The aim of this document is to provide an update on the knowledge surrounding the role of children in the transmission of SARS-CoV-2 and the role of schools in the COVID-19 pandemic, based on the experience in the EU from August-December, 2020. This document also addresses transmission to and from staff in school settings, school-related mitigation measures including risk communication, testing, contact tracing and the efficacy of partial and full school closures. This document draws upon and updates evidence presented in the previous report from ECDC on this topic, which was published on August 6, 2020. This report does not consider educational settings related to young adults or adults, such as universities or vocational schools or any school with overnight stays, such as boarding schools. This report does not consider the epidemiology of COVID19 in relation to new variants of SARS-CoV-2, for which robust evidence on the potential impact in school settings is not yet available, such as one recently observed in the United Kingdom. There is a general consensus that the decision to close schools to control the COVID-19 pandemic should be used as a last resort. The negative physical, mental health and educational impact of proactive school closures on children, as well as the economic impact on society more broadly, would likely outweigh the benefits. In surveillance data, among childhood COVID-19 cases, children between 1-18 years of age have lower rates of hospitalisation, severe hospitalisation and death than do all other age groups. Children of all ages are susceptible to and can transmit SARS-CoV-2. Younger children appear to be less susceptible to infection, and when infected, less often lead to onward transmission than older children and adults. This report does not consider the epidemiology of COVID-19 in relation to new variants of SARSCoV-2, for which robust evidence on the potential impact in school settings is not yet available, such as one recently observed in the United Kingdom. School closures can contribute to a reduction in SARS-CoV-2 transmission, but by themselves are insufficient to prevent community transmission of COVID-19 in the absence of other nonpharmaceutical interventions (NPIs) such as restrictions on mass gathering.
COVID-19 in children and the role of school settings in transmission - first update