The role of children in the spread of COVID-19: Using household data from Bnei Brak, Israel, to estimate the relative susceptibility and infectivity of children
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
One of the significant unanswered questions about COVID-19 epidemiology relates to the role of children in transmission. This study uses data on infections within households in order to estimate the susceptibility and infectivity of children compared to those of adults. The data were collected from households in the city of Bnei Brak, Israel, in which all household members were tested for COVID-19 using PCR (637 households, average household size of 5.3). In addition, serological tests were performed on a subset of the individuals in the study. Inspection of the PCR data shows that children are less likely to be tested positive compared to adults (25% of children positive over all households, 44% of adults positive over all households, excluding index cases), and the chance of being positive increases with age. Analysis of joint PCR/serological data shows that there is under-detection of infections in the PCR testing, which is more substantial in children. However, the differences in detection rates are not sufficient to account for the differences in PCR positive rates in the two age groups. To estimate relative transmission parameters, we employ a discrete stochastic model of the spread of infection within a household, allowing for susceptibility and infectivity parameters to differ among children and adults. The model is fitted to the household data using a simulated maximum likelihood approach. To adjust parameter estimates for under-detection of infections in the PCR results, we employ a multiple imputation procedure using estimates of under-detection in children and adults, based on the available serological data. We estimate that the susceptibility of children (under 20 years old) is 43% (95% CI: [31%, 55%]) of the susceptibility of adults. The infectivity of children was estimated to be 63% (95% CI: [37%, 88%]) relative to that of adults.
Article activity feed
-
SciScore for 10.1101/2020.06.03.20121145: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:We have used a model with two age groups, due both to computational complexity considerations and data limitations, though it is likely that susceptibility and infectivity would vary in a graded way with age. Specifically, more recent population-level data (as discussed above regarding the results of school opening) may suggest that individuals of age group 15-19 would be more appropriately classified as adults with respect to …
SciScore for 10.1101/2020.06.03.20121145: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:We have used a model with two age groups, due both to computational complexity considerations and data limitations, though it is likely that susceptibility and infectivity would vary in a graded way with age. Specifically, more recent population-level data (as discussed above regarding the results of school opening) may suggest that individuals of age group 15-19 would be more appropriately classified as adults with respect to transmission characteristics. We have used imputation to account for the under-detection of infections, and our imputation process assumes that missed cases occur as independent random events, whose probability depends only on the age group, as estimated using the serological data. Violation of this assumption could lead to bias in our estimates. However, the sensitivity tests have shown that our general conclusions are robust to various variations in modelling assumptions. We would suggest, in conclusion, the importance of carrying out further studies in households and in other settings, in order to refine our understanding of heterogeneity in transmission, whether related to age or to other factors, which is crucial for guiding public health policy. In particular, improving the resolution of data collection by frequent and regular testing of all individuals would allow to track the course of transmission in a more detailed way, enabling inference based on timing of detection and not only on final outcomes, and preventing under-detection and the need t...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
-
-
-