Are children less likely to spread COVID-19? The research points to yes.

School will start up again in August or September, and plans are in flux — in most school districts but also in families. The American Association of Pediatrics offered its advice this week, and it was a little unexpected. Children should be "physically present in school" as much as possible, AAP "strongly" urged. One of their rationales: Unlike with the flu, it seems "children may be less likely to become infected and to spread infection" of the COVID-19 coronavirus.

"What we have seen so far in the literature — and anecdotally, as well — is that kids really do seem to be both less likely to catch the infection and less likely to spread the infection," pediatric infectious disease specialist Sean O'Leary, who helped write the AAP's guidelines, tells The New York Times. "It seems to be even more true for younger kids, under 10 or under 12." There are very few reports of the virus spreading in U.S. day care centers, he said. "And it seems like in countries where they have reopened schools, it plays a much smaller role in driving spread of disease than we would expect."

"Austria, Denmark, Germany, and Norway have reopened schools without major outbreaks," though they opened slowly, limited class size, and used aggressive mitigation strategies, epidemiologist Jennifer Nuzzo and pediatrician Joshua Sharfstein elaborate in a New York Times op-ed. "Israel experienced outbreaks in schools, but only after loosening limitations on class sizes." They ran through some other data points:

Early in the COVID-19 epidemic, Australia identified 18 infected youth in 15 schools; health officials traced 863 contacts of the students, only two of whom were found to have been infected. The Pasteur Institute in France found just three probable cases of COVID-19 in school-age children among 510 students in a town that experienced a major outbreak; the children did not pass the infection to teachers or other students. [Nuzzo and Sharfstein, The New York Times]

"Accumulating evidence and collective experience argue that children, particularly school-aged children, are far less important drivers of SARSCoV-2 transmission than adults," but it's not clear why, Dr. Benjamin Lee and Dr. William Raszka write in the journal Pediatrics. Maybe because infected children "are so frequently mildly symptomatic, they may have weaker and less frequent cough, releasing fewer infectious particles into the surrounding environment." But it could also be that kids have been staying more socially distant. It would be nice to know more before classes start.