Children are unlikely to have been the primary source of household SARS-CoV-2 infections

Yanshan Zhu; Conor J Bloxham; Katina D Hulme; Jane E Sinclair; Zhen Wei Marcus Tong; Lauren E Steele; Ellesandra C Noye; Jiahai Lu; Keng Yih Chew; Janessa Pickering; Charles Gilks; Asha C Bowen; Kirsty R Short

There are important caveats that need to be acknowledged when interpreting these data for public health policy. Our analysis of household transmission clusters was also based on the assumption that the incubation period for SARS-CoV-2 was approximately equivalent in children and adults. Whilst we did not observe any significant difference in the incubation time of infected children and their infected adult relatives (data not shown), others have suggested there might be a longer incubation period for SARS-CoV-2 in children 71 . It is also possible that the analysis performed herein was impaired by the policy within particular countries to only test contacts of a known COVID-19 patient when and if they become symptomatic. This could result in the number of asymptomatically infected individuals being underestimated. Importantly, China rapidly implemented a policy to test both symptomatic and non-symptomatic contacts, suggesting that this limitation would only apply to transmission clusters detected outside of China. Nevertheless, despite these important limitations, these data suggest that children are unlikely to be driving the household transmission of SARS-CoV-2.