Educational continuity is essential to long term social cohesion and economic success. That is why in the context of COVID-19, we must better understand what it might mean to reopen schools so students can continue their education, whilst staying ahead of the virus.

Schools are a unique setting in society: they educate and protect children and create the foundation for a generation’s successes. This is particularly true when girls are educated. Schools provide children with not only education, but are also important sources of mental well-being, security, social well-being and – particularly in poorer communities – food. For many primary and secondary students, schools are also a key location for vaccine campaigns.

Communities around the world are conducting risk assessments to determine whether and how to reopen schools. Drs Mike Ryan and Maria Van Kerkhove from the World Health Organization (WHO) have said: A safe return to school can be managed only at the local level and only if local disease transmission is low.

This means that overcrowded schools with the fewest resources and most socio-economically disadvantaged students will be at a disproportionately high risk for outbreaks.

Going back to school depends on the local epidemiology, the local transmission, the local profile of schools, the size of schools, the density of schools, the resources that schools have.

Dr Mike Ryan, Executive Director, WHO Health Emergencies Programme

The age of the children in a given school will help tailor the risk calculus: younger children will have a harder time complying with precautionary measures (e.g. masking in under 10s), while older children will likely have more inclination to socialize without physical distancing.

The WHO/UNICEF/International Pediatrics Association guidance recommends that:

• children aged up to 5 years should not wear masks for source control;
• for children between 6 and 11 years of age, a risk-based approach should be applied to the decision to use of a mask; and,
• children and adolescents 12 years or older should follow the WHO guidance for mask use in adults.

There is no ”one size fits all” for individual family decisions on returning children to schools – all families will have their own risk profiles, including elderly or vulnerable family members living in the house, that must be considered.

The greatest risk for schools re-opening is for employees who are exposed to people each day they work on campus. These school employees, regardless of the level of educational institution, are at an increased risk of contracting and transmitting COVID because of their contact with a high number of people every day. This includes teachers, administrators, professors, aides, janitorial, grounds, maintenance and security staff.

Many schools are implementing creative, innovative re-opening strategies such as staggering start times, reducing student movement around the school, requiring masks and hybrid approaches (i.e. part in-person learning, part virtual learning environments). However, the decision to or not to reopen schools is complex, depending tremendously on local context and virus transmission rates, and is an obvious source of worry for parents, teachers, and students. Importantly, schools don’t operate in isolation; if there is transmission in communities, there can be transmission in the schools that operate in those communities.

Importantly, testing is no guarantee of a safe return to school because of the high rate of false-negative results with currently available tests. The challenge with false-positives isn’t that the test is inaccurate, but instead in interpreting what the test results might mean: it could mean that one did not have COVID-19 at the time of testing, but developed it later, or that the sample was not collected properly or collected too early in the infection. A negative test doesn’t prevent subsequent infection, so testing provides only a point in time understanding of COVID in a population.