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Science Brief: Transmission of SARS-CoV-2 in K-12 schools

Thorough overview of the international research by the CDC, including the data behind the most updated distancing guidelines.

CDC report, March 19, 2021

Children in elementary schools don’t need to be kept six feet apart, the C.D.C. said.

In a major policy revision intended to encourage more schools to welcome children back to in-person instruction, federal health officials relaxed the six-foot distancing rule for elementary school students, saying they need only remain three feet apart in classrooms as long as everyone is wearing a mask.

By Roni Caryn Rabin and Dana Goldstein, The New York Times, March 19, 2021

COVID-19 in Primary and Secondary School Settings During the First Semester of School Reopening — Florida, August–December 2020

Summary: Both community-level and school-based mitigation measures are important in limiting transmission of COVID-19; school reopening can likely be achieved without widespread student illness in K–12 settings.

Morbidity and Mortality Weekly Report, March 19, 2021

Low SARS-CoV-2 Transmission in Elementary Schools — Salt Lake County, Utah, December 3, 2020–January 31, 2021

Summary: These findings add to evidence that in-person elementary schools can be opened safely with minimal in-school transmission when critical prevention strategies including mask use are implemented, even though maintaining ≥6 ft between students’ seats might not be possible

Morbidity and Mortality Weekly Report, March 19, 2021

Minimal SARS-CoV-2 Transmission After Implementation of a Comprehensive Mitigation Strategy at a School — New Jersey, August 20–November 27, 2020

Summary: Comprehensive mitigation approaches including frequent testing and universal masking can help prevent outbreaks in in-person high school settings even when community transmission is ongoing

Morbidity and Mortality Weekly Report, March 19, 2021

Association of Children’s Mode of School Instruction with Child and Parent Experiences and Well-Being During the COVID-19 Pandemic — COVID Experiences Survey, United States, October 8–November 13, 2020

Summary: Findings suggest that virtual instruction might present more risks than does in-person instruction related to child and parental mental and emotional health and some health-supporting behaviors.

Morbidity and Mortality Weekly Report, March 19, 2021

Special Report: As U.S. schools shuttered, student mental health cratered, Reuters finds

Reuters nationwide survey of school districts serving more than 2.2 million students. 74% of districts reported increased mental health stresses among students and nearly 90% cited higher rates of absenteeism or disengagement.

Article in Reuters March 19, 2021

How the Pandemic has Impacted Teen Mental Health

Household survey of nearly 1,000 families with a child aged 13-18. 3 in 4 parents say the pandemic has had a negative impact on their teen.

C.S. Mott Children’s Hospital National Poll on Children’s Health from University of Michigan, March 15, 2021

Is it safe to reopen schools? An extensive review of the research

Collection of over 130 COVID studies by research specialist John Bailey gives schools a solid grounding to reopen. “Any public health benefit gained from school closures must be weighed against the significant—and potentially lasting—costs imposed on individual students and society as a whole. A growing body of research suggests children face greater health risks due to missed health screenings, food insecurity, and mental health challenges.”

March 11, 2021

Effectiveness of three versus six feet of physical distancing for controlling spread of COVID-19 among primary and secondary students and staff: A retrospective, state-wide cohort study

Conclusion: Lower physical distancing policies can be adopted in school settings with masking mandates without negatively impacting student or staff safety.

Journal of Clinical Infectious Disease, March 10, 2021

CDC misinterpreted our research on opening schools. It should loosen the rules now

“Keeping schools closed or even partially closed, based on what we know now is unwarranted, is harming children and has become a human rights issues”

By Dr. Tara O. Henderson, Dr. Monica Gandhi, Dr. Tracy Beth Hoeg, Dr. Daniel Johnson in USA Today, March 9, 2021

Zero COVID Risk is the Wrong Standard

“Whether school poses a small risk or an extremely small risk hardly matters, because the alternative is a social catastrophe that dwarfs any public health effect”

Opinion piece by Jonathon Chiat in the NY Magazine, March 3, 2021

COVID-19 Cases and Transmission in 17 K–12 Schools — Wood County, Wisconsin, August 31–November 29, 2020

Wisconsin study with 5,530 students and staff members in 17 different schools in rural WI. Only 7 (3.7%) of these cases were associated with in-school transmission, all in students. No teachers were infected in school. This was during widespread community transmission with up to 40% positivity. COVID-19 incidence in schools was 37% lower than in the surrounding community.

Morbidity and Mortality Weekly Report, January 29, 2021

Data on COVID in Charleston County School Stuns Doctor who Crunched the Numbers

South Carolina study of 38,000+ students and staff. Only a handful of cases acquired in the classroom and no evidence of transmission from students to teachers.

Article from Medical University of South Carolina, January 19, 2021

Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools

Duke study of 90,000 students and staff in K-12, in 11 different schools over 9 weeks in fall 2020. Only 32 cases of infection were acquired within schools compared to 773 cases of community-acquired infection over the same time period. No instances of child-to-adult transmission were reported within schools.

Journal of the American Academy of Pediatrics, January 8, 2021.

Schools and the Path to Zero: Strategies for Pandemic Resilience in the Face of High Community Spread

Expert panel recommendations on school reopening from Harvard, Brown, Boston and Tufts Universities. “Recommendations to get students back for in-person learning are necessary, for the good of students, and reasonable, because safety can be achieved.”

December 21, 2020

SARS-CoV-2 infection and transmission in educational settings: a prospective, cross-sectional analysis of infection clusters and outbreaks in England

SARS-CoV-2 infections and outbreaks were uncommon in educational settings during the summer half-term in England. The strong association with regional COVID-19 incidence emphasises the importance of controlling community transmission to protect educational settings. Interventions should focus on reducing transmission in and among staff.

The Lancet, December 8, 2020