Worldwide, relatively few children have been reported with COVID-19, the disease caused by the novel coronavirus. 

The novel coronavirus is mainly spread between adults and from adult family members to children. The spread of COVID-19 among children or from children to adults is less common. In general, the younger the children, the less significant the role they play in spreading the virus. 

Contagiousness increases with age

There is an increased number of novel coronavirus infections in all age groups, including children. Even so, children play a minor role in spreading the novel coronavirus. The number of infections in children and how contagious they are do increase as they get older. 
It is and will remain important to follow the basis recommendations (such as the hygiene rules) at home whenever possible, and to make sure that children over 13 years old who have symptoms do get tested.

Virus often spreads outside school, no quarantine for classmates

The novel coronavirus is often spread outside of school. This mainly happens during intensive contact with friends or classmates in their free time. Infection at school and in the classroom is limited. Therefore, classmates do not have to be quarantined. If a child has had intensive contact with friends and classmates outside of school, they should go into quarantine. If a student tests positive for COVID-19, the Municipal Public Health Service (GGD) analyses which 'out-of-school' contacts need to be in quarantine.

Primary and secondary schools stay open

Education is important for children’s well-being, development and health. In addition, children play a limited role in spreading the novel coronavirus. That is why primary and secondary schools can stay open. 
Protocol 'Fully opening secondary schools' (only in Dutch). 

Source and contact tracing, testing and staying home

Municipal Public Health Services (GGDs) perform source and contact tracing. RIVMNational Institute for Public Health and the Environment has drafted a Guidance document (in Dutch) for source and contact tracing for children. It contains examples of situations involving infections in childcare and schools. For information on specific rules for children, distancing, testing and staying home, see government.nl.

Hygiene in childcare facilities and schools

Good hygiene (and hand hygiene) help prevent the novel coronavirus from spreading. There are hygiene guidelines for childcare facilities, kindergartens and after-school childcare (in Dutch), and primary schools (in Dutch). For secondary schools, the general hygiene guidelines (in Dutch) are being followed. In addition, pay extra attention to cleaning frequent touch points, such as door handles, toilet controls, light switches and banisters. Also regularly clean electronic devices, such as computers and tablets, for example with a dry microfibre cloth.

See also Hygiene and COVID-19

Ventilation and airing in childcare facilities and schools

Ventilation is important for a comfortable and healthy indoor climate in childcare facilities and schools. Ventilating refreshes the indoor air with outside air. Good ventilation also helps to limit transmission of respiratory infections, such as COVID-19. For that reason, it is important to properly ventilate homes, businesses and other buildings, such as schools. This can be done by leaving windows open at a tilt, by opening ventilation grilles or gaps, or by using mechanical ventilation systems. Indoor spaces where multiple people will be spending time, such as classrooms, should also be aired out. This should be done at times when the indoor spaces are not occupied by multiple people. Air out the indoor spaces for 10 to 15 minutes by, for example, opening windows and doors across from each other during the break. This quickly refreshes the air inside the room. Read more about properly ventilating classrooms in the ‘Protocol on education at school during corona’ (in Dutch) and the ‘ventilation guidelines’ (in Dutch).  It is also important to follow the basic recommendations.  For example, wash your hands regularly and stay home if you have symptoms.

For more information:

More information for schools

The website of the Dutch Government offers more information on the novel coronavirus in the context of various types of childcare and education. The site also provides detailed information for schools, such as protocols to minimise the spread of the coronavirus:

RIVM.nl also has more information for Pregnant workers (only in Dutch)

Researching the role of children in the spread of the virus

RIVM is conducting various studies on the role of children in the spread of the novel coronavirus:

  • RIVM is conducting a detailed study on the reports of COVID-19 patients received from the Municipal Public Health Services (GGDs) in the Netherlands.
  • RIVM is working closely with the monitoring stations operated by the Netherlands Institute for Health Services Research (NIVEL) to investigate the registrations provided by GPs on patients with flu-like symptoms who are tested for COVID-19.
  • RIVM is conducting research among Dutch COVID-19 patients and their family contacts
  • RIVM has taken blood samples to test for antibodies against COVID-19 in the PIENTER Corona study.
  • RIVM is keeping track of relevant literature on children and COVID-19. This also includes studies that have been conducted in other countries.

Data from Municipal Public Health Services (GGDs)

Based on reports from Municipal Public Health Services (GGDs), children aged 0-17 years only represent 7.3% of all patients with COVID-19 reported between 1 June 2020 to 23 August, although they comprise 20.7% of the population. This can be shown as follows.
Of all people who tested positive:

  • 0.3% were aged 0-3 years
  • 1.7% were aged 4-11 years
  • 5.2% were aged 12-17 years

Only 2.9% of the hospitalisations reported since 1 June involved children under the age of 18.

  • 2.0% were aged 0-3 years
  • 0.4% were aged 4-11 years
  • 0.6% were aged 12-17 years

There are no reports of children who have died from COVID-19.

Since 1 June 2020, all Dutch people with (mild) symptoms can be tested for the coronavirus. Data from the GGD test lanes show that more than 100,000 tests have been administered to children between 1 June 2020 and 23 August 2020, of which a total of 1.1% were positive.

  • 1.1% of all children aged 0-3 years tested positive (5,700 children in this age group were tested in total)
  • 0.8% of all children aged 4-11 years tested positive (42,000 children in this age group were tested in total)
  • 1.7% of all children aged 12-17 years tested positive (56,000 children in this age group were tested in total)

In the same period, over 44,000 people working in education or childcare were tested. 0.7% of these employees tested positive. This percentage is lower than the total of 2.0% of the over 940,000 adults tested in the test lanes in the same period.
 

 

 

Results of childcare and primary education employees from GGD test lanes  

Spread of COVID-19 between people in the same age group

When reporting a COVID-19 patient, it is also possible to report which other patient is a probable source of the infection. This data shows that COVID-19 is primarily spread between people who are about the same age. The figure below shows data (up to 14 September 2020) on 7,641 paired patients, displaying the ages of both the source patient and the patient that they infected. Transmission of the virus appears to take place mainly between people of about the same age, and less frequently between parents and children (of all ages).

 

Infected contacts according to the age of the source patient

Municipal Public Health Services (GGDs) conduct source and contact research for COVID-19 patients. They monitor the contacts of a source patient and test them if they develop symptoms. In the period from 29 June to 6 September (week 27 to 36), more than 62,000 contacts were monitored within the framework of source and contact tracing. The figure below shows the absolute numbers (infected/non-infected or not tested) of contacts according to the age of the source patient. Nearly half of the contacts had a source patient in the age group of 18-29 years, while 7.7% had a source patient under the age of 18 years.

The chart below shows the age distribution of the source patient. Of the total number of infected contacts, 0.3% (n=14) had a source patient under the age of 4, while 0.7% (n=36) had a source patient aged 4-11 years, and 4.6% had a source patient aged 12-17 years. Of the vast majority of contacts that became infected (94.4%), the source patient was 18 years or older.

One infected child in GP practices

Around 40 GP practices in the Netherlands are registering the number of patients visiting the practice with flu-like symptoms; these are the Nivel monitoring stations. Using a cotton swab, a smear is taken from the nose and throat of some of these patients; the resulting culture is examined in the laboratory to detect viruses, including COVID-19. In one of the 183 patients under the age of 18 that were tested (0.5%), a COVID-19 infection was detected (data from February to early September 2020). The infected patient was 15 years old. Of the 1021 adults tested, 65 were positive (6.4%).

COVID-19 in Dutch households

Within a short time frame, RIVMNational Institute for Public Health and the Environment set up a study to find out more about people infected with COVID-19 and their family contacts. In cooperation with GGD Utrecht, various families took part in this study. A total of 54 households took part up to mid-April, involving 239 participants, including 185 household members. The first results of this study are now known. In this family-based study, there were no indications found in any of the 54 participating families that a child <12 years old was the source of COVID-19 within the family.

Frequently Asked Questions

How can proper ventilation of the classroom prevent infection?

Ventilating refreshes the indoor air with outside air. This can be done by, for example, leaving a window open at a tilt or configuring the ventilation system at the correct setting. Leaving the classroom windows and doors open during the break quickly refreshes the indoor air. This helps create a comfortable and healthy indoor climate. Ventilation can help prevent infection with the novel coronavirus. It is currently not known to what extent it helps. Read more about ventilation.
Read more about properly ventilating classrooms in the ‘Protocol on education at school during corona’ and the ‘ventilation guidelines’. It is also important to follow the basic rules:  For example, wash your hands regularly and stay home if you have symptoms.

What role do secondary school students play in the spread of the virus?

There is an increased number of infections in all ages. That includes children, teens and young adults. Yet children play only a minor role in spreading the novel coronavirus. COVID-19 is less common in children and they spread the virus less often. The number of infections in children and how contagious they are do increase as they get older. The virus is often spread outside of school, during intensive contact in their free time with friends or classmates. Infection at school and in the classroom is limited.
Education is important for the well-being, development and health of children and young people. In addition, children play only a limited role in spreading the novel coronavirus. That is why secondary schools can stay open. Advice on this is given in the 'Fully opening secondary school' protocol. 

I have schoolchildren. How likely am I to get infected? 

The novel coronavirus is mainly spread between adults and from adult family members to children. The spread of COVID-19 among children or from children to adults is less common. In general, the younger the children, the less significant the role they play in spreading the virus. Read more about the spread of the novel coronavirus
Even at home, it is important to follow the basic recommendations as much as possible, such as hygiene rules, and to get children older than 13 years tested if they show any symptoms.

Why are classmates not quarantined if a student tests positive for COVID-19?

Children play a minor role in the spread. COVID-19 is less common in children and they spread the virus less often. The number of infections in children and how contagious they are do increase as they get older. There is also an increased number of infections in teens and young adults. However, the virus is often spread outside of school, during intensive contact in their free time with friends or classmates. Infection at school and in the classroom is limited. Therefore, classmates do not have to be quarantined, but if a child has intensive contact with friends or classmates outside of school, they do need to be quarantined. If a student tests positive for COVID-19, the Municipal Public Health Service (GGD) analyses which 'out-of-school' contacts need to be quarantine.

Should children also stay 1.5 metres apart? 

Children are not always required to stay 1.5 metres apart from each other and/or from adults. 
See the details for the 1.5-metre measure among children on Government.nl

My child has symptoms. Can my child attend childcare, primary school or secondary school?

Information on when to keep your child home from childcare or primary school can be found at Government.nl. Children and adolescents in vocational education (MBO) or higher education are subject to the basic rules for staying home that apply to everyone.

Should I stay home because my child has symptoms?

Household members of children and adolescents in secondary school, vocational education (MBO) or higher education are subject to the basic rules for staying home that apply to everyone. For household members of children in childcare or primary school, see Government.nl.

Can I have my child tested?

Specific rules apply for young children (0 to 4 years) and primary school children; see Government.nl. Children and adolescents in secondary school, vocational education (MBO) or higher education are subject to the basic rules for testing that apply to everyone.

My child belongs to a risk group. Can my child go to school, childcare and after-school care?

Children with underlying medical problems do not appear to have a higher risk of severe illness from COVID-19 than healthy children. If you are unsure, please consult your child’s doctor or paediatrician and the school management. If a family member belongs to a risk group, consult with the doctor and the school management.

Can COVID-19 cause a severe inflammatory reaction in children? 

There are reports from other countries about a number of children who have had a severe inflammatory reaction, which has been linked to COVID-19. These kids developed a fever, skin rash and inflammation around the heart. The symptoms are similar to Kawasaki’s disease. Further research is needed to determine whether there is a link with COVID-19. For now, that link has not been confirmed. 

What about the vaccinations for my child in the National Immunisation Programme and the novel coronavirus?

It is very important for your child to receive the usual vaccinations from the National Immunisation Programme. If, for example, you postpone the 14-month shots, there is a risk that your child will contract diseases such as measles and meningococcal meningitis. These are highly contagious diseases that still occur in the Netherlands. If you or your child has cold symptoms or a fever, or if someone in the family has a fever, please contact the well-baby clinic.

Would you like to know more over vaccinations and the novel coronavirus? Go to the frequently asked questions on the site of the National Immunisation Programme (in Dutch).