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Child care centers unlikely source for COVID-19 transmission, study finds

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University of Pittsburgh
Publication Date: 
24 Oct 2023


Children in child care centers are not spreading COVID-19 at significant rates to caregivers or other children at the center, nor to their households, according to a study led by University of Pittsburgh School of Medicine and UPMC Children's Hospital of Pittsburgh pediatrician-scientists and published in JAMA Network Open.

The findings suggest that recommendations to test symptomatic children for SARS-CoV-2, the virus that causes COVID-19, and keep positive children home from child care for prolonged periods can be revised to align with those for other serious respiratory viruses.


"No one wants to give up on controlling SARS-CoV-2 spread, but focusing on testing and long exclusion periods for children in child care centers appears to be unnecessary, while subjecting families to the expense of frequent testing, absence from work and lost wages, and loss of education and socialization for children."

Current recommendations from the U.S. Centers for Disease Control and Prevention advise that any child with congestion, runny nose or other respiratory symptoms be tested for COVID-19 and, if positive, be kept home from child care for at least five days.

For influenza and respiratory syncytial virus—equally serious respiratory viruses that infect and spread among children in child care centers at higher rates—recommendations are for the child to return to child care when symptoms are resolving and they have been fever-free for 24 hours.


Most household cases were acquired from outside the child care center.

In contrast, once someone in a household had COVID-19, transmission to other household members was high, at 50% for children and 67% for adults.


"In households, the higher rates can be explained by much more prolonged and closer contact, especially with sick children."


Nevertheless, the study's results point to the importance of vaccinating children against COVID-19, which other research has shown to be safe and effective.

"Though we found COVID-19 transmission was low in child care centers, our study shows that transmission was very high in households, and young children still often contracted COVID-19 from people outside the child care center," said Shope.