Explainer: Children might have a bigger role in spreading COVID-19

FILE PHOTO: A computer image created by Nexu Science Communication together with Trinity College in Dublin, shows a model structurally representative of a betacoronavirus which is the type of virus linked to COVID-19, better known as the coronavirus linked to the Wuhan outbreak, shared with Reuters on February 18, 2020. NEXU Science Communication/via REUTERS

MANILA, Philippines — It is finally the Christmas season. Before COVID, it has been a tradition for many families to bring their children to malls. However, the current pandemic as well as the quarantine restrictions might push some to suspend their tradition this year.

On Monday Interior Secretary Eduardo Ano announced that minors may soon be allowed to go to malls as long as they are accompanied by parents or guardians.

However, Ano clarified the following day that minors will remain barred from malls. He said that local government units should first craft an ordinance that would allow children to go out.

The Metro Manila mayors on Wednesday said they will soon vote on the matter. A decision will be formulated by the 17 mayors on Thursday based on a presentation by the Philippine Pediatric Society (PDS).

For areas under General Community Quarantine (GCQ), only those who are aged 18 to 65 are allowed to go out and enter malls.

Is it really worth risking our children and family’s health just to keep the Christmas spirit alive? Research by international medical experts says otherwise.

Children: possible spreader of COVID-19?

Children and young adults play a huge role in COVID-19 transmission. This is revealed by a Princeton-led study and research by Harvard-affiliated Massachusetts General Hospital (MGH).

Researchers from the Princeton Environmental Institute (PEI), Johns Hopkins University, and the University of California, Berkeley published a study last September titled “Epidemiology and transmission dynamics of COVID-19 in two Indian states.”

The research, conducted in India, identified children and young adults as the key transmitters of the virus within households. This is contrary to earlier studies that said children have less susceptibility to infection and transmission.

“Kids are very efficient transmitters in this setting, which is something that hasn’t been firmly established in previous studies,” said lead researcher Ramanan Laxminarayan in an article published by Princeton University.

“We found that reported cases and deaths have been more concentrated in younger cohorts than we expected based on observations in higher-income countries,” he added.

On the other hand, the Mass General Hospital for Children (MGHfC) in August stated that children can still carry the virus.

“Kids are not immune from this infection, and their symptoms don’t correlate with exposure and infection,” Alessio Fasano, director of the Mucosal Immunology and Biology Research Center at MGH, told The Harvard Gazette.

“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,” he added.

How can children and young adults spread COVID-19?

When asked during his live stream whether or not minors should be allowed to go to malls, health reform advocate Dr. Tony Leachon responded:

“No, ang mga bata though malalakas resistensya niyan pwede magdala ng asymptomatic cases.”

(No. Though children have a strong immune system, they can carry asymptomatic cases.)

In a separate Facebook post, Leachon also cited the MGH-conducted research – which was also featured in The Harvard Gazette last August.

The study, “Pedriatric SARS-COV-2: Clinical Presentation, Infectivity, and Immune Responses,” observed 192 pediatric patients ages 0 to 22. Forty-nine (49) children were positive for COVID-19 while 18 were reported to have late-onset of Covid-related symptoms.

Based on the nose and throat swabs and blood samples, research detected a high level of virus in the airways of infected children. Researchers also noted that it was higher compared to adults receiving COVID-19 treatments in ICUs.

“Nasopharyngeal viral load was highest in children in the first 2 days of symptoms, significantly higher than hospitalized adults with severe disease,” the research stated.

“I was surprised by the high levels of virus we found in children of all ages, especially in the first two days of infection,” Lael Yonker, director of Massachusetts General Hospital (MGH) Cystic Fibrosis Center and lead author of the research, told The Harvard Gazette.

“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,” she added.

According to Yonker, a high viral load may cause greater transmissibility or risk of contagion.

However, she explained that symptoms of COVID-10 like fever, cough, and runny nose can still be misdiagnosed among children. The same symptoms are often observed in common illnesses among children such as influenza and common colds.

Asymptomatic carriers

The research by MGH concluded that cases of COVID-19 among children can be milder compared to adults. Yet, it emphasized that children can still be a “potential source of contagion” despite exhibiting few no symptoms of the disease.

Researchers also clarified that even though children have lower numbers of immune receptors for the virus, they can still become infected and spread COVID-19.

“Data from the group show that although younger children have lower numbers of the virus receptor than older children and adults, this does not correlate with a decreased viral load,” the MGH News and Public Affairs stated in The Harvard Gazette.

“According to the authors, this finding suggests that children can carry a high viral load, meaning they are more contagious, regardless of their susceptibility to developing COVID-19 infection,” the statement added.

Despite the ongoing discussions among lawmakers, the research alone might give an answer to whether minors should leave their homes.

The medical experts also reiterated the importance of transmission and protective measures such as social distancing, wearing face mask and face shields, and effective hand-washing protocols.

JPV