As officials around the country evaluate the risks posed by sending children back to school this fall, a new report suggests children of all ages are susceptible to coronavirus infections and may spread it to others.
The report, released Friday by the Centers for Disease Control and Prevention details an outbreak at a sleep-way camp in Georgia last month in which 260 children and staff - more than three-quarters of those tested - contracted the virus less than a week after spending time in close quarters together. The children had a median age of 12. Unlike staff, they were not required to wear masks, or to open windows to keep their cabins well-ventilated.
While reports of similar case clusters around funerals, weddings, teenage parties and adult gatherings have emerged regularly throughout the covid-19 pandemic, few super-spreading events like those have been documented among gatherings of children.
The report is certain to add fuel to an already fraught nationwide discussion about whether sending children back to crowded school buildings is worth the risk, in large part because so little data has been available about children's vulnerability to the infection and their ability to transmit the virus.
The Trump administration has pushed for schools to reopen in recent weeks, while many states and major cities - including Washington, D.C. - have announced they will resume online only to begin the year.
Advocates of reopening schools for in-person instruction argue that early research shows children are less prone to infection and severe outcomes from the virus than adults. While data continues to support that idea, little had been known about the extent to which they could transmit it - particularly when they are not showing symptoms.
According to the report released Friday, the outbreak at the camp identified only as "Camp A" suggests children "might play an important role in transmission."
"These findings demonstrate that SARS-CoV-2 spread efficiently in a youth-centric overnight setting, resulting in high attack rates among people in all age groups, despite efforts by camp officials to implement most recommended strategies to prevent transmission," the report said.
"Asymptomatic infection was common and potentially contributed to undetected transmission, as has been previously reported. This investigation adds to the body of evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection."
Of those who became infected, 231 were ages 17 or younger; the remaining 29 were adults.
Data about symptoms was available for only 136 patients: 36, or 26%, reported no symptoms; of 100 children and staff (74%) with symptoms, those most commonly reported were documented or subjective experiences of fever (65%), headache (61%), and sore throat (46%).
The CDC released a separate statement with a headline about "the importance of CDC mitigation strategies," rather than about the incident's implications for viral transmission in children. The statement noted that by not requiring campers to wear masks, or airing out cabins, the camp had not followed CDC reopening guidance, and also pointed to "daily vigorous singing and shouting" as potential contributing factors.
"Correct and consistent use of cloth masks, rigorous cleaning and sanitizing, social distancing, and frequent hand washing strategies, which are recommended in CDC's recently released guidance to reopen America's schools, are critical to prevent transmission of the virus in settings involving children and are our greatest tools to prevent covid-19," the statement read.
Authors of the initial report noted the study was limited by its data set, which didn’t include all campers in attendance and therefore could be missing more related cases. In addition, since Georgia experienced a jump in covid-19 transmission over the summer, some campers may have caught the virus before arriving at the camp, it noted. The CDC report acknowledged it could not determine which campers did and did not adhere to recommendations for physical distancing, which also limits the kind of conclusions that can be drawn from the data.