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Early this spring, school gates around the world slammed shut. By early April, an astonishing 1.5 billion young people were staying home as part of broader shutdowns to protect people from the novel coronavirus. The drastic measures worked in many places, dramatically slowing the spread of SARS-CoV-2, the virus that causes COVID-19.
However, as weeks turned into months, pediatricians and educators began to voice concern that school closures were doing more harm than good, especially as evidence mounted that children rarely develop severe symptoms from COVID-19. (An inflammatory condition first recognized in April, which seems to follow infection in some children, appears uncommon and generally treatable, although scientists continue to study the virus’ effect on youngsters.)
Continued closures risk “scarring the life chances of a generation of young people,” according to an open letter published this month and signed by more than 1500 members of the United Kingdom’s Royal College of Paediatrics and Child Health (RCPCH). Virtual education is often a pale shadow of the real thing and left many parents juggling jobs and childcare. Lower-income children who depend on school meals were going hungry. And there were hints that children were suffering increased abuse, now that school staff could no longer spot and report early signs of it. It was time, a growing chorus said, to bring children back to school.
By early June, more than 20 countries had done just that. (Some others, including Taiwan, Nicaragua, and Sweden, never closed their schools.) It was a vast, uncontrolled experiment.
Some schools imposed strict limits on contact between children, while others let them play freely. Some required masks, while others made them optional. Some closed temporarily if just one student was diagnosed with COVID-19; others stayed open even when multiple children or staff were affected, sending only ill people and direct contacts into quarantine.
Data about the outcomes are scarce. “I just find it so frustrating,” says Kathryn Edwards, a pediatric infectious disease specialist at the Vanderbilt University School of Medicine who is advising the Nashville school system, which serves more than 86,000 students, on how to reopen. Her research assistant spent 30 hours hunting for data—for example on whether younger students are less adept at spreading the virus than older ones, and whether outbreaks followed reopenings—and found little that addressed the risk of contagion in schools.
When Science looked at reopening strategies from South Africa to Finland to Israel, some encouraging patterns emerged. Together, they suggest a combination of keeping student groups small and requiring masks and some social distancing helps keep schools and communities safe, and that younger children rarely spread the virus to one another or bring it home.
“Outbreaks in schools are inevitable,” says Otto Helve, a pediatric infectious disease specialist at the Finnish Institute for Health and Welfare. “But there is good news.” So far, with some changes to schools’ daily routines, he says, the benefits of attending school seem to outweigh the risks—at least where community infection rates are low and officials are standing by to identify and isolate cases and close contacts.
How likely are children to catch and transmit the virus?
Several studies have found that overall, people under age 18 are between one-third and one-half as likely as adults to contract the virus, and the risk appears lowest for the youngest children. The reason remains the subject of intense study. But the town of Crépy-en-Valois, home to 15,000 people on the northern outskirts of Paris, provides some confirmation that younger age reduces risk of infection—and transmission.
When two high school teachers developed minor respiratory symptoms in early February, no one suspected COVID-19. It was cold and flu season, and health officials still assumed the novel coronavirus was mostly confined to China. It wasn’t until 25 February, after one of their contacts was hospitalized in Paris, that the teachers realized they had been infected with SARS-CoV-2. For at least 12 days before the start of winter break on 14 February, and before France instituted precautionary measures, the virus had been spreading freely at the school.
Arnaud Fontanet, an epidemiologist at the Pasteur Institute, and his colleagues started an investigation in Crépy-en-Valois in late March to see whether they could piece together the virus’ reach in the town and its schools. In the high school, antibody testing showed that 38% of pupils, 43% of teachers, and 59% of nonteaching staff had been infected. (By then, several people associated with the school had been hospitalized with COVID-19 complications.) In six elementary schools, they found a total of three children who had caught the virus, likely from family members, and then attended school while infected. But, as far as the researchers could tell, those younger children didn’t pass the virus on to any close contacts.