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Study: Children up to Age 9 Unlikely to Spread COVID-19

May 12, 2021 by Alexa Hornbeck

According to a recent study which followed a cohort of Israeli children there is little chance that kids up to age 9 will spread COVID-19 while returning to school.   

“The main question was whether school reopening was accompanied by higher rates of COVID-19 infections in children, and whether opening was a major driver of COVID-19 spread in the community as seen in other infections, such as influenza,” said Eli Somekh, professor of Pediatrics at Sackler School of Medicine, Tel Aviv University. 

The analysis compared 47,620 children up to age 9 to multiple older age groups, which were examined during two different periods of school reopening.  

The first period was from September 1 to September 17, 2020, and the second period from November 1 to the end of December 2020, when the third wave of COVID-19 necessitated Israel’s national lockdown and school closure. 

“If school reopening contributes significantly to COVID-19 spread, then we were supposed to observe a surge in infections of children that would be followed by infections of adults. This phenomenon was not observed. In contrast, the relative increase in SARS-CoV-2 infections following school reopening was lowest in young children,” said Somekh. 

During the pandemic the U.S. closed down 124,000 public and private schools across the nation.  

Recently, the Centers for Disease Control and Prevention updated Guidance for Operating Child Care Program During COVID-19, finding that , “fewer children have been sick with COVID-19 compared with adults during the pandemic,” and in the cases where children did get the virus they had, “mild symptoms, and some have no symptoms at all.”  

In 2019, the CDC issued recommendations for school closures be short term, two weeks, as “children may be less impacted by social isolation from their peers for shorter time frames. ” It also stated the medium term closure of four weeks “provides more protection for older staff and students.” 

Somekh said that prolonged school closure should be prevented, especially for young children, as it exposes children to serious mental and social distress and has been a questionable preventive measure not supported by sufficient evidence. 

In fact, evidence from February shows that, “school closures during the COVID-19 pandemic are likely to be associated with significant health harms to children and young people,” and that, “a systematic review of the evidence is needed to inform policy decisions around school closures and reopenings during the pandemic.”  

Two of the health harms predicted by researchers in 2019-2020 included an “11.1% rise in childhood obesity in young children over the following year,” and “high rates of depression and most likely anxiety during and after enforced isolation ends.” 

While it is unknown why younger children tend to get infected and transmit the infection less than adults, Somekh said one hypothesis is that children have fewer receptors the virus can bind to to generate productive infection.

On the other hand, older children and adolescents, such as college students, may transmit the infection more effectively, and therefore these results could not be automatically translated to them. 

Although children are at low risk of transmitting the virus, the CDC still recommends mask use for those two and up, and social distancing in elementary school classrooms, where it is recommended students remain at least three feet apart, regardless of whether community transmission is low, moderate, substantial, or high. 

“Even though implementation of social distancing was not great in Israeli schools, I do believe that such measures are important for decreasing spread and preventing school outbreaks,” said Somekh. 

Children older than 7 are required to wear masks in Israeli schools, although the study did not specifically address the benefits of mask-use and social distancing in classrooms. 

“The physical conditions in schools in Israel, which are more crowded than most U.S. schools, and the lack of appropriate cohorting that accompanied full reopening of schools, suggests that even under these conditions, the spread of the virus was not an important factor in the resurgence,” said Somekh. 

“These results thus might be translated to the U.S., and other countries where there is effective cohorting and less classroom crowding,” he said.  

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