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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
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 https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm?s_cid=mm6931e1_w#T1_down
Lots of kids infected, including young children
2/13 https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm?s_cid=mm6931e1_w#T1_down
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
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 https://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1
Attack rate is pretty high though!
4/13 https://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1
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
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.29.2001352
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
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.29.2001352
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 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2768952
6/13 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2768952
See here (L'Huillier)
https://wwwnc.cdc.gov/eid/article/26/10/20-2403_article
Here (Jones)
https://www.medrxiv.org/content/10.1101/2020.06.08.20125484v1
Here (Kawasuji)
https://www.medrxiv.org/content/10.1101/2020.06.02.20120014v1
Confused? Me too.
7/13
https://wwwnc.cdc.gov/eid/article/26/10/20-2403_article
Here (Jones)
https://www.medrxiv.org/content/10.1101/2020.06.08.20125484v1
Here (Kawasuji)
https://www.medrxiv.org/content/10.1101/2020.06.02.20120014v1
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
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 https://jamanetwork.com/journals/jama/fullarticle/2769034
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 https://jamanetwork.com/journals/jama/fullarticle/2769034
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 https://www.ijidonline.com/article/S1201-9712(20)30598-1/fulltext
Not sure we've gotten any further
10/13 https://www.ijidonline.com/article/S1201-9712(20)30598-1/fulltext
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
https://www.medrxiv.org/content/10.1101/2020.07.19.20157362v2
11/13
The first by @mugecevik @mlipsitch and @EdwardGoldste16 (a veritable A team of #COVID19) on age and transmission
https://www.medrxiv.org/content/10.1101/2020.07.19.20157362v2
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
https://www.medrxiv.org/content/10.1101/2020.07.25.20162107v2
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
https://www.medrxiv.org/content/10.1101/2020.07.25.20162107v2
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!
https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/
13/13
Hoping to get the @DFTBubbles #COVID19 in children review up to date soon too!
https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/
13/13
