11/20—Childcare and educational institutions unlikely to spread COVID-19 [Rapid review]
COVID-19 in children and the role of school settings in COVID-19 transmission
Available evidence indicates that closures of childcare and educational institutions are unlikely to be an effective single control measure for community transmission of COVID-19 and such closures would be unlikely to provide significant additional protection of children’s health, since most develop a very mild form of COVID-19, if any.
Living Rapid Review Update 10: What is the specific role of daycares and schools in COVID-19 transmission?
The risk of transmission from children to children and children to adults in primary school and daycare settings appears low. Surveillance data of outbreaks in school and daycare settings in the United States is inconsistent with data reported from other jurisdictions. Variation across the United States suggesting levels of community transmission is important is consistent with recent analyses from the United Kingdom and Canada.
Transmission of COVID-19 in school settings and interventions to reduce the transmission: a rapid review
Limited evidence from 2 observational studies suggests that keeping schools open for children younger than 15 years old is not associated with higher infection rates in these children. Evidence from modelling studies suggests that the reopening of schools at reduced capacity is not associated with a second epidemic wave; and that contact tracing strategies are required to control community transmission in case of full return to school.
Evidence summary of potential for children to contribute to transmission of SARS-CoV-2
Three studies (from Ireland, Finland and Singapore) analysed the spread of SARS-CoV-2 from a total of nine confirmed cases (five students and four staff) across eight educational settings. From 1,036 close contacts, no confirmed transmission from a child was reported. Three studies (from Australia, South Korea and Israel) analysed the spread of SARS-CoV-2 from a total of 74 confirmed cases (59 students and 15 staff) across 66 education facilitates to over 13,000 close contacts. In total, 198 (183 linked to student cases and 15 linked to staff cases) additional cases associated with initial cases at their educational settings were reported. Of the 198 cases, 178 were from one study in Israel, the applicability of which is uncertain given concerns about adherence to precautionary measures such as physical distancing and mask wearing. Household or community transmission also cannot be ruled out for these cases.
COVID-19 Transmission in US Child Care Programs
Data were obtained from U.S. child care providers (N=57,335) reporting whether they had ever tested positive or been hospitalized for COVID-19 (N=427 cases). Background transmission rates were controlled statistically. No association was found between exposure to child care and COVID-19 in both unmatched (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.82 to 1.38) and matched (OR, 0.94; 95% CI, 0.73 to 1.21) analyses. In matched analysis, being a home-based provider (as opposed to center-based) was associated with COVID-19 (OR, 1.59; 95% CI, 1.14 to 2.23), but showed no interaction with exposure.
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