The benefits of in-person schooling with mitigations in place outweigh the risks of COVID-19 for children, write Shamez N. Ladhani and the sKIDs Investigation Team in this Perspective. School closures since the beginning of the pandemic have affected not only the education of children, the authors write, but also their social and emotional well-being. Closures have also limited their access to social and welfare services, school meals, and school-based immunizations. The authors highlight several studies of school systems undertaken since 2020 that show that the risk of acquiring SARS-CoV-2 in school remains very low, as has the risk of cases from schools leading to outbreaks in the community. Reasons for lower transmission by children compared to adults remain uncertain, the authors note, but include higher rates of asymptomatic infection, smaller lung capacity, and shorter duration of viral shedding than in adults. Although the risk of severe COVID-19 in children and their households is low, concerns remain about Long Covid in children, and the emergence of more transmissible variants of concern pose additional challenges for educational settings. Vaccinating adults, however, will protect staff and household members against COVID-19, and the attendant lower community infection rates should confer indirect (herd) protection that will help reduce infection risk in children, the authors say. “The focus now must be on assessing and implementing evidence-based mitigations to reduce the risk of infection in schools not only to protect students and staff but also to minimize disruption to education and access to additional services,” they say.
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