Science - USA (2021-11-05)

science.org SCIENCE

PHOTO: WOLFGANG RATTAY/REUTERS

By Shamez N. Ladhani1,2

and the sKIDs Investigation Team

C

hildren have a very low risk of severe

or fatal COVID-19 but, early in the

pandemic, uncertainties about their

role in virus transmission led most

countries to close educational set-

tings as part of national lockdowns

to control the spread of severe acute re-

spiratory syndrome coronavirus 2 (SARS-

CoV-2). In many countries, including parts

of North America and the Asia-Pacific re-

gions, schools remained closed to in-person

teaching for more than a year. School clo-

sures affect not only the education of chil-

dren, but also their social and emotional

well-being, and limit access to social and

welfare services, school meals, and school-

based immunizations. Therefore, under-

standing the role of children in SARS-CoV-2

infection and transmission, and identifying

effective interventions to mitigate risks, are

critical for keeping schools safe for staff,

students, and their families.

Reports early in the pandemic in 2020

indicated that children represented only

a tiny fraction of total cases, hospitaliza-

tions, and deaths due to COVID-19 and

invariably developed mild, transient, and

self-limiting illnesses. Case fatality rates are

strongly associated with age, ranging from

0.1% in <20-year-olds but remaining below

1% among <50-year-olds and then rising

exponentially to 35% among ≥80-year-olds

( 1 ). Moreover, household contact studies

VIEWPOINT: COVID-19

Children and COVID-19 in schools

The benefits of in-person schooling with mitigations in

place outweigh the risks of COVID-19 for children

PERSPECTIVES

INSIGHTS

680 5 NOVEMBER 2021 • VOL 374 ISSUE 6568