As summer holidays come to an end, parents everywhere are getting ready to start the new school year. This year feels unlike any other year, as some parents will be sending their kids to school while others will have them learn from home. Whether it’s safe or not to open schools has been controversial for the past months, but the good news is that a growing number of studies from countries that have opened schools show that the answer may not be one or the other. It is possible for schools to open safely by focusing on hygiene, social distancing and rapid public health responses that keep community transmission low.
What do we know from countries that have opened schools?
Data collected from studies in Australia and Europe show that schools can open safely when community transmission is low. A survey by the European Center for Disease Prevention and Control found that reopening school in several European countries was not associated with a significant increase in the number of cases. Sweden and Iceland kept preschools or primary schools open with measures (e.g. hand hygiene, physical distancing, staying home when ill, etc.) during their epidemic did not report larger numbers of hospitalized cases among children, despite the overall outbreak being severe and prolonged in Sweden. EU countries that partially opened their schools before the summer break, often with community measures, have not experienced school outbreaks. (1)
In New South Wales in Australia, a study analyzed data from schools and day-care centers that remained open for children of healthcare workers between late January and early April. During that period, the state had an average of 193 cases per day. Out of 7,700 open schools and daycare centers, only 25 reported an infectious child or staff during that period. Secondary transmission was only reported in 3 out of 15 schools and 1 out of 10 daycares. Only 1 daycare center had a sustained outbreak. It’s worth noting that very strict public measures were applied in the state, as well as effective testing and contact tracing. (2)
Where there any negative experiences to look out for?
One outbreak was reported in a high school in Israel 10 days after reopening schools in May. At the time, there were 127 cases per day (15 cases per million people). The outbreak affected 153 students, 25 staff and 87 family members and friends. What were the conditions that lead to this? The students were in air-conditioned rooms with 30 classmates not wearing masks.
A similar outbreak was reported in Chile, where classrooms were also crammed with more than 30 children. These examples suggest that the key contributors to the outbreaks poor ventilation, large classroom sizes and the lack of wearing masks. (3)
The bottom line from the above experiences is to comfort parents that schools can still be a safe place. None the less, it’s important for schools to be vigilant about the public health measures: illness policies, diligent masking, appropriate class sizes, avoid gatherings, social distancing and hand washing. Testing and contact tracing in the community are absolutely essential to avoid outbreaks. Going back to school may not be the SAFEST option but it's important to objectively weigh the risks against the evidence. Once again, there is nothing black and white about the decisions we make while living with COVID-19.
2) Macartney, K. et al. Lancet Child Adol. Health https://doi.org/10.1016/S2352-4642(20)30251-0 (2020).
3)Stein-Zamir, C. et al. Eurosurveillance https://doi.org/10.2807/1560-7917.ES.2020.25.29.2001352 (2020).