Children become less seriously ill and almost never need to be hospitalised because of the coronavirus SARS-CoV-2. See the overview of the COVID-19 epidemiological situation in the Netherlands.
Contagiousness increases with age. In general, the younger the children, the less significant the role they play in spreading the virus. This applies to the original virus variant and to the more contagious virus variants that have been circulating in the Netherlands since the end of last year. However, the more contagious variants involve more transmission of the virus in all age groups, compared to the old variants. Read more about the spread of the virus.
Contagiousness increases with age
When the number of SARS-CoV-2 infections in the Netherlands increases, infections increase in all age groups, including children. See the overview of the COVID-19 epidemiological situation in the Netherlands (in Dutch). The current increase in SARS-CoV-2 is mainly caused by the emergence of virus variants that are more contagious than the original or ‘wild type’ variant. These variants are also more contagious in children. The increase we see in children is also because many more children are being tested than before, even if they have no symptoms. However, younger children who are infected play a less significant role in spreading the COVID-19 compared to older children and adults. Children have more contact with different people than adults do, because the schools have reopened, so it is very probable that they now play a larger role in spreading the virus. In view of the current increase in the number of infections, it remains important to follow the basic recommendations, such as the hygiene rules and the guidelines for testing and staying home that apply to children.
Video on testing children for COVID-19
Spread of the virus at school and outside of school
The number of SARS-CoV-2 infections in the Netherlands is high right now, even among children. Since January, the testing policy for children has been adjusted so that SARS-CoV-2 infections in children can be detected more quickly in order to prevent further spread.
Schools adopted stricter precautions when they reopened, with the aim of preventing transmission. If a pupil or student is infected, the Municipal Public Health Service (GGD) checks which classmates were close contacts and therefore need to be quarantined. Due to the additional recommendation to have these children and school employees tested, clusters (outbreaks) can be detected and addressed more quickly and effectively.
We see clusters among children both outside school and within schools. At school, clusters are often seen in the classroom, and often involve mixed clusters in which both teachers and pupils are infected. Since schools reopened, there has been a clear increase in clusters related to the school/childcare setting.
The service document for childcare and primary education and for secondary education (in Dutch) describe what the schools are doing to reduce the risk of the virus spreading among children and staff. These measures are based on advice from RIVMNational Institute for Public Health and the Environment
. All pupils are allowed to go to school in person at least one day a week, and more where possible.
For more information on specific rules for young children and schoolchildren, distancing, testing and staying home, see Government.nl.
Hygiene in childcare facilities and schools
Good hygiene and hand hygiene help prevent COVID-19 from spreading. There are hygiene guidelines for childcare facilities, kindergartens and after-school childcare, and for primary schools. Secondary schools should follow the general hygiene guidelines. 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:
- Indoor and outdoor environment for primary schools (in Dutch)
- Ventilation and COVID-19
- Government.nl: ventilation and buildings
- Government.nl: COVID-19 and ventilating school buildings (in Dutch)
More information for schools
The website of the Dutch Government offers more information on the coronavirus SARS-CoV-2 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:
- Primary education and special education
- Secondary education
- Secondary vocational education (MBO)
- Universities of applied sciences and research universities
- Rules for distancing
RIVM.nl also has more information for pregnant workers.
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 SARS-CoV-2:
- RIVM is conducting a detailed study on the reports and outbreaks of COVID-19 infections 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 COVID-19 patients and their family contacts in the Netherlands. The results of the first part of this study are now known. The second part of the family study started recently, focusing on households where the child was the first infected person in the family.
- RIVM has launched a study on SARS-CoV-2 infections in primary schools.
- 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)
Children who tested positive for COVID-19
The number of reported positive tests per 100,000 inhabitants decreased in the past week in all age groups, including 0-12 and 13-17 years.
The number of tests taken also decreased in all age groups. The largest decrease was in the age group of 0-12 years and 13-17 years (about 20% fewer tests compared to the week before that).
The charts below on the number of reported positive tests per 100,000 inhabitants show the number of reports per week by age and age group (see other tab). It is also possible to compare the reported positive tests for the different age groups. The chart based on age groups can be used to compare different age groups, such as reported positive tests in children compared to adults.
The figure below shows the data from 6 January 2021 on. The diagram shows the percentage of people who tested positive for COVID-19 for each age group, as a proportion of all the confirmed cases reported to the GGD. The corresponding percentages are also displayed.
Influence of changed testing policy
Since January, all children can be tested if they have mild symptoms. Since 3 February, children and adults who are a close contact with an infected person at school, or are a contact of an infected person outside of school, are advised to get tested. This applies even if they do not have any symptoms.
Although children aged 0 to 17 years old comprise 20.7% of the population, they represent a lower percentage of the people who tested positive for COVID-19.
The figure below is based on data from the GGD test lanes from 30 November on. The chart shows the number of COVID-19 tests taken and the percentage of positive tests per age category. The grey bars represent the number of tests with results per 100,000 inhabitants. The pink line shows the percentage of positive tests.
We see that the number of children getting tested has increased significantly, accompanied by an increase in the number of positive tests. The percentage of positive tests in children has fallen sharply. Many of the tested children fortunately tested negative for COVID-19, even though they have symptoms. This is due to a major increase in common colds since the schools reopened. The highest relative increase in testing is among children with symptoms, without being a known contact of a person who tested positive for COVID-19.
The charts show that the number of children getting tested for COVID-19 has been increasing since the week of 8 February. As explained earlier, this is related to the changed test policy. The percentage of children aged 11 and under who tested positive for COVID-19 decreased after the number of tested children increased. The downward trend in percentage of positive tests applies both to testing among children with symptoms and to testing among children without symptoms in the context of a contact investigation, and is visible in all age groups up to 11 years. From the week of 15 March on, the percentage of positive tests has remained roughly the same among all age groups. The number of tests per 100,000 inhabitants is no longer increasing as rapidly as in the previous weeks.
Employees working in schools and childcare facilities
From 30 November 2020 to 14 March 2021, over 263,900 people working in education or childcare were tested. 7.6% of those tests were positive. This percentage is lower than the total of 11.0% of the over 4.2 million adults tested in the test lanes in the same period.
During the week of 8 to 14 March 2021, 33,455 people working in education or childcare were tested. 4.5% of those tests were positive. This percentage is lower than the total of 8.4% of the 343,657 adults tested in the test lanes in the week before that.
If we look at all hospital admissions reported by the NICE Foundation in 2020, 0.4% were younger than 4 years old. 0.1% were aged 4-11 years and 0.2% were aged 12-17 years. The vast majority (99.3%) of all people admitted to hospital with COVID-19 were aged 18 years or older.
The same pattern can be observed in 2021 (1 January to 6 April). Despite the fact that reported positive tests among children and adolescents are increasing, the percentage of children and adolescents admitted to hospital is not changing.
Spread of COVID-19 between people in the same age group
When reporting a person who has COVID-19, it is also possible to report which other person with COVID-19 is a probable source of the infection. This data shows that the virus is primarily spread between people who are about the same age. The figure below shows data (up to 7 March 2021) on 296.181 paired infected individuals, displaying the ages of both the source and the infected person. Transmission of the virus appears to take place mainly between people of about the same age, and somewhat less frequently between parents and children (of all ages).
Infected contacts according to the age of the source patient
The data on infected contacts according to the age of the source as derived from source and contact tracing is currently being updated and will be posted shortly.
Infected children 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 the coronavirus SARS-CoV-2. A COVID-19 infection was detected in four of the 242 patients under the age of 18 who were tested (1.7%). Of the 1349 adults who were tested, 110 tested positive (8.2%). This is based on data from February 2020 to 5 April 2021.
Frequently Asked Questions
Do children pass on the UK variant of the virus more easily?
Studies done so far show that the UK variant of the virus is more contagious than the variant that was most common in the Netherlands. This applies to all age categories – including children. Research in the municipality of Lansingerland showed that children can become infected with the UK variant, although less frequently than adults. They are likely to develop symptoms somewhat more often than with the old variant. However, these symptoms are generally milder in children than in adults. Infected children can pass on the virus within a household and also at school. It is not yet clear whether primary school children also present a lower transmission risk for the virus variants compared to adults, as is the case for the ‘old’ variant.
If someone in the class has tested positive for COVID-19, why does the whole class or group have to be quarantined?
Because of the high number of infections and the more contagious variants of the virus, a stricter policy on source and contact tracing has been implemented. That includes children. This stricter policy ensures that people get tested sooner and that contacts are advised to go into quarantine more often. That includes classmates and children at the childcare centre who (cumulatively) have a lot of contact with each other. This ensures that the virus has fewer opportunities to spread. It also helps us see where the virus is spreading.
If the number of contacts per child or employee is limited, for example by working with fixed groups or letting the same children play with each other, then the Municipal Public Health Service (GGD) does not consider the other classmates as close contacts. In that case, they do not need to be quarantined. They are still advised to get tested, but do not have to stay home.
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?
Can I have my child tested? Yes, that is possible. Information about testing children is available on Government.nl.
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 coronavirus SARS-CoV-2?
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 about vaccinations and the coronavirus SARS-CoV-2? Go to the frequently asked questions on the site of the National Immunisation Programme (in Dutch).