October 27, 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 today 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.
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.
The research team found that SARS-CoV-2 transmission rates within child care centers was low, about 2% to 3%, indicating that neither children nor caregivers were often spreading COVID-19 to others in the centers. Child care attendance was also a minor cause of COVID-19 in households, since only 17% of household infections resulted from children who got COVID-19 at their child care centers. 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.