This evidence synthesis has been compiled by members of the CITF Secretariat and does not necessarily represent the views of all CITF members.

By Marija Djekic Ivankovic

The global COVID-19 pandemic has led to unprecedented levels of educational disruption through school closures. The resumption of in-person learning has proven to be controversial, as officials and communities weigh the risks of potential transmission of SARS-CoV-2 in schools against the benefits of in-person learning. The available evidence, summarized recently in JAMA Pediatrics, indicates that children are less likely to transmit SARS-CoV-2 compared to adults and not likely to get severely ill. However, the relative risk of transmission from children remains uncertain and public health prevention strategies such as the continuous use of masks and physical distancing continue to be important. The authors of the manuscripts suggest expanding vaccine eligibility for children, encouraging uptake of vaccines among educators and school staff, and addressing vaccine hesitancy to safely provide the most optimal learning opportunities for children.

 

Is it safe to go back to school and resume normal activities?

Key points:

  1. While the relative risk of transmission from children with SARS-CoV-2 infection remains uncertain, it is clear that children can transmit the virus.
  2. The collective implications of available studies indicate that children appear to be less likely to transmit SARS-CoV-2 compared to adults, and that transmission in schools can be mitigated by teacher masking, daily symptom screens, and appropriate isolation and quarantine.
  3. Expanding vaccine eligibility for children, encouraging uptake of vaccines among educators and school staff, and addressing vaccine hesitancy can provide greater opportunities for increased protection.
  4. Understanding the transmission dynamics among children is key to making decisions about in-person learning and what can be done to resume in-person daycare, preschool, and school safely.

 

The authors suggest that to adequately assess the risks of potential transmission of SARS-CoV-2 in schools, three key questions should be addressed: (1) What is the role of children in community transmission of infectious pathogens? (2) What is the role of children specifically in SARS-CoV-2 transmission? (3) What can be done to get children safely back in daycare, preschool, and school?

According to U.S. Centers for Disease Control and Prevention recommendations, in-person learning for children in kindergarten through 12th grade can resume through a phased reopening and the prioritization of the correct and consistent use of masks and physical distancing. The implementation of multiple prevention strategies including continued use of masks by teachers, daily symptom screening, and appropriate isolation and quarantine when required, further reduces transmission risk in schools. Finally, expanding vaccine eligibility for children, encouraging uptake of vaccines among educators and school staff, and addressing vaccine hesitancy will provide greater opportunities to increase protection and reduce transmission risk in schools.

Because in-school transmission events seem to parallel community transmission, there is a need to remain vigilant in the commitment to public health prevention strategies; these should be flexible to respond to an evolving virus while providing the safest and most optimal learning opportunities for the children.

 

Rostad CA, Kamidani S, Anderson EJ. Implications of SARS-CoV-2 viral load in children: Getting back to school and normal. JAMA Pediatr. 2021 Jun 11. doi:10.1001/jamapediatrics.2021.2022.

 

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