What all parents should know about school closures and COVID-19

You are not alone. About 87 per cent of the world’s student population has been affected by COVID-19 school closures — that’s 1.5 billion learners in 165 countries.

There are reasons for school closures in pandemics: Threats to children’s health concern the public, government, media and, of course, parents. Children learn in confined spaces, in close physical proximity for extended periods. They sneeze, cough and touch all sorts of things — ideal conditions for sharing infections and transmitting them to others. In past pandemics, children had high levels of infections and negative health outcomes. In the 2008-09 H1N1 influenza pandemic, youth represented 32 per cent of those infected and hospitalized in the U.S., and 10 per cent of deaths.

School closures in the past may not apply to COVID-19: The negative health impact of COVID-19 on children and youth is much lower than earlier pandemics. In the U.S., in February and April, only two per cent of those with the virus were under 18, with three deaths. In Canada, as of May 24, six per cent of those with the virus were under 20, with no deaths. In contrast, 35 per cent of those with the virus were over 60, accounting for 96 per cent of all deaths. A scientific review of 18 studies, including 1,065 0-19 year olds with confirmed SARS-CoV-2 infection, reported most had mild respiratory symptoms (fever, dry cough, and fatigue); some were asymptomatic; and there were no deaths. Children and youth do get infected, but the chances of serious negative health effects are very low.

It is unknown whether school closures will prevent the spread of COVID-19: A scientific review of 16 studies found no evidence that school closures helped control the spread of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) or COVID-19. The authors write, “Currently, the evidence to support national closure of schools to combat COVID-19 is very weak and data from influenza outbreaks suggest that school closures could have relatively small effects …” The effectiveness of school closures for limiting SARS-CoV-2 depends on how susceptible children are to infection and their infectiousness. Studies suggest that children play a minor role in transmission: they represent a small fraction of cases; seem to have lower viral loads than adults; and are rarely responsible for within-household disease transmission.

It is known that school closures have negative consequences: Most parents can attest to the frustration and guilt of trying to balance parenting and work. Concern is growing that child mental health and safety may be compromised because of the isolation and family stress they are experiencing. School closures could be particularly damaging for the one in five students experiencing socio-economic disadvantage. We know that children lose educational ground over July and August, but this year, “summer” lasts for six months. Educational setbacks are more serious for disadvantaged children than their peers, and over time lead to ever-widening performance gaps. E-learning may work for some children, but will not work for children from families with limited resources living under constant stress.

The options: 1. keep schools closed until there is an all-clear sign — no cases or deaths, or an effective vaccine. 2. open up schools with no guidelines. Sweden has not closed daycare centres and elementary schools since COVID-19 emerged. Swedish newspapers have reported a couple of school outbreaks, but there are no official reports of children experiencing negative health effects associated with these outbreaks. 3. open up schools with guidelines such as daily screening for mild symptoms (fever, cough, sore throat, shortness of breath, loss of taste or smell, or runny nose); school-entry hygiene (using handsanitizer), physical distancing (adjusting class size or seating); wearing a mask; and testing teachers for the virus.

Moving forward: In five months, there have been about 16,500 scientific COVID-19 articles written; only 52 look at school closures and none offer clear advice about when or how schools should open. This uncertainty should motivate governments and school boards to use different approaches for opening schools and evaluate how well each one works. The lack of evidence about the impact of school closures should be addressed to prepare for future challenges associated with this pandemic or ones like it.

In the meantime, parents, take heart. Unlike past pandemics, COVID-19 does not seem to be targeting the young, and there is little reason to think that this will change in the coming months.