COVID-19: Close-Contact Risk Factors / Case Spike in Children

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Here are some of the latest COVID-19 developments:

Close-contact risk factors: A retrospective study in The Lancet Infectious Diseases details risk factors for SARS-CoV-2 transmission among close contacts of COVID-19 patients. Researchers studied over 7500 close contacts (household, work, or social) of patients with confirmed COVID-19 in Singapore between January and April 2020. Contacts underwent RT-PCR testing for SARS-CoV-2 if they developed symptoms. Overall, 6% of household contacts developed symptoms and tested positive, versus 1% of work or social contacts. Sharing a bedroom or a vehicle with a case, or being spoken to by a case within 2 meters — particularly for 30 minutes or longer — were significant risk factors for transmission. In addition, using data from serology testing, the researchers calculated that symptom-based testing missed over half of contacts with SARS-CoV-2 infection. They conclude, "Targeted community measures should include physical distancing and minimizing verbal interactions. Testing of all household contacts, including asymptomatic individuals, is warranted."

Case spike among children: Nearly 200,000 U.S. children were diagnosed with COVID-19 in October — accounting for 23% of all pediatric cases since the pandemic began — the American Academy of Pediatrics reports. In the week of Oct. 22 alone, over 61,000 new pediatric cases were reported. The overall hospitalization rate among children ranges from 0.5% in Hawaii to 6.7% in New York City.