Detailed contact tracing of 43 cases
- 5 teachers
- 38 children

Whole classes tested regardless of symptoms, and swabbed a second time 10-14d later if the first was within 6 days of exposure

How much onward transmission?

2/8
Pre school (6 kids, 2 teachers) - 0/156 (0%)
Primary school (14 kids) - 1/266 (0.44%)
Secondary school (23 kids, 5 teachers) - 38/572 (6.64%)

Notice a pattern here?

3/8
Infection prevention is important, in these schools:
- 1m between children
- Masks except when at desks in secondary schools (not mandatory in primary schools)
- Staggered entry/exit times to avoid crowing
- If classroom to small, rotas to half class size

4/8
A useful study which reflects knowledge from early in the pandemic and what we observe now in many countries

Risk of transmission appears much lower for younger children than older children/adolescents - in spite of lack of mandatory masking for younger kids

Why is that?

5/8
Part will be mixing profiles; older children mix more. But we should expect a larger proportion of infections based on that

Part seems very likely to be the reduced susceptibility of younger children than older children to getting infected

Could there be something else?

6/8
Some people are theorising droplet transmission might be similar from children to adults, hence similar household transmission rates

But - their ability to generate aerosols might be much lower due to their low symptom burden, small size, lung volume and expiratory force

7/8
This would mean you would probably need prolonged, close contact to a small child to acquire infection, and lower risk of larger scale aerosol transmission events

An interesting hypothesis which would explain observations, but needs some empirical evidence!

End

8/8
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