Doctors say children who tested positive displayed much higher levels of coronavirus in their airways than adult ICU patients.
BOSTON — The role of children in the spread of COVID-19 has been the subject of debate for months. It’s especially a concern with back-to-school in full swing, and parents torn over virtual or in-person learning. Now, a new study seemingly confirms a potential worst case scenario regarding kids and the coronavirus. Not only are children quite capable of “silently spreading” COVID-19, they appear to be significantly more contagious than infected adults.
The study, led by doctors from Massachusetts General Hospital and Mass General Hospital for Children, suggests that kids likely play a much larger part in the spread of COVID-19 than originally thought.
Of the 122 children (ages 0-22 years old) included in this research, 49 tested positive for the coronavirus. Another 18 experienced late onset COVID-19 related symptoms. Kids who tested positive displayed much higher levels of the virus in their airways than even adult ICU coronavirus patients.
“I was surprised by the high levels of virus we found in children of all ages, especially in the first two days of infection,” says lead study author Dr. Lael Yonker, director of the MGH Cystic Fibrosis Center, in a release. “I was not expecting the viral load to be so high. You think of a hospital, and of all of the precautions taken to treat severely ill adults, but the viral loads of these hospitalized patients are significantly lower than a ‘healthy child’ who is walking around with a high SARS-CoV-2 viral load.”
The higher an infected individual’s “viral load,” the more contagious that person is to the people around them. Identifying coronavirus-infected children is difficult because most don’t exhibit symptoms. Even the ones that do often develop symptoms that can be confused for influenza or the common cold. With all this in mind, there’s no telling just how many young “silent spreaders” are unknowingly infecting others.
Coronavirus fears as children head back to school
These findings, of course, have major implications as school across the country begin to open their doors to students for a new school year.
“Kids are not immune from this infection, and their symptoms don’t correlate with exposure and infection,” explains senior author Dr. Alessio Fasano, director of the Mucosal Immunology and Biology Research Center at MGH. “During this COVID-19 pandemic, we have mainly screened symptomatic subjects, so we have reached the erroneous conclusion that the vast majority of people infected are adults. However, our results show that kids are not protected against this virus. We should not discount children as potential spreaders for this virus.”
These findings affect far more people than just children. If a child picks up the coronavirus from another student and then bring it home, adults and or grandparents living under the same roof can be exposed to the virus. This is especially concerning for lower-income families who are more likely to have multiple generations living in one home. Among the infected children in this study, 51% come from low-income communities. Conversely, only 2% live in high-income communities.
Children have fewer immune receptors for SARS-CoV2, which has led to many theorizing they’re far less likely to become infected, ill, or contagious to others. This work challenges that theory. A lack of immune receptors does not appear correlate with a lower viral load after all. While it does seem to be true for the most part that children develop symptoms less often, they’re still quite capable of infecting others and becoming infected themselves.
Going virtual the smarter option?
So, what can schools do to keep kids, teachers, and families safe? The study’s authors say that relying on temperature checks and symptom monitoring just won’t be enough. It’s a tough situation, but they believe mandatory social distancing, universal use of face masks, routine hand-washing tutorials, and the incorporation of remote learning whenever possible, can all go a long way toward mitigating the coronavirus risk in schools across the country.
“This study provides much-needed facts for policymakers to make the best decisions possible for schools, daycare centers and other institutions that serve children,” Dr. Fasano concludes. “Kids are a possible source of spreading this virus, and this should be taken into account in the planning stages for reopening schools.”
“If schools were to reopen fully without necessary precautions, it is likely that children will play a larger role in this pandemic,” the study concludes.
The study is published in the Journal of Pediatrics.