With just a few weeks remaining before schools in the U.S. are scheduled to reopen, and the federal government encouraging in-person schooling, there remain many questions about the risk COVID-19 poses to children and their role in transmission of the disease. Indeed, other countries have not reopened schools with the levels of community transmission found in the U.S., coupled with its insufficient testing and limited contact tracing.
Our review of the latest available data indicates that, while children who are infected with COVID-19 are more likely to be asymptomatic and less likely to experience severe disease (though a small subset become quite sick), they are capable of transmitting to both children and adults.
What remains unclear and where evidence is still needed is: whether children are less likely to be infected than adults and, when infected, the frequency and extent of their transmission to others. There is some evidence for an age gradient in infectiousness, with younger children less likely and older children more likely to transmit at levels similar to adults.
While other countries that reopened schools have generally not experienced outbreaks in school settings, almost all had significantly lower levels of community transmission than the U.S. and greater testing and contact tracing capacity. Moreover, several disease clusters connected to schools and children have been reported.
Taken together, the evidence indicates that where there is already widespread community transmission, as in many areas in the U.S., there is clearly a risk of further spread associated with reopening schools. The risks of reopening need to be considered carefully in light of the recognized benefits of in-person education.
