Young children may pose greatest COVID risk in household

Babies and toddlers transmit COVID-19 to members of their households faster than teens and children above the age of 3, according to new research published in the journal JAMA Pediatrics.  

After reviewing data from 6,280 homes, the authors determined that the risk of transmission to other household members was 40% higher when the first infected child was 3 or younger, compared to carriers within a household between the ages of 14 and 17. 

Follow-up analysis revealed that 27.3% of children up to 3 years old infected at least one other person in their household before they fully recovered. 

 “A possible explanation for this finding is that younger children are not able to self-isolate from their caregivers when they are sick, irrespective of the timing of testing,” the authors said. 

Young children, of course, are also less  likely to follow relevant protocols like hand-washing, and they may fidget with their face masks throughout the day. 

Children may be as contagious as adults 

In the early days of the pandemic, experts were unclear how contagious COVID-infected kids are because they’re more likely to be asymptomatic carriers. Now we know that many infected people can transmit the virus without having shown any symptoms.  

In fact, one of the things that makes the novel coronavirus so challenging is that a large portion of the population is most contagious right before the onset of symptoms — i.e., before they are even aware that they are ill. 

Given that younger children may make a full recovery without ever experiencing symptoms, clinicians recommend testing your child if you suspect that they may have been exposed to the virus. 

Children under the age of 3 carry a high risk of transmission within a household even when there are no symptoms, when there is no school or childcare involved, and when there are no regional outbreaks. 

When the researchers controlled for delays in testing, children between the ages of 4 and 8 were found to pose a significant transmission risk within a household as well — though not as much as children up to 3. 

Current school guidelines 

On July 27,  the Centers for Disease Control and Prevention published guidance recommending all students and staff wear face masks during school even if they’re vaccinated. 

This advisory was a reaction to rising case numbers and hospitalizations caused by the more contagious Delta variant, which is now the dominant coronavirus strain in the U.S. and around the world.

In addition to being more transmissible, the Delta variant also affects young children more severely than previously recorded strains. The new strain is causing an increasing number of unvaccinated children to be hospitalized. 

“Health officials are warning of the steepest surge in COVID hospitalizations among children since the pandemic began, with rates 4.6 times higher than it was just five weeks ago,”  Anne Flaherty and Dr. Mark Abdelmalek wrote Tuesday for ABC News. “Those rates now put pediatric hospitalizations on par with the height of the pandemic.”

Currently, 80% of the nation’s 100 largest school districts will allow students to learn remotely, with the remaining waiting to see how cases play out in the fall.