Thread by @apsmunro

OK I'm busy trying to catch up with what I've missed on #COVID19 in children, which looks like a lot!

People seem to be making a big deal out of some new papers, but frankly there's not a huge amount of new information here - quick run down

1/13

This paper examines a big outbreak at an overnight camp in Georgia (USA) during a period of high community transmission

Lots of kids infected, including young children

2/13

cdc.gov/mmwr/volumes/6…

Over such a brief period of time, likely kids didn't actually have time to transmit to each other. Mainly got infected by staff

Good break down here by @DiseaseEcology (although I disagree with the take on household transmission studies!)

3/13

https://twitter.com/DiseaseEcology/status/1289298074804711425?s=20

We've known for some time children can get infected in mass spreading events, albeit has mostly been demonstrated in older children (see study from France)

Attack rate is pretty high though!

4/13

medrxiv.org/content/10.110…

Next an outbreak in a high school in Israel

We cannot tell direction of transmission, but to me this looks like too many cases too fast to all be spread between children; I imagine multiple sources of entry

Secondary schools do seem higher risk

5/13

eurosurveillance.org/content/10.280…

Next a surprising study showing higher viral loads in younger children than adults?! At odds with previous studies showing similar, or lower VL

6/13

jamanetwork.com/journals/jamap…

See here (L'Huillier)

wwwnc.cdc.gov/eid/article/26…

Here (Jones)

medrxiv.org/content/10.110…

Here (Kawasuji)

medrxiv.org/content/10.110…

Confused? Me too.

7/13

We already known children have transmissible virus, so this isn't new information

It's nice that they targeted ONLY symptomatic individuals, so at least we have a consistent denominator

Shame we still don't know how many children are asymptomatic...

8/13

Next a study suggesting school closures in the USA may have prevented infections/deaths

Sadly it's impossible to tell from these studies the true effect as school closures are never adopted in isolation

Not sure it's helpful

9/13

jamanetwork.com/journals/jama/…

On which note, this study from Japan on the same topic found it made no difference

Not sure we've gotten any further

10/13

ijidonline.com/article/S1201-…

Finally, 2 excellent pre-print review articles to highlight

The first by @mugecevik @mlipsitch and @EdwardGoldste16 (a veritable A team of #COVID19) on age and transmission

medrxiv.org/content/10.110…

11/13

The next also by @mugecevik et al. on viral dynamics of #COVID19

Includes interesting findings on duration of viral shedding according to age (although kids data poor, might explain apparent reduced infectivity of children despite similar VL?)

12/13

medrxiv.org/content/10.110…

Quick whistle stop tour there - hope to come back to some of these when (or if!) I have more time!

Hoping to get the @DFTBubbles #COVID19 in children review up to date soon too!

dontforgetthebubbles.com/evidence-summa…

13/13