Journal Club

Meet You in the Schoolyard: Can Schools Reopen Safely?

Reviewed by Terri Stillwell, MD

With the COVID-19 pandemic crossing the one-year mark, many children in the United States continue their educational efforts virtually to some degree. Recently, two studies in the Morbidity and Mortality Weekly Report characterized COVID-19 trends in younger individuals and analyzed COVID-19 infection rates within several Wisconsin schools. These data provide helpful insights that may inform the ongoing discussions regarding return to in-person schooling.

In the first article, Leidman et al. describe COVID-19 trends among those aged 0 to 24 years, from March 1, 2020, to December 12, 2020. Infection rates in those 0 to 10 years of age were consistently lower when compared to older age groups, with a majority of cases occurring in the 18-to-24-year-old group (57.4%, compared to 10.9% in those 5-10 years of age and 7.4% in those 0-4 years of age). There were no indications that increased incidence in adults was preceded by increases in this younger population, lessening concerns that younger children were driving community transmission.

A subsequent study by Falk et al. analyzed COVID-19 cases across 17 K-12 Wisconsin schools offering in-person schooling during the fall 2020 semester. This study included 4,876 students and 654 staff members. Mask wearing was required for all, with reported student compliance of > 92%. Classrooms were divided into cohorts of 11 to 20 students to minimize interactions. Those with symptoms and close contacts of symptomatic individuals remained at home for the appropriate time periods.

COVID-19 case rates for students and staff were lower than those of the local community by 37%. Only 3.7% of cases were associated with in-school transmission; none of the infections in staff members were linked to in-school transmission. Case investigations showed most transmission occurred outside of school.

These studies suggest that with masking, maintaining small cohorts of students, social distancing, and isolation of symptomatic individuals and their close contacts, transmission of COVID-19 within schools can be mitigated.

(Leidman et al. MMWR Morb Mortal Wkly Rep. 2021;70(3);88–94.)

(Falk et al. MMWR Morb Mortal Wkly Rep. 2021;70(4);136–140.)