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Review
. 2021 Dec 16:9:751451.
doi: 10.3389/fpubh.2021.751451. eCollection 2021.

Considerations for the Safe Operation of Schools During the Coronavirus Pandemic

Ronan Lordan  1 , Samantha Prior  2 , Elizabeth Hennessy  1 , Amruta Naik  3 , Soumita Ghosh  1 , Georgios K Paschos  1 , Carsten Skarke  1 , Kayla Barekat  1 , Taylor Hollingsworth  1 , Sydney Juska  1 , Liudmila L Mazaleuskaya  1 , Sarah Teegarden  1 , Abigail L Glascock  1   4 , Sean Anderson  1 , Hu Meng  1 , Soon-Yew Tang  1 , Aalim Weljie  1   5 , Lisa Bottalico  1   5 , Emanuela Ricciotti  1   5 , Perla Cherfane  1 , Antonijo Mrcela  1 , Gregory Grant  1   6 , Kristen Poole  7 , Natalie Mayer  1 , Michael Waring  8 , Laura Adang  9 , Julie Becker  10 , Susanne Fries  1 , Garret A FitzGerald  1   5 , Tilo Grosser  1   5
Affiliations
Review

Considerations for the Safe Operation of Schools During the Coronavirus Pandemic

Ronan Lordan et al. Front Public Health. .

Abstract

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, providing safe in-person schooling has been a dynamic process balancing evolving community disease burden, scientific information, and local regulatory requirements with the mandate for education. Considerations include the health risks of SARS-CoV-2 infection and its post-acute sequelae, the impact of remote learning or periods of quarantine on education and well-being of children, and the contribution of schools to viral circulation in the community. The risk for infections that may occur within schools is related to the incidence of SARS-CoV-2 infections within the local community. Thus, persistent suppression of viral circulation in the community through effective public health measures including vaccination is critical to in-person schooling. Evidence suggests that the likelihood of transmission of SARS-CoV-2 within schools can be minimized if mitigation strategies are rationally combined. This article reviews evidence-based approaches and practices for the continual operation of in-person schooling.

Keywords: COVID-19; SARS-CoV-2; education; multisystem inflammatory syndrome in children (MIS-C); pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS); post-acute sequelae of SARS-CoV-2 infection (PASC); vaccination.

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Conflict of interest statement

LA serves on the medical advisory board of the MLD Foundation, CureMLD and “Don't Forget Morgan”. She is a consultant for Orchard Therapeutics, Biogen, and Takeda. She receives compensation and/or research funding for these roles. Additionally, she serves as an uncompensated member of the Board of Trustees and the scientific COVID-19 advisory committee of the Waldorf School of Philadelphia. GF is a chief scientific advisor for the journal Science Translational Medicine and is a senior advisor to Calico Laboratories and receives compensation for both roles. TG serves as an editor for the journal Circulation Genomic and Precision and receives compensation from the American Heart Association for this work. He was an uncompensated member of the Board of Trustees of the Waldorf School of Philadelphia and serves on the school's scientific COVID-19 advisory committee without compensation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Infection dynamics in schools. Multiple factors and mitigation measures (in blue) modify the probabilities of (P1) infection of students or teachers outside of school, (P2) the import of infection into school, (P3) the spread among students and teachers, (P4) development of prolonged post-acute sequelae of SARS-CoV-2 infection (“long COVID”), (P5) progression to severe acute COVID-19, and (P6) development of multisystem inflammatory syndrome in children (MIS-C), also referred to as pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Viral circulation in the regional population is a key determinant of infection risk of students and teachers. Secondary transmission within schools can amplify infections in the regional population.
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