Why do children attend school, engage in other activities, or socialise when they have symptoms of an infectious illness? A cross-sectional survey

Objectives: To prevent the spread of infectious disease, children are typically asked not to attend school, clubs or other activities, or socialise with others whilst they have specific symptoms. Despite this, many children continue to participate in these activities whilst symptomatic. Design and setting: We commissioned a national cross-sectional survey with data collected between 19 November and 18 December 2021. Participants: Eligible parents (n=941) were between 18 and 75 years of age, lived in the UK and had at least one child aged between four and 17 years old. Parents were recruited from a pre-existing pool of potential respondents who had already expressed in interest in receiving market research surveys. Outcome measures: Parents were asked whether their children had exhibited either recent vomiting, diarrhoea, high temperature/fever, a new continuous cough, a loss or change to their sense of taste or smell in the absence of a negative (PCR) COVID-19 test (“stay-at-home symptoms”) since September 2021 and whether they attended school, engaged in other activities outside the home or socialised with members of another household whilst symptomatic (“non-adherent”). We also measured parent’s demographics and attitudes about illness. Results: One-third (33%, n=84/251, 95% CI 28% to 39%) of children were “non-adherent” in that they had attended activities outside the home or socialised when they had stay-at-home symptoms. Children were significantly more likely to be non-adherent when parents: were aged 45 and younger; allowed their children to make their own decisions about school attendance; agreed that their child should go to school if they took over the counter medication; or believed that children should go to school if they have mild symptoms of illness. Conclusion: To reduce the risk of spreading disease, parents and teenagers need guidance to help them make informed decisions about engaging in activities and socialising with others whilst unwell. STRENGTHS AND LIMITATIONS OF THIS STUDY A strength of the study is that we investigated reported behaviour, rather than intentions. The study used a non-probability sample, thus there is a risk of some sampling bias. Data about children’s demographics were not collected, which limits our ability to interpret the data