key: cord-0929913-gd25dly6 authors: Khamis, Faryal; Al Awaidy, Salah T. title: Letter in Reply: Epidemiology of COVID-19 Infection in Oman date: 2020-11-30 journal: Oman Med J DOI: 10.5001/omj.2020.134 sha: cd9d333a86648008955c7f175b443d14a4162975 doc_id: 929913 cord_uid: gd25dly6 nan W e read with keen interest the remarks made by Al-Mendalawi, 1 and thank him for his interest in our manuscript. 2 In our study, we described the epidemiological aspects of the first 1304 laboratory-confirmed cases (incidence) in Oman. Oman has a strong communicable disease surveillance system across all governorates and regions within the country. It is unlikely we have missed some cases, particularly in the pediatric age group, as the country was providing the COVID-19 screening services to all health facilities free of charge at the time of the study. The role of children in spreading the coronavirus has been a key question since the early days of the COVID-19 pandemic. In addition, the reality aspect of COVID-19 is that children appear to be infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), far less frequently than adults and, when infected, typically have mild symptoms in up to 80% of cases. 3 About six months into the pandemic, an accumulating evidence have shown that children, particularly school-aged children, are far less important drivers of SARS-CoV-2 transmission than adults. [3] [4] [5] Furthermore, another possibility is that because schools and nurseries closure occurred across the country in March 2020, which is in earlier stages of the pandemic, along with or before widespread physical distancing orders, most close contacts became limited to households, reducing opportunities for children to become infected in the community and present as index cases. This supports the low cases among the pediatric age group. In our study, children and adolescents under 18 years old represented a smaller fraction of confirmed COVID-19 cases. These findings are largely consistent with a report on pediatric COVID-19 patients reported in China, Spain, and the US. 3, 6, 7 Oman has already started (since 14 July 2020) implementing a nationwide sero-prevalence survey among different age groups through which the country will be able to know the prevalence of the disease among different age groups. r efer ences Is the Prevalence of the Pediatric COVID-19 Infection in Oman Underestimated? Epidemiology of COVID-19 infection in Oman: analysis of the first 1304 cases COVID-19 in 7780 pediatric patients: a systematic review CDC COVID-19 Response Team. Coronavirus disease 2019 in children -United States Epidemiology of COVID-19 among children in China Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention Screening and severity of coronavirus disease 2019 (COVID-19) in children in madrid e210 Letter in Reply: Epidemiology of COVID-19