Are kids less likely to transmit the coronavirus? Here is what experts know now

As parents start to consider summer camps, day cares and kids returning to schools in the fall, experts share what they know now about kids and the coronavirus.
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As camps, day care and schools look to reopen, questions remain about how often children transmit the coronavirus.John Tlumacki / Boston Globe via Getty Images
/ Source: TODAY

With summer camps opening and schools making plans for fall, the risk of the coronavirus to children and the role they play in spreading it is top of mind.

In a recent interview with CNN, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, called keeping schools closed come September "a bit of a stretch," but added that schools reopening should depend on the amount of virus circulating in the area.

Early in the pandemic, experts learned that kids were less likely to become severely ill from COVID-19, but stories of deaths of young children, as well as the multisystem inflammatory syndrome linked to the virus, have made it difficult for many parents to stay calm.

Even as more data flows in about kids and the coronavirus, many questions remain unanswered. In particular, it's not clear why there seems to be such a large difference between adults' and kids' symptoms — and what this means for kids' infection and transmission rates.

Kids' coronavirus infection rates

At this stage, one of the most comprehensive studies looking at infection rates among adults and kids came out of Iceland and was published in April.

One of its primary findings was that children were less likely to test positive than adults. This was the case in situations where families were in quarantine due to virus exposure, and also in other portions of the population where people were not under strict quarantine.

"In quarantine, adults were much, much more likely to get infected," Dr. Kari Stefansson, co-author of the study and founder of deCODE genetics, which funded the study, told TODAY.

The Icelandic study also isolated and analyzed data from people under 20. For this group, it found there was "a gradual increase with older age in the percentage who tested positive."

A small Israeli study published on June 1 had similar results. "Children of 5–17 years of age were 61% and children of 0–4 years of age were 47% less likely to have positive (test) results compared with adults residing in the same household," the abstract stated.

Kids' coronavirus transmission rates

Stefansson explained that his study showed that "if (children) were infected, they were much less likely (than adults) to infect others." This applied to kids infecting both adults and fellow children, he said.

When asked why there appears to be such a discrepancy between kids' and adults' transmission rates, Stefansson said there's no clear answer yet.

Dr. Rick Malley, an infectious disease pediatrician at Boston Children's Hospital, told TODAY that one possible explanation for this difference between kids and adults relates to the body's immune response to the coronavirus. Because adults may have had more exposure than kids to similar viruses prior to infection, their body could react in a stronger way, he explained.

Dr. Allison Agwu, a professor of infectious diseases at Johns Hopkins School of Medicine in Baltimore, Maryland, pointed to the difference in size between kids and adults as another theory.

"When you think about an adult whose lungs are bigger ... they sneeze or cough, and there's bigger spray than a little kid, who may not be able to generate that much force," she told TODAY. "The mechanics of big people versus little people may be a big part of it."

What does the data mean?

While Stefansson said he's "pretty confident (his study) is going to be reality," not all experts agree.

Malley said that it's important to take current data "with a grain of salt," but that he feels "more confident than not that children are not major (sources of transmission)."

He also pointed out that because U.S. schools closed early on in the pandemic, there's no large-scale way to track how often kids transmit the virus to each other.

"It would be a reasonable argument to think about reopening some schools but to do it in a cautious fashion," he added.

Agwu called much of the data looking at kids and the coronavirus "somewhat flawed," adding that she's hesitant to "leap" to a conclusion on whether we know if kids are transmitters.

"The pool of data is often based on people who are tested, and that’s often people who are symptomatic," she explained. "By definition, you’re ruling out a bunch of kids, who are more likely to be asymptomatic ... There are studies that I'm not sure tell the whole story."

What should parents do?

Both Malley and Agwu said precautions for children at camp and as schools reopen are still important and that what you allow your child to do should depend on your own family's risk factors. For example, if you have a high-risk person living in your household, you might be more cautious.

"Kids, while most likely may be asymptomatic or have lower symptoms, can have severe disease," Agwu stressed. "I want us to be mindful of that and to move from the rhetoric that 'Kids will be OK' because ... we don't understand all of the factors."

Still, she discourages the idea that "kids need to stay at home forever."

Malley suggested that parents think about the benefit of precautions — like mask wearing, social distancing and staying home if a child has symptoms — as both for their family and community.

"There's a very low likelihood that children will suffer terribly from COVID ... (but) why take the risk if you don't have to?" he said.