A rapid review
Last Updated on September 13, 2020 by Vincent Iannelli, MD