Stepwise School Opening and an Impact on the Epidemiology of COVID-19 in the Children

Abstract

Background: Data on severe acute respiratory syndrome coronavirus-2 transmission from a pediatric index patient to others at the school setting are limited. Epidemiological data on pediatric coronavirus disease 2019 (COVID-19) cases after school opening are warranted. Methods: We analyzed data of the pediatric patients with COVID-19 collected from the press release of the Korea Centers for Disease Control and Prevention. Information on the school opening delay and reopening policies were achieved from the press release of the Korean Ministry of Education. Results: The school openings were delayed three times in March 2020. Online classes started from April 9, and off-line (in-person) classes started from May 20 to June 8 at four steps in different grades of students. There was no sudden increase in pediatric cases after the school opening, and the proportion of pediatric cases among total confirmed cases in the nation around 7.0%. As of July 31, 44 children from 38 schools and kindergartens were diagnosed with COVID-19 after off-line classes started. More than 13,000 students and staffs were tested; only one additional student was found to be infected in the same classroom. The proportions of pediatric patients without information on infection sources were higher in older age groups than in younger age groups (17.4% vs. 52.4%, P = 0.014). In the younger age group, 78.3% of children were infected by family members, while only 23.8% of adolescents in the older age group were infected by family members (P < 0.001). Conclusion: Korea had a successful transition from school closure to online and off-line school opening, which did not cause significant school-related outbreak among the pediatric population.

SARS-CoV-2 transmission in K-12 schools in the Vancouver Coastal Health Region: a descriptive epidemiologic study

“…Our findings support the growing body of evidence that schools are likely not a significant driver of SARS-CoV-2 transmission (23,35,36). In concordance with other studies, we found that a household case was the predominant source of infection for school-aged children (30,32), and that school-based acquisitions were uncommon (29,30,32,33).…”

Clinical Characteristics and Transmission of COVID-19 in Children and Youths During 3 Waves of Outbreaks in Hong Kong

“…Other effective public health measures, including travel restrictions, border control, and social distancing, should be enforced to prevent the importation of infections and transmission within the community. 6 , 7 , 27 , 28 Furthermore, when the transmission rate is low, schools could be reopened cautiously 29 and in a staged manner, with strict physical distancing within the campus and regular disinfection with chlorine or alcohol. 26 Additional measures should also be implemented in schools, such as installing plastic partitions between classroom desks or canteen tables, minimizing group activities, reinforcing infection-control measures like teaching students good hand hygiene and monitoring symptoms, providing basic protective equipment to teachers, and incorporating digital teaching tools in classrooms.…”

Preparing for the Coronavirus Disease (COVID-19) Vaccination: Evidence, Plans, and Implications

“…As epidemiological data on COVID-19 have accumulated, evidence has suggested that COVID-19 is less severe in adolescents and infants, 83 and that its transmission in schools is not serious in Korea. 84 Therefore, we can carefully consider resuming in-person classes as part of social reopening.…”