Are Kids COVID’s Secret Weapon?

F. Perry Wilson, MD MSCE
5 min readAug 28, 2020

High viral loads with minimal symptoms may be a recipe for disaster

This week, one of the headline-generatingist COVID studies coming out in a while, appearing in the Journal of Pediatrics.

You’ve probably seen this one in the news. USA Today suggested that healthy kids may be more contagious than sick adults. Kaiser health news gave it a similar treatment. And Fox news gives us this, for example:

The message from these headlines is pretty clear — but they all contain an error. That error… will become clear by the end of this commentary.

Ok let’s walk through the study because there are actually quite a few worthy take-home points here.

Kids in the MGH Study

Researchers from MGH recruited kids who presented to the hospital or urgent care clinic with COVID-like symptoms or high-risk contacts — 192 in total making this one of the biggest pediatric cohorts to date. But only 49 of those kids were COVID-positive. Another 18 had the multisystem inflammatory syndrome that we are beginning to recognize as a post-covid complication in kids. The rest had other infections that give you upper respiratory symptoms.

Symptoms in COVID+ vs COVID- kids

First key takeaway — it was pretty hard to distinguish the acute COVID-infected kids from kids with other infections based on symptoms alone.

Anosmia was more common in COVID, but only 20% of the COVID-positive kids had that symptom. Fever was present in about half of kids regardless — that’s probably why they were in urgent care after all. Reading this gave me some real heartburn about what to do when cold and flu season ramp up —…

F. Perry Wilson, MD MSCE

Medicine, science, statistics. Associate Professor of Medicine at Yale University. New book “How Medicine Works and When it Doesn’t” available now.