A few weeks ago a study from SK got lots of attention for reportedly showed children aged 10 - 19 were just as, or more infectious than adults with #COVID19

But that was not the whole story

This study on the very same children shows why

https://adc.bmj.com/content/early/2020/08/06/archdischild-2020-319910

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They took ALL children with #COVID19 in SK (107 of them, median age 15) and looked at how many secondary cases were associated

BUT - they removed cases with *shared exposure", who most likely got infected at the same time as the child

What did they find?

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1 case of onward transmission from 248 household contacts (from a 16y old to their sibling, aged 14y)

A secondary attack rate of 0.5%

This is compared to a household SAR from adults of 7.6% using the same method of analysis

https://ophrp.org/journal/view.php?doi=10.24171/j.phrp.2020.11.2.04

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Important caveats:

This extraordinarily low SAR is in the setting of intense infection prevention (child and household members immediately quarantined from each other, caregiver in full PPE!)

Some of the excluded cases may have been true secondary cases, but likely few

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Can children transmit the virus? Of course, and given more exposure I'm certain more household transmission would have occurred

Using the same method of assessment, it appears less frequent than from adults in the same circumstances

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Take away points:
- Be careful interpreting studies with lots of confounders
- Do not rely on any single study; see the whole literature in context
- Children may transmit less readily than adults, but we definitely need more evidence to be sure, or to quantify that fact

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