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Schools are set to reopen but how safe are they from Covid-19?

Without a significantly improved test and trace programme, reopening schools could lead to a second wave in December. 

By Nicu Calcea

Even as the number of Covid-19 cases rises again in several countries, the world’s schools are preparing to reopen their doors.

Boris Johnson says it is “vitally important” for children to return to the classroom and other European leaders have taken a similar view. In France children will return at the start of September, with masks for teachers and older pupils; German states have stepped up hygiene measures and offered free tests for staff; Spanish students will be required to socially distance when they return next month.

In the US, the Center for Disease Control and Prevention (CDC) has assured parents that their children will be safe. But figures from an American state-level data report give some cause for concern.

The study, by the American Academy of Pediatrics and the Children’s Hospital Association, found that children account for a rapidly rising proportion of Covid-19 cases. On 16 April, just 2 per cent of all US cases were attributed to children. By 20 August, children represented 9.3 per cent of all cases. The total number of cases among children during that time increased from 9,259 to 442,785. 

Children are less likely to show severe Covid-19 symptoms, with only 92 child deaths recorded in 45 US states and New York City. But being less likely to show symptoms also makes infected children more difficult to identify. In the meantime, they can still spread the disease to older family members, teachers and other school staff.

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A recent study by the Massachusetts General Hospital confirmed that children “may be a potential source of contagion in the Sars-CoV-2 pandemic in spite of milder disease or lack of symptoms” and that children “can spread infection and carry [the] virus into their household”.

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Reopening schools for in-person learning will likely increase the number of transmissions, although it is difficult to estimate to what extent. While US authorities do not release official data on the number of Covid-19 infections occurring in schools, a crowd-sourced dataset started by a teacher and maintained by a group of volunteers is aiming to fill that gap.

It has found at least 4,282 recorded cases of Covid-19 in 1,081 schools, leading to 75 deaths. Meanwhile, Public Health England reported 70 confirmed cases among children in educational settings and 128 among staff in June alone.

While this indicates a fairly low risk of infections in schools, it should be noted that it was mostly preschools and primary schools that reopened and operated in a reduced capacity. The number of cases is likely to increase as all schools fully reopen.

One model suggests that the UK government needs to significantly increase testing and contact tracing to be able to safely reopen schools. If not, opening schools full-time in September will likely lead to a second Covid-19 peak in December. If schools are opened under a part-time rota system, the second wave might occur around February next year.

In Israel and Australia, the reopening of schools has already been linked to an increase in the number of Covid-19 cases. Lower-income countries may find it even more difficult to reopen their schools. Households in developing countries are more likely to have children and elderly people living under the same roof.

In the UK, around 1 per cent of children lived with their grandparents in 2001, double the number in 1994. However, poorer families are more likely to rely on grandparents to help look after young children.

The extent to which children can spread the virus is not yet clear. Some studies suggest that children are half as likely as adults to infect others while others indicate that they spread the virus as much as adults.

Despite the risks, there are significant advantages in allowing children to return to classrooms. Pupils, particularly those from disadvantaged backgrounds, may rely on schools for free meals and childcare while their parents work. The same children were less likely to spend time learning from home or to have access to the resources they need to learn during the lockdown, according to a report by the Institute for Fiscal Studies.

These inequalities have intensified a pre-existing gap between the richest and poorest pupils and will likely be felt for years to come. Ultimately, schools can be opened, provided effective testing and contract testing systems are in place. The same model that predicted a potential second peak in December if schools reopen full-time also estimates that an epidemic rebound can be avoided if 68 per cent of contacts are traced and 75 per cent of those with symptoms are tested, and positive cases are isolated.

The UK’s testing and tracing programme has received its share of criticism. Given those limitations, some outbreaks in schools are inevitable. The question is, how effective will schools and the government be in containing them?