Excerpted from preface
A striking feature of the COVID-19 pandemic is that children are less often and less seriously ill than adults. In China, South Korea, Italy, the Madrid region of Spain and the United States, 1-5% of laboratory-confirmed SARS-CoV-2 infections involved individuals up to 19 years of age. 1-5 Many tests have been carried out in Iceland in relation to population size. Icelandic children under 10 years of age tested for suspected COVID-19 were less likely to have a positive PCR result for SARS-CoV-2 than children ≥ 10 years of age (6.7% vs. 13.7%). In a random sample of 10,797 persons (3% of the population) none of the children <10 years old had a positive PCR result; the prevalence in persons aged 10-19 years was 0.3% and in 40-49 year olds 1.5%. 6
There is also no evidence that children are a major source of infection. In publications about patient clusters, the index patient is almost always an adult. In the international literature, only a limited number of clusters have been described in which a child may have been - but not proven - the index. 7.8
Based on available international surveillance and research data, the role of children in the transmission of SARS-COV-2 appears to be limited. Yet many countries, including the Netherlands, have decided to close schools as one of the means to fight the COVID-19 pandemic. On 16 March 2020, the National Institute for Public Health and the Environment (RIVM) was commissioned by the national 'Outbreak Management Team' (OMT) to provide further research in order to advise the government on further policy with regard to school closure. the role of children in the epidemic in the Netherlands.
The purpose of the research we describe here is to:
(a) identify from national surveillance data whether children play a role in the transmission of the virus to other children and adults; and
(b) to understand in families with a COVID-19 patient the symptomatic and asymptomatic infections in the children and their possible role in transmission.