In this May 27, 2020 photo, Aaron Rainboth, a teacher at the Frederickson KinderCare daycare center in Tacoma, Wash., wears a mask as he takes the temperature of Benjamin Simpson, 4, after he complained of feeling hot following an outdoor play period, but found it to be normal. In a world weary of the coronavirus, many working parents with young children are now struggling with the decision on when or how they’ll be comfortable returning to their child care providers. Frederickson KinderCare, which has been open throughout the pandemic to care for children of essential workers, removed carpets and spaced out tables and chairs as part of their measures to control the spread of the coronavirus.

There’s more evidence that children may be silent spreaders of COVID-19 and can be contagious without showing symptoms, according to infection data from childcare centers.

A CDC report found that at least 31 coronavirus cases were linked to outbreaks at three childcare facilities in Utah from April 1 to July 10. At least one person was hospitalized. 

Infected staff members appear to have spread the disease to children before showing symptoms, and the children subsequently infected family members, including parents, even without showing symptoms.  

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As the fall semester begins, school reopenings have been cause for concern among parents, staff, and children who worry about exposure to the novel coronavirus.

But another vector of disease, particularly among younger children, is childcare centers.

Three outbreaks at childcare centers in Salt Lake County, Utah, led to 31 people becoming infected with COVID-19. At least 12 children were infected and spreading the virus to at least 12 other people outside the childcare centers, one of whom was hospitalized, according to a new Centers for Disease Control and Prevention (CDC) report.

All of the infected children had mild symptoms or were asymptomatic, researchers found. 

Including the confirmed cases, an estimated 184 people were directly exposed to the virus as a result of the 12 patients. 110 of these were children, but the number also including childcare staff, parents, and family members of patients.

More than half of the people exposed were asymptomatic and never tested, so the actual number of cases linked to these outbreaks could be far higher. 

The data, collected between April 1 and July 10 across 17 childcare facilities in Salt Lake County, adds to existing evidence that children can be “silent spreaders” of COVID-19 while showing few or no signs of illness themselves, and may pass the disease on to more vulnerable family members or caregivers. 

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Coronavirus can spread from childcare facilities to homes and vice versa, the report found

Of the confirmed cases linked to childcare centers, 22 patients (75%) were staff or children at the facilities. The remaining nine were people associated with staff or children who were indirectly exposed, as people who picked up the virus at childcare facilities passed it on to other contacts in their social circle, such as family members. 

At one facility, contract tracers found that a staff member at the childcare facility was infected by someone in their household. The staffer self-isolated within a day after symptoms appears. Still, during that short period, at least two other people at the facility were infected. 

At another facility, a staff member contracted COVID-19 from someone in their household, and appears to have spread the disease before showing symptoms.

Five total cases were reported at the facility, and young patients passed the disease onto at least four other people outside the facility, two of them parents, in less than a week.

Finally, in a third, larger facility, 10 children and five staff members were confirmed to have COVID-19, although the source of the outbreak could not be determined.

These patients spread the coronavirus to at least five other people outside the childcare center, and one parent of an infected child was subsequently hospitalized. In these cases the children did not show symptoms until three to five days after they were infected, researchers found. 

Consistent mask wearing may have helped slow the spread

Deep cleaning, sanitizing procedures, and daily temperature and symptom checks were reported at the three facilities where outbreaks occurred. Two of the facilities required staff members to wear masks, but none required children to wear masks. 

That could have contributed to infections, according to researchers. Current CDC recommendations are that everyone aged 2 or older wear a mask in public. However, that may not have been enough either — in one case, an infected 8-month old child spread the illness to both parents. 

Overall, these cases are further evidence that children can be contagious while having mild or no coronavirus symptoms. 

While more research is needed, the CDC is recommending that consistent testing with timely results be conducted in cases where children are present, particularly in large groups, and including families. 

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