Three great new studies of COVID in children this week!

First, household transmission in Germany 🇩🇪

Contacts of PCR pos cases tested Serology

Children both less susceptible AND less infectious when index cases than adults…

Next COVID in children from in Hong Kong 🇭🇰

>300 children positive, only 3 cases acquired in School and all the rest in the household or from travel…

Finally, a household contact study from Israel 🇮🇱

Contacts tested with both PCR AND Serology (subset)

Children about half as susceptible to adults and nearly half as infectious…

People keep trying to suggest children are just as susceptible and infectious as adults (or even more!)

There are so many studies published now, you can find a handful that make this look like the case

The totality of evidence continues to be overwhelmingly to the contrary


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More from @apsmunro

19 Mar
Great @bmj_latest study from OpenSAFELY

Despite schools being the only thing open for much of wave 2 in the UK, living w/ children associated with marginal increased absolute risk of COVID-19 infection/hospitalisation, and no increase in death…

The study compared hospital records of over 9mil adults <65yrs during wave 1 and wave 2, comparing those who lived with children (split by primary and secondary age) to those who don't

They adjusted for covariates such as deprivation, age, BMI, smoking, etc

Wave 1: No difference in outcomes, except much lower risk of death for people with children

Wave 2: Tiny increase risk in infection and hospitalisation for those living with children (smaller for young children), but same or lower risk of death from COVID-19 or any cause.

Read 7 tweets
11 Mar
The #SARSCoV2 variant b.1.1.7 is taking over

But is this variant especially scary in children? ☠️

Are they suddenly driving infections? 🚗

Is this quadruple worrisome? 😱🚨⚠️

Let's take a look at the evidence

b.1.1.7 became of concern initially following a surge of cases in SE England after autumn lockdown

Case trends in children had previously lagged adults by a week or so (because adults drive infection rates), but this surge happened near simultaneously…

Some scientists leaked to the press of "hints" that there was something unique to children about this variant

This was based on an increased share of b.1.1.7 cases in children compared to adults during the late Autumn…

Read 16 tweets
18 Feb
I have seen some repeated assertions about the evidence on #COVID19, children and schools recently which sound convincing, but unfortunately are false

It is a sensitive and important topic, which is important to get right

Shall we bust some myths? 💥

Let's go!

Myth 1. Evidence suggesting limited transmission within schools is based on flawed evidence as only children with symptoms were tested ❌

There are many studies drawn on symptom based testing, there are MANY which are not, and all find the same thing

Here's just a few...

Read 12 tweets
5 Feb
You may have seen this headline today

It may even have been accompanied by scary emojis ⚠️ 🚨 💥 😱

The reality is much less scary (as is the article compared to the headline)

These numbers are roughly accurate, but do not reflect anything like a comparable scenario to spring

These children are MUCH less unwell, due to a combination of recognising less severe cases, early management, and perhaps a degree of over diagnosis to be on the safe side

Only a couple of patients per day are even unwell enough to be enrolled in the worlds only clinical trial for this condition, the RECOVERY trial

Very few cases of coronary artery aneurysms, which even after spring resolved for most children over follow up

Read 4 tweets
4 Feb
I don't put too much stock in ecological modelling studies, but I understand that some others do

A new study from the USA looks at which age groups appear to drive transmission trends

It has some interesting findings…

They use age specific mortality data to eliminate bias from undertesting of cases, alongside mobility and contact data

They found adults age 20 - 49 are the origins of most infections

This did not change over time, nor with school reopenings

"This study provides evidence that the resurgent COVID-19 epidemics in the US in 2020 have been driven by adults aged 20-49, and in particular adults aged 35-49, before and after school reopening."

Read 5 tweets
29 Jan
I've seen suggestions that the idea younger children might be less susceptible to infection with #COVID19 is a "myth", based on children just not being tested enough

That is untrue!

Whilst it's true children are under tested, this is not where this idea came from!

It comes from household contact tracing studies

When someone in a home is identified as being infected, the other members of the house are tested to see if they are infected

It's a useful experiment as everyone at home gets very similar exposure

Some early studies did only test contacts with symptoms, but actually most large studies since then have tested ALL close contacts REGARDLESS of symptoms

Here are just a handful




Read 8 tweets

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