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Children Have Milder COVID-19 Symptoms, Better Outcomes Children Have Milder COVID-19 Symptoms, Better Outcomes

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Children are much less likely to be diagnosed with COVID-19 than adults, generally have mild if any symptoms, and have “very, very low rates of mortality,” according to Jonathan Suk, PhD, of the European Centre for Disease Control and Prevention (ECDC).

A special session at the 2020 ESCMID Conference on Coronavirus Diseases (ECCVID), co-organised with the ECDC, addressed school closures and reopenings in the context of the pandemic.

Suk said that less than 5% of confirmed COVID-19 cases in the European region were in children, with just five recorded deaths in children under 16 years (of 19,654 cases in TESSy (0.03% crude case fatality rate).

In relation to disease transmission, children are very rarely identified as the index case; though this is complicated by children generally showing fewer symptoms and having shorter periods of viral shedding, and asymptomatic infectiousness is still an unknown, he said.

Studies on COVID-19 infection related to schools in the European region show few outbreaks/clusters, with identified cases mainly coming from household exposure and very little onward spread in the school setting.

“Schools are unlikely to be worse propagating environments than occupational or leisure activities with similar densities of people with proper measures in place.”

Decisions on control measures in schools should be made consistently with decisions on other physical distancing and public health response measures within the community as a whole, Suk said:  “Closures of childcare and educational institutions are unlikely to be an effective single control measure for community transmission of COVID-19 and cannot be justified based on protecting the health of children, most of whom develop very mild, if any, disease from COVID-19.”

Expert commentary:

Question: Are masks useful in helping prevent the spread of Covid-19 among children?

Suk: “For older children they may help, especially in more crowded settings, and certainly for teachers, but not for younger children.”

References: Suk J. COVID-19 and children. ECCVID 2020. 9am session, 23 September 2020