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 while they have specific symptoms. Despite this, many children continue to participate in these activities while 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 4 and 17 years. Parents were recruited from a pre-existing pool of potential respondents who had already expressed an 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 while 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; they allowed their children to make their own decisions about school attendance; they agreed that their child should go to school if they took over-the-counter medication; or they 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 while unwell.