tag:theconversation.com,2011:/us/topics/coronavirus-and-children-84536/articlesCoronavirus and children – The Conversation2022-02-09T13:23:10Ztag:theconversation.com,2011:article/1752162022-02-09T13:23:10Z2022-02-09T13:23:10ZPandemic-related school closings likely to have far-reaching effects on child well-being<figure><img src="https://images.theconversation.com/files/443545/original/file-20220131-25-nypi1j.jpg?ixlib=rb-1.1.0&rect=49%2C0%2C5521%2C3628&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Schools are wrestling with the consequences of long-term closures because of the pandemic.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/APTOPIXVirusOutbreak-CaliforniaSchools/2a962a3bafab4f62a6737755fc714a7f/photo">AP Photo/Jae C. Hong</a></span></figcaption></figure><p>A global analysis has found that kids whose schools closed to stop the spread of various waves of the coronavirus <a href="https://academic.oup.com/wbro/article/36/1/1/6174606">lost educational progress and are at increased risk of dropping out</a> of school. As a result, the study says, they will <a href="https://www.worldbank.org/en/news/press-release/2021/12/06/learning-losses-from-covid-19-could-cost-this-generation-of-students-close-to-17-trillion-in-lifetime-earnings">earn less money from work over their lifetimes</a> than they would have if schools had remained open. </p>
<p>Educational <a href="https://scholar.google.com/citations?user=C9YZiOsAAAAJ&hl=en&oi=ao">researchers like me</a> know these students will feel the <a href="https://en.unesco.org/covid19/educationresponse/consequences">effects of pandemic-related school closures</a> for many years to come. Here are four other ways the closings have affected students’ well-being for the long term.</p>
<h2>1. Academic progress</h2>
<p>At the end of the 2020-2021 school year, most students were about <a href="https://www.mckinsey.com/industries/education/our-insights/covid-19-and-education-the-lingering-effects-of-unfinished-learning">four to five months behind</a> where they should have been in math and reading, according to a July 2021 report by McKinsey and Co., a global management consulting firm.</p>
<p>When the researchers looked at the data from fall 2021, though, they found <a href="https://www.mckinsey.com/industries/education/our-insights/covid-19-and-education-an-emerging-k-shaped-recovery">students attending majority-white schools are catching up</a>. But students from historically disadvantaged backgrounds – including those attending majority-Black or low-income schools – are falling further behind. As a result, students attending majority-Black schools are now estimated to be a full year behind those attending majority-white schools.</p>
<p>Differences also can vary by grade level. High schools have been <a href="https://www.nber.org/system/files/working_papers/w29398/w29398.pdf">closed more total days</a> than elementary schools. According to a recent news report, <a href="https://www.chalkbeat.org/2022/1/24/22895461/2021-graduation-rates-decrease-pandemic">2021 graduation rates dipped</a> across the country, and some education leaders fear future graduating classes may be hit even harder. Schools have scrambled to provide options such as credit recovery to boost graduation rates, leaving concerns about the quality of learning. </p>
<p>College and university leaders have been <a href="https://www.colorado.edu/center/teaching-learning/2021/09/01/assessingu-should-we-worry-about-learning-loss">preparing</a> for first-year students with less knowledge, weaker study habits and more difficulty concentrating than new college arrivals in past years.</p>
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<a href="https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Children wearing masks sit on a classroom floor" src="https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/443547/original/file-20220131-118117-1td8b9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Schools are adapting their classroom procedures to prevent the spread of disease.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/VirusOutbreakStandardizedTests/7ce902458dfc4acdabc13b3c557ae50b/photo">AP Photo/Mary Altaffer</a></span>
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<h2>2. Social-emotional development</h2>
<p>Even early in the pandemic, <a href="http://doi.org/10.1001/jamapediatrics.2021.5840">school closings were harming students’ social and emotional well-being</a>, according to a review of 36 studies across 11 countries including the U.S. By summer 2021, <a href="https://www.mheducation.com/prek-12/explore/sel-survey.html">teachers and administrators in the U.S.</a> said students felt more emotional distress, disengagement, depression, anxiety and loneliness than in previous years.</p>
<p>When schools resumed in fall 2021, large numbers of children in the U.S. had <a href="https://doi.org/10.1016/S0140-6736(21)01253-8">lost a primary caregiver</a> over the previous year to COVID-19. A colleague and I raised concerns about the <a href="https://theconversation.com/students-are-returning-to-school-with-anxiety-grief-and-gaps-in-social-skills-will-there-be-enough-school-mental-health-resources-165279">anxiety and grief</a> those students would likely feel.</p>
<p>In addition, <a href="https://www.mckinsey.com/industries/education/our-insights/covid-19-and-education-an-emerging-k-shaped-recovery">28% of all parents</a> of children in grades K-12 are “very concerned” or “extremely concerned” about their child’s mental health and social and emotional well-being. That’s down from a high of 35% in spring 2021, but is still 7 percentage points higher than before the pandemic. Parents of Black and Hispanic students are 5 percentage points more likely to be worried than parents of white students.</p>
<p>Schools and organizations have focused resources on supporting students’ social, emotional and mental health. The <a href="https://www.ed.gov/news/press-releases/us-department-education-releases-new-resource-supporting-child-and-student-social-emotional-behavioral-and-mental-health-during-covid-19-era">U.S. Department of Education</a>, for example, recommends, based on research, that teachers integrate lessons around compassion and courage into classroom activities, and that schools establish wellness teams to help students.</p>
<p>States have said they plan to address these needs with <a href="https://www.ncsl.org/ncsl-in-dc/standing-committees/education/cares-act-elementary-and-secondary-school-emergency-relief-fund-tracker.aspx">federal funds meant to help schools respond to the pandemic</a>. In <a href="https://ctmirror.org/2021/11/26/school-age-children-are-seeking-out-mental-health-care-more-than-ever/">Connecticut</a>, for example, school districts will hire additional mental health support staff, offer social-emotional programs and partner with local agencies to increase access to supports. </p>
<h2>3. Behavioral habits</h2>
<p>The return to in-person learning has been accompanied by school leaders’ <a href="https://www.edweek.org/leadership/threats-of-student-violence-and-misbehavior-are-rising-many-school-leaders-report/2022/01">reports</a> of increasing student misbehavior and threats of violence. These increases were more likely to be reported in larger districts and where most students had engaged in remote or hybrid learning – rather than in-person instruction – during the prior school year.</p>
<p>Viral social media “challenges” – like memes on TikTok suggesting students “<a href="https://www.distractify.com/p/tiktok-school-challenges-list-2021">smack a staff member</a>” or skip school on a particular day – certainly aren’t helping educators provide safe and supportive environments. </p>
<p>Parents’ distress is also affecting their children. Students whose parents are depressed, anxious, lonely and exhausted are <a href="https://doi.org/10.1016/j.appdev.2021.101375">more likely to misbehave in school</a> – and <a href="https://doi.org/10.1016/j.appdev.2021.101375">that connection grew stronger</a> during lockdown periods when schools were closed.</p>
<p>Meanwhile, news reports show students are <a href="https://edsource.org/2021/absenteeism-surging-since-schools-reopened/661507">missing more school</a> than they were before the pandemic, with more kids out for more than 15 days of a school year. Given <a href="https://link.springer.com/article/10.1007/s10964-019-01072-5">links</a> between chronic absenteeism and increased high school dropout rates, <a href="https://www.mckinsey.com/industries/education/our-insights/covid-19-and-education-an-emerging-k-shaped-recovery">researchers warn</a> this increase in missed school could lead between 1.7 million and 3.3 million students in eighth through 12th grade to not graduate on time.</p>
<h2>4. Physical health</h2>
<p>Adults have suffered <a href="https://www.asrn.org/journal-nursing/2665-the-pandemic-body-how-the-covid-era-changed-us-%E2%80%93-from-hair-loss-to-weight-gain.html">hair loss, sore eyes, irritable bowels and skin flare-ups</a> as a result of the pandemic. One study found that Chinese preschool children whose schools closed during the pandemic <a href="https://doi.org/10.1038/s41366-021-00912-4">were shorter than preschoolers</a> in previous years, though the researchers did not observe noteworthy differences in weight change. </p>
<p>Schools can be a primary place for children to access physical activity and healthy food. Amid school closures, researchers are exploring the effects of losing out on these benefits. During lockdowns in Italy, <a href="https://doi.org/10.1002/oby.22861">children with obesity engaged in less physical activity</a>, slept and used screens more and increased their consumption of potato chips and sugary drinks.</p>
<p>In the U.S., <a href="https://doi.org/10.1056/NEJMp2033629">1 in 4 families</a> with school-age children don’t have reliable access to food. Abrupt school closures cut off <a href="https://doi.org/10.1056/NEJMp2033629">more than 30 million children</a> from free and reduced-price lunches and breakfasts delivered at school.</p>
<p>The U.S. Department of Agriculture, which oversees school food programs, provided waivers to <a href="https://www.fns.usda.gov/fns-disaster-assistance/fns-responds-covid-19/child-nutrition-covid-19-waivers-previous-school-years">let schools provide meals</a> in ways that fit their students’ needs. In Connecticut, for example, researchers found that letting families know about wider availability and pickup sites for to-go school meals <a href="https://doi.org/10.5304/jafscd.2021.102.020">boosted the number of students who received food</a> during the pandemic.</p>
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<p>Time will tell if the costs of school closings will be <a href="https://doi.org/10.1001/jamanetworkopen.2020.28786">worth the benefits</a>. These early indicators show that decisions are not as simple as reducing the physical health risks of COVID-19. A full assessment would consider the effects across all aspects of child well-being, including how diverse populations are affected. </p>
<p>Connection, collaboration and positive interaction are fundamental to <a href="https://www.tandfonline.com/doi/full/10.1080/10888691.2018.1515296">healthy childhood</a> growth and development. Working together, schools, families and communities can <a href="https://doi.org/10.3389/fpsyg.2021.758788">assess and address every child’s needs</a> to reduce the lasting effects of school closings.</p><img src="https://counter.theconversation.com/content/175216/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sandra M. Chafouleas receives funding from the National Institutes of Health, U.S. Department of Education, Connecticut State Department of Education, the Neag Foundation, and the Principal Foundation.</span></em></p>The ways in which school closings affect children are just beginning to be known, but early indications are they’re taking a negative toll on kids’ learning and overall well-being.Sandra M. Chafouleas, Professor of Educational Psychology, University of ConnecticutLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1583892021-04-13T12:42:36Z2021-04-13T12:42:36ZWhy student athletes need a new playbook to stay safe in the COVID-19 era<figure><img src="https://images.theconversation.com/files/394410/original/file-20210412-15-tg9yf8.jpg?ixlib=rb-1.1.0&rect=632%2C265%2C3822%2C2479&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">High school water polo player Cami Rowan gets to work out in the home pool in Corona, Calif. on Feb. 18, 2021.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/high-school-water-polo-player-cami-rowan-gets-to-work-out-news-photo/1231256506?adppopup=true">Frederic J. Brown/AFP/Getty images</a></span></figcaption></figure><p>Kids are eager to play ball, and parents are eager to be back on the sidelines supporting them. But <a href="https://www.washingtonpost.com/health/2021/04/06/youth-sports-outbreaks-covid-testing/">COVID-19 cases have risen</a> in places where kids have been playing sports, complicating the issue. </p>
<p>Michigan, where I live, is now the <a href="https://www.msn.com/en-us/health/medical/michigan-leads-us-with-highest-number-of-covid-19-cases-per-capita/vi-BB1fk41b">epicenter of COVID-19 cases</a> in the U.S. The resumption of youth sports activities has been widely implicated in Michigan’s latest COVID-19 surge, with <a href="https://www.cbsnews.com/news/covid-michigan-cases-spike-kids/">40% of new outbreaks</a> occurring in K-12 schools or youth programs.</p>
<p>Experts also blame Michigan’s unprecedented rise to the top on an unfortunate mixture of reopening, <a href="https://www.wilx.com/2021/04/07/covid-19-numbers-continue-to-surge-with-michigan-not-slowing-down/">virus variants and COVID-19 fatigue</a>.</p>
<p>As an <a href="https://education.wayne.edu/profile/gr7894">exercise scientist and clinician</a>, I believe that <a href="https://doi.org/10.1016/j.joep.2012.02.007">sports participation</a> – and <a href="https://doi.org/10.1186/s41256-018-0068-9">even watching sports</a> – has health and social benefits which far exceed winning and losing. My physiologist brain, however, argues that at this very moment, people should be focusing their energy not against each other, but rather toward defeating the world’s deadliest team: SARS-CoV-2, or, if you will, Team Coronavirus. </p>
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<img alt="Two teenagers practicing volleyball." src="https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/394415/original/file-20210412-23-tibnu6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Teens practiced volleyball in Gilbert, Ariz. on March 25, 2020, shortly after schools shut down there.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/VirusOutbreakArizona/a8fc51bb049a462b817d2618be427c7d/photo?Query=kids%20playing%20sports%20coronavirus&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=10&currentItemNo=5">Matt York/AP</a></span>
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<h2>Humans as the underdog</h2>
<p>Parents in Michigan have started a group called <a href="https://www.msn.com/en-us/sports/more-sports/let-them-play-ca-settles-lawsuit-all-sports-allowed-to-return/ar-BB1efjnT">Let Them Play Michigan</a> to press the issue. Specifically, the group opposes mandatory weekly testing of student athletes, which the state requires, and quarantining of young athletes who test positive.</p>
<p>Recently, Let Them Play Michigan <a href="https://www.msn.com/en-us/news/us/youth-sports-lawsuit-could-cut-mandatory-testing-and-quarantine-from-michigan-schools/ar-BB1ftdTL">filed a lawsuit</a> against the state of Michigan to ease mandatory testing restrictions in high school athletes, arguing that the state health department does not have the authority to issue these restrictions.</p>
<p>I still consider myself an athlete, even though jogging three miles a day is a low performance bar. That’s why at an emotional level, the <a href="https://www.msn.com/en-us/sports/more-sports/let-them-play-ca-settles-lawsuit-all-sports-allowed-to-return/ar-BB1efjnT">Let Them Play</a> youth sports movement touches my heart, since athletes resent anything that keeps them off the field, court or pitch.</p>
<p>So I suggest public health experts, parents and other stakeholders consider the issue through the lens of sports – Team People against Team Coronavirus. Team Coronavirus is focused solely on winning (survival) and will seize upon any <a href="https://doi.org/10.1038/s41385-020-00340-z">mammal</a> with properly fitting <a href="https://doi.org/10.1038/s41593-020-00771-8">ACE2 (angiotensin converting enzyme 2), liver heparin or other receptors high in sialic acid</a>. Once Team Coronavirus invades a cell’s nucleus, the virus delivers instructions to replicate, particularly within lung and upper airway cells. </p>
<p>Once a person is infected, <a href="https://doi.org/10.1016/S1473-3099(20)30484-9">millions</a> of coronavirus particles can <a href="https://doi.org/10.1063/5.0026360">spew out</a> of an infected host’s <a href="https://doi.org/10.1016/S1473-3099(20)30484-9">nose and mouth</a> with every breath, cough, sneeze or word spoken. It can even exit through the <a href="https://doi.org/10.1093/gastro/goaa067">rectum</a>. The SARS-CoV-2 virus can also enter our bodies through the <a href="https://doi.org/10.1016/j.immuni.2021.01.017">mucous membranes of our eyes</a>, as fast as cutting an onion can make us cry. </p>
<p>A particularly daunting skill set of Team Coronavirus is its ability to change shape and <a href="https://doi.org/10.1016/j.cell.2021.03.013">evade the Team People’s defense, or immune, system</a>. So think of it like a new team taking the court after half-time. Not only have the players never seen this team, but the coaches haven’t seen the films. </p>
<p>The possibility that Team Coronavirus can hide undetected within tissue reservoirs, such as in the <a href="https://doi.org/10.1038/s41593-020-00771-8">brain</a>, <a href="https://doi.org/10.1016/j.tmaid.2020.101642">nervous system</a>, <a href="https://doi.org/10.1016/j.immuni.2021.01.017">eyes</a>, <a href="https://doi.org/10.1001/jamacardio.2020.3551">heart</a> or <a href="https://doi.org/10.1111/ajt.16532">lungs</a>, is another under-recognized skill of SARS-CoV-2. Scientists hypothesize that this ability may contribute to its persistence in both <a href="https://doi.org/%2010.1056/NEJMoa2001316">acute</a> and <a href="https://doi.org/10.1038/s41591-021-01283-z">chronic</a> disease states, such as long haulers’ COVID-19. </p>
<p>Given our current understanding of Team Coronavirus’ expanding playbook, is it possible to safely let kids play sports during a pandemic, without some restrictions?</p>
<h2>The NBA did it, but at a high cost</h2>
<p>The success of the <a href="https://www.forbes.com/sites/tommybeer/2020/10/20/report-nbas-bubble-prevented-15-billion-in-losses/?sh=1a0db5e43823">NBA Bubble</a> demonstrates that competitive sports can be performed safely – and without vaccines – by adhering to strict safety protocols. That includes rigorous – meaning daily – testing, isolation and quarantine measures. </p>
<p>The <a href="https://en.wikipedia.org/wiki/2020_NBA_Bubble">financial cost</a> of allowing 22 NBA teams to compete over about 100 days was about US$190 million, with additional, intangible <a href="https://www.msn.com/en-us/sports/nba/lebron-james-admits-he-s-thought-about-leaving-bubble/ar-BB18w5b2">mental health and emotional costs</a> experienced by players and coaches. </p>
<p>However, the bubble clearly showed that Team Coronavirus can be defeated, but with significant personal and financial sacrifice.</p>
<p>The irony of the youth sports movement, as detailed in the current <a href="https://www.wilx.com/2021/04/02/let-them-play-group-files-lawsuit-against-michigan-due-to-mandatory-athlete-testing/">Let Them Play Michigan lawsuit</a>, is the unsportsmanlike intention to cut corners on the evidenced-based safety measures in order for the kids to play. Adults filing the lawsuit on kids’ behalf are suggesting that weekly testing is too much, or that quarantining if an infection is found is too onerous. This parental response may be because kids are complaining. </p>
<p>Adults cannot let kids make these decisions. Despite the best of intentions, <a href="https://doi.org/10.1001/jamanetworkopen.2020.31509">adolescents are poor judges of health risks</a>. Sure, they may not want to accept weekly COVID-19 testing, but adults need to make sure they follow the rules. The NBA’s experience shows that testing should be an essential part of the rules.</p>
<p>One of Team Coronavirus’ most devastating offensive plays is its invisibility, or <a href="https://doi.org/10.1001/jamanetworkopen.2020.35057">asymptomatic spread</a>. Regular COVID-19 testing, as a major defensive strategy, identifies genetic material from Team Coronavirus so that any infected players can promptly be removed from play, limiting the spread of COVID-19 by removing their best players – superspreaders with high viral loads. This is why quarantining is so important. </p>
<p>Another highly effective defensive strategy against Team Coronavirus is covering both mouths and noses with masks to limit the airborne transfer of viral particles between players. The argument that masks are ineffective is true when face masks are not worn correctly (as widely seen around the chin).</p>
<p>If regular testing and wearing masks during games could save the life of a beloved <a href="https://www.nbcwashington.com/news/sports/nbcsports/college-football-player-jamain-stephens-jr-dies-after-complications-from-covid-19/2413981/">football player</a>, fellow <a href="https://www.nytimes.com/2020/09/29/us/college-student-dies-covid.html">basketball-playing exercise science student</a> or collegiate <a href="https://abcnews.go.com/Sports/alabama-basketball-fans-death-prompts-covid-19-contact/story?id=76860269">March Madness superfan</a>, how can parents and coaches not consider such minor inconveniences to save a coach’s, parent’s or teammate’s life?</p>
<p>Every COVID-19 death is preventable. Every loss, unconscionable. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/91RfrP9bosw?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">CDC Director Rochelle Walensky discusses youth sports and coronavirus spread.</span></figcaption>
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<h2>Going into overtime</h2>
<p>One scary consequence of COVID-19 is the potential for <a href="https://doi.org/10.1038/s41591-021-01283-z">long-lasting disability</a> in those infected with SARS-CoV-2. While people itching for normalcy may think of an attack by Team Coronavirus as a “one-and-done” affair, post-infective fatigue, mental debility, neuralgia and psychoses are just getting started in patients with long-haul cases. </p>
<p>A growing body of evidence suggests that recovery from asymptomatic or mildly symptomatic COVID-19 may be associated with residual <a href="https://doi.org/10.1001/jamacardio.2020.4916">inflammation around the heart</a>, <a href="https://doi.org/10.1152/ajpheart.00897.2020">impairment of blood flow</a>, <a href="https://doi.org/10.1101/2020.10.14.20212555">multi-organ impairment</a> (brain, lungs, kidney, liver, pancreas and spleen), <a href="https://doi.org/10.1101/2020.11.24.20238261">sustained fatigue and exercise intolerance</a>.</p>
<p>This post-COVID-19 syndrome is recognized as “<a href="https://doi.org/%2010.1001/jama.2020.17709">long-haulers</a>” syndrome worldwide and causes <a href="https://doi.org/10.1016/j.tins.2020.10.009">neurologic dysfunction</a> and debilitating fatigue in both <a href="https://doi.org/10.1371/journal.pone.0240784">young adults</a> and <a href="https://doi.org/10.1111/apa.15673">children</a>. </p>
<p>The SARS epidemic from 2003 provides a cautionary tale. In fact, 40.3% of patients who were diagnosed with SARS-CoV-1 faced chronic fatigue, and 42.5% experienced psychiatric illness <a href="https://doi.org/10.1001/archinternmed.2009.384">up to four years later</a>. </p>
<h2>Let them play, but with firm rules in place</h2>
<p>The question for parents, public health officials and school officials is: How do we let kids play and keep them safe? I believe there are ways to do this.</p>
<ul>
<li><p>Get tested regularly.</p></li>
<li><p>Wear masks properly – block virus transmission by covering both the mouth and nose.</p></li>
<li><p>Embrace shared sacrifice.</p></li>
<li><p>Support one another – sustained sacrifice is hard, so work together and check in regularly with teammates.</p></li>
<li><p>Play outside – or have adequate ventilation inside to disperse viral particles.</p></li>
<li><p><a href="https://doi.org/10.1016/j.cell.2020.09.040">Get vaccinated</a>. </p></li>
</ul>
<p>As current underdogs, athletes, coaches, parents and fans need to dig deep, embrace discomfort and beat this virus once and for all.</p>
<p>[<em>Get facts about coronavirus and the latest research.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=coronavirus-facts">Sign up for The Conversation’s newsletter.</a>]</p><img src="https://counter.theconversation.com/content/158389/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tamara Hew-Butler does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Kids want to play sports again, and who can blame them? An exercise scientist and physiologist explains why adhering to safety protocols is imperative.Tamara Hew-Butler, Associate Professor of Exercise and Sports Science, Wayne State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1427062020-07-22T11:58:33Z2020-07-22T11:58:33ZHow other countries reopened schools during the pandemic – and what the US can learn from them<figure><img src="https://images.theconversation.com/files/348707/original/file-20200721-19-1oxa443.jpg?ixlib=rb-1.1.0&rect=411%2C74%2C4580%2C2994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Class is in session in Uruguay, one of the first countries in the Western Hemisphere to reopen its schools. </span> <span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/APTOPIX-Virus-Outbreak-Uruguay/f51b789442b54e789666b36e87ffed29/1/0">AP Photo/Matilde Campodonico</a></span></figcaption></figure><p>As American school officials debate when it will be safe for schoolchildren to return to classrooms, looking abroad may offer insights. Nearly every country in the world <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/apa.15432">shuttered their schools early in the COVID-19 pandemic</a>. Many have since sent students back to class, with varying degrees of success.</p>
<p>I am a <a href="https://spcs.richmond.edu/people/bspires/">scholar of comparative international education</a>. For this article, I examined what happened in four countries where K-12 schools either stayed open throughout the pandemic or have resumed in-person instruction, using press reports, national COVID-19 data and <a href="https://globalhealth.washington.edu/sites/default/files/COVID-19%20Schools%20Summary%20%282%29.pdf?mkt_tok=eyJpIjoiTkRreE5XWXlORFF3TXpNeCIsInQiOiJIbVNQTTVySEo0Vzk1cHVBZVVqWnFGVmR1UEJxRGdpd01mTXg4OGw3Mk5nTnpmaUoyMGt2UXIwWVZBOE5GVjIybHA5aStrbzJ3MUxsanoxamZibmlocmpSbXZyVFVoV0VHYU1aTGx0RnpsMXlmOEtXSVJqaDJsZ0RJU1BQcVZjZSJ9">academic studies</a>. </p>
<p>Here’s what I found.</p>
<h2>Israel: Too much, too soon</h2>
<p>Israel took stringent steps early on in the coronavirus pandemic, including severely restricting everyone’s movement and closing all schools. By June, it was being <a href="https://www.cnn.com/2020/07/08/middleeast/israel-coronavirus-second-wave-netanyahu-intl/index.html">lauded internationally</a> for containing the spread of COVID-19.</p>
<p>But shortly after schools reopened in May, on a <a href="https://www.ft.com/content/224fa625-657c-4ffb-a6a0-a40e04d685b9">staggered schedule paired with mask mandates and social distancing rules</a>, COVID-19 cases <a href="https://twitter.com/DrEricDing/status/1278682387325616129">surged</a> across Israel. <a href="https://www.thedailybeast.com/israeli-data-show-school-openings-were-a-disaster-that-wiped-out-lockdown-gains">Schoolchildren and teachers</a> were among the sick. Today, <a href="https://www.sciencemag.org/news/2020/07/school-openings-across-globe-suggest-ways-keep-coronavirus-bay-despite-outbreaks">several hundred Israeli schools have closed again</a>. </p>
<p>Some blame <a href="https://www.vox.com/2020/7/15/21324082/coronavirus-school-reopening-trump-children-safety">lax enforcement of health guidelines</a> in schools. The weather didn’t help: In May, a <a href="https://www.sciencemag.org/news/2020/07/school-openings-across-globe-suggest-ways-keep-coronavirus-bay-despite-outbreaks">record heat wave hit Israel</a>, making masks uncomfortable for students to wear. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Children wearing face masks walk close together with an adult" src="https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/348709/original/file-20200721-25-1xczr28.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">No social distancing here, Tel Aviv, July 6, 2020.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Virus-Outbreak-Israel/1266fc7e9be44f51920286f6e0c1a2ba/1/0">AP Photo/Sebastian Scheiner</a></span>
</figcaption>
</figure>
<p>But schools were only part of a broader reopening in Israel that, many experts say, <a href="https://www.timesofisrael.com/where-we-went-wrong-expert-says-these-3-blunders-caused-new-israeli-covid-chaos/">came too soon and without sufficient testing capacity</a>. </p>
<p>[<em>Get facts about coronavirus and the latest research.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=coronavirus-facts">Sign up for The Conversation’s newsletter.</a>]</p>
<p>“The reopening happened too fast,” said <a href="https://www.thedailybeast.com/israeli-data-show-school-openings-were-a-disaster-that-wiped-out-lockdown-gains">Mohammed Khatib, an epidemiologist on Israel’s national COVID-19 task force</a>. “It was undertaken so quickly that it triggered a very sharp spike, and the return to more conservative measures came too little, much too late.”</p>
<p>Israel’s public health director, Siegal Sadetski, resigned in early July, saying the health ministry had ignored her warnings about <a href="https://www.nbcnews.com/news/world/israel-battles-new-wave-coronavirus-infections-after-reopening-n1233139">reopening schools and businesses</a> so rapidly.</p>
<h2>Sweden: A hands-off approach</h2>
<p>Schools never closed in Sweden, part of the Scandinavian country’s risky <a href="https://www.nytimes.com/interactive/2020/05/15/world/europe/sweden-coronavirus-deaths.html">gamble on skipping a coronavirus lockdown</a>. Only students 16 and older stayed home and did remote learning. <a href="https://www.nationalgeographic.com/history/2020/05/sweden-hasnt-locked-down-but-normal-life-is-a-luxury/">Social distancing</a> and <a href="https://www.sciencemag.org/news/2020/07/school-openings-across-globe-suggest-ways-keep-coronavirus-bay-despite-outbreaks">masks were recommended but optional</a>, in line with the Swedish government’s emphasis on personal choice. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="People sit at tables inside a small restaurant" src="https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/348706/original/file-20200721-27-1j24pw1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A restaurant in Stockholm still full of diners, March 25, 2020.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Virus-Outbreak-Sweden/1f62c6496c1a4f01be9f99339c58c5d0/4/0">AP Photo/David Keyton</a></span>
</figcaption>
</figure>
<p>This strategy earned <a href="https://www.washingtonpost.com/world/europe/schools-reopening-coronavirus/2020/07/10/865fb3e6-c122-11ea-8908-68a2b9eae9e0_story.html">praise from President Donald Trump</a> but some resistance from Swedish parents, especially those whose children have health issues. The government threatened to <a href="https://www.businessinsider.com/coronavirus-sweden-compels-parents-send-kids-to-school-2020-5">punish parents</a> who didn’t send their kids to school. </p>
<p>Sweden’s plan <a href="https://www.axios.com/coronavirus-schools-sweden-denmark-5ff88c81-67e3-4c33-8b74-fe57b9555827.html">seems to have been safe enough</a>. Its health agency reported on July 15 that <a href="https://www.reuters.com/article/us-health-coronavirus-sweden-schools/swedens-health-agency-says-open-schools-did-not-spur-pandemic-spread-among-children-idUSKCN24G2IS">COVID-19 outbreaks among Sweden’s 1 million school children</a> were no worse than those in neighboring Finland, which did close schools. And pediatricians have seen <a href="https://doi.org/10.1093/cid/ciaa864">few severe COVID-19 cases</a> among school-age children in Stockholm. Only <a href="https://www.statista.com/statistics/1107913/number-of-coronavirus-deaths-in-sweden-by-age-groups/">one young Swedish child is believed to have died of the coronavirus</a> as of this article’s publication. </p>
<p>However, officials in Stockholm have admitted they don’t know how the disease may have affected teachers, parents and other adults in schools.</p>
<p>Sweden had <a href="https://www.coronatracker.com/country/sweden/">over 70,000 COVID-19 cases</a> as of July 21, which puts it in the middle of the pack in Europe, according to <a href="https://doi.org/10.1093/cid/ciaa864">a joint study</a> from Sweden’s Upsala University and the University of Virginia. Of those, slightly more than <a href="https://www.folkhalsomyndigheten.se/contentassets/c1b78bffbfde4a7899eb0d8ffdb57b09/covid-19-school-aged-children.pdf">1,000 involved children and teens</a>. </p>
<h2>Japan: So far, so good</h2>
<p>Japan, which has mostly <a href="https://www.coronatracker.com/?country_code=JP">kept COVID-19 under control</a>, took <a href="https://www.washingtonpost.com/world/asia_pacific/japan-coronavirus-schools-reopen/2020/06/06/9047be8c-a645-11ea-8681-7d471bf20207_story.html">a conservative approach</a> to reopening schools in June. </p>
<p>Different schools have <a href="https://english.kyodonews.net/news/2020/06/bdd000c967a7-school-restarts-picking-up-in-japan-amid-lingering-coronavirus-fears.html">different strategies</a>, but generally Japanese students <a href="https://www.japantimes.co.jp/news/2020/05/18/national/japan-schools-reopen-state-of-emergency/">attend class in person on alternating days</a>, so that classrooms are only half full. Lunches are silent and socially distanced, and students undergo daily temperature checks. </p>
<p>These precautions are <a href="https://globalhealth.washington.edu/sites/default/files/COVID-19%20Schools%20Summary%20%282%29.pdf?mkt_tok=eyJpIjoiTkRreE5XWXlORFF3TXpNeCIsInQiOiJIbVNQTTVySEo0Vzk1cHVBZVVqWnFGVmR1UEJxRGdpd01mTXg4OGw3Mk5nTnpmaUoyMGt2UXIwWVZBOE5GVjIybHA5aStrbzJ3MUxsanoxamZibmlocmpSbXZyVFVoV0VHYU1aTGx0RnpsMXlmOEtXSVJqaDJsZ0RJU1BQcVZjZSJ9">more stringent than those in many other countries</a>. Still, some Japanese school children have <a href="https://english.kyodonews.net/news/2020/06/bdd000c967a7-school-restarts-picking-up-in-japan-amid-lingering-coronavirus-fears.html">gotten COVID-19</a>, particularly in major cities. </p>
<p>A survey from Save the Children found that Japanese school children <a href="https://www.nippon.com/en/japan-data/h00744/">wanted more clear and detailed information</a> about the virus and the outbreaks. <a href="https://www.japantimes.co.jp/news/2020/04/06/national/japan-parents-back-to-school-coronavirus/">Parents</a>, students and <a href="https://japan-forward.com/what-its-like-going-back-to-school-after-the-coronavirus-emergency/">teachers</a> continue to express hesitancy about returning to school and <a href="https://www.japantimes.co.jp/news/2020/06/09/national/japanese-students-coronavirus-measures-school/">displeasure over reopening measures</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Nurse in protective gear takes the temperature of a small child" src="https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/348720/original/file-20200721-35-wmj61x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Temperature check at Kinugawa Elementary School in Nikko, Japan, June 3, 2020.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/pupil-has-her-temperature-taken-by-a-school-nurse-at-news-photo/1217222086?adppopup=true">Carl Court/Getty Images</a></span>
</figcaption>
</figure>
<h2>Uruguay: A+ for safety</h2>
<p>Analysts credit Uruguay’s <a href="https://www.wlrn.org/post/small-uruguay-big-proof-committing-public-health-can-contain-covid-19#stream/0">well-organized and efficient public health system</a> and Uruguyans’ <a href="https://theconversation.com/uruguay-quietly-beats-coronavirus-distinguishing-itself-from-its-south-american-neighbors-yet-again-140037">strong faith in government</a> for its success stopping the coronavirus. The progressive South American country of 3.4 million has the region’s <a href="https://www.wlrn.org/post/small-uruguay-big-proof-committing-public-health-can-contain-covid-19#stream/0">lowest rates of COVID-19 cases and deaths</a>, and it never shut down its economy entirely. </p>
<p>Uruguay was one of the Western Hemisphere’s first countries to send its students back to school, using a <a href="https://blogs.iadb.org/educacion/en/uruguayreopening/">staged approach</a>. </p>
<p>In late April, Uruguay <a href="https://www.elobservador.com.uy/nota/gobierno-anuncio-que-el-22-de-abril-se-pueden-retomar-las-clases-en-973-escuelas-rurales-202048204622">reopened schools in rural areas</a>, where the student population is small. In early June, it brought vulnerable student groups, which were <a href="https://blogs.iadb.org/educacion/en/uruguayreopening/">struggling to access online learning</a>, and high school seniors back into classrooms. Then all students in non-urban areas went back to classrooms. </p>
<p>Finally, on June 29, <a href="https://www.infobae.com/america/america-latina/2020/06/29/uruguay-completa-la-reapertura-de-las-escuelas-256-mil-alumnos-vuelven-a-clase-en-montevideo/">256,000 students in the capital of Montevideo</a> returned to school. An <a href="https://labs.ebanx.com/en/notes/uruguay-one-of-the-first-in-the-americas-to-reopen-schools/">alternating schedule</a> of in-person and virtual instruction reduces the number of students in classrooms at one time. </p>
<p>Uruguay is notable for residents’ <a href="https://www.bloomberg.com/news/articles/2020-06-30/in-midst-of-covid-chaos-one-latin-american-nation-gets-it-right">consistent and early adoption of measures</a> like social distancing and masks. Its successful pandemic response comes despite its <a href="https://www.bloomberg.com/news/articles/2020-06-30/in-midst-of-covid-chaos-one-latin-american-nation-gets-it-right">proximity to hard-hit Brazil</a>, where schools remain closed.</p>
<h2>Final grades</h2>
<p>There is no perfect way to reopen schools during a pandemic. Even when a country has COVID-19 under control, there’s no guarantee that schools can reopen safely.</p>
<p>But the policies and practices of countries that have had some initial success with schools point in the same direction. It helps to slowly stage the reopening. Strict mask wearing and social distancing is critical, both in schools and surrounding communities. And both officials and families need <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/puar.13252">reliable and up-to-date data</a> so that they can continually assess outbreaks – and change course quickly if necessary.</p>
<p><iframe id="uPQAB" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/uPQAB/3/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>That complicates school reopenings in the U.S., with its <a href="https://theconversation.com/experts-agree-that-trumps-coronavirus-response-was-poor-but-the-us-was-ill-prepared-in-the-first-place-133674">soaring COVID-19 cases</a>, limited testing capacity and decentralized education system. Most countries have national education systems. In the U.S., school officials in all 50 states must sort through the same <a href="https://www.nytimes.com/2020/02/28/us/politics/trump-accuses-media-democrats-coronavirus.html">politicized messaging</a> and <a href="https://theconversation.com/coronavirus-numbers-confusing-you-heres-how-to-make-sense-of-them-142624">confusing data</a> as everyone else to make their own decisions about whether, when and how to welcome back students.</p><img src="https://counter.theconversation.com/content/142706/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bob Spires does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Nearly every country in the world shuttered its schools due to COVID-19. Now, from Israel to Uruguay, many students are back in class, with varying degrees of success.Bob Spires, Assistant Professor of Education, University of RichmondLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1345382020-03-25T23:18:57Z2020-03-25T23:18:57ZOther countries are shutting schools – why does the Australian government say it’s safe to keep them open?<p>Victoria <a href="https://www.theguardian.com/world/2020/mar/25/australia-coronavirus-stage-2-shutdown-not-lockdown-which-places-closed-what-open">started school holidays</a> a week early while parents can choose whether to send their children to school in other states. All states and territories are working towards reopening schools in term two. </p>
<p>Prime Minister Scott Morrison <a href="https://www.pm.gov.au/media/press-conference-australian-parliament-house-5">has said</a> the medical expert advice is that it is safe to send your children to school.</p>
<p>This seems inconsistent with other strict quarantine measures the country is adopting to reduce the spread of COVID-19, the disease caused by coronavirus, termed SARS-CoV-2. </p>
<p>People are told not to leave the house if possible. All non-essential travel in and out of the country (and between some states) has been banned. Many <a href="https://www.theguardian.com/world/2020/mar/25/australia-coronavirus-stage-2-shutdown-not-lockdown-which-places-closed-what-open">businesses have closed</a> and services, including open house inspections, have been banned. Even funerals are limited to no more than ten people.</p>
<p>Why then are our schools still open? And why are so many other countries closing their schools? </p>
<p>In short, strict quarantine measures have been shown to be more effective in reducing the spread of COVID-19 than closing schools. And many countries where schools have closed had community transmission for too long before putting in measures to prevent it.</p>
<p>But let’s look at it in more detail.</p>
<h2>Children appear to spread the disease less</h2>
<p>There is a lot we still don’t know about COVID-19. But <a href="https://www.businessinsider.com.au/most-us-coronavirus-deaths-ages-65-older-cdc-report-2020-3?r=US&IR=T">we do know</a> children appear to very rarely have serious disease and complications, compared to those in the older age groups like their parents and especially grandparents. </p>
<p>We have a lot of data from a number of countries (<a href="https://www.nejm.org/doi/full/10.1056/NEJMc2005073">China</a>, <a href="https://www.cdc.go.kr/board/board.es?mid=a30401000000&bid=0029">South Korea</a>, <a href="https://toyokeizai.net/sp/visual/tko/covid19/en.html">Japan</a>, <a href="https://www.epicentro.iss.it/coronavirus/bollettino/Infografica_25marzo%20ITA.pdf">Italy</a>) where this pandemic has infected large numbers of people. The data show children have rarely (and in many countries never) died from the infection.</p>
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Read more:
<a href="https://theconversation.com/worried-about-your-child-getting-coronavirus-heres-what-you-need-to-know-131909">Worried about your child getting coronavirus? Here's what you need to know</a>
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<p>Even those under the age of 30 have rarely died from the disease. Children also <a href="https://www.businessinsider.com.au/most-us-coronavirus-deaths-ages-65-older-cdc-report-2020-3?r=US&IR=T">appear to get infected</a> at a much lower rate than those who are older – although we can only confirm that once we have rolled out large-scale testing. </p>
<p>Children can get infected. And both here and in other countries, children with infections have attended schools. But there have been no documented outbreaks in the schools infected children attended and the schools were shut and cleaned.</p>
<h2>Australia has low community transmission</h2>
<p>In Australia (as of March 25) <a href="https://www.health.nsw.gov.au/Infectious/diseases/Pages/covid-19-latest.aspx#statistics">we still have</a> very <a href="https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers">low community transmission</a> of this virus.</p>
<p>Some <a href="https://twitter.com/djoll/status/1242404062999412736?s=20">argue we haven’t detected</a> community transmission because we are not testing enough. Yes, there will be some cases that might be missed – but not many. Australia has <a href="https://thenewdaily.com.au/life/science/2020/03/24/coronavirus-test-kits-australia/">done more than 135,000 tests with only 1%</a> of those tested showing positive results. </p>
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<p>Australia has <a href="https://thenewdaily.com.au/life/science/2020/03/24/coronavirus-test-kits-australia/">one of the highest</a> per capita testing rates in the world and one of the lowest rates of positive diagnoses. And more importantly, current testing includes people who come to hospital with pneumonia, especially if they need to go to the intensive care unit. </p>
<p>If there was already widespread community spread we would be picking up these cases. </p>
<p>The cases we are seeing <a href="https://www.health.nsw.gov.au/Infectious/diseases/Pages/covid-19-latest.aspx#statistics">are overwhelmingly still</a> in returned travellers and in their contacts. Hopefully by quarantining cases and high-risk people (close contacts and returned travellers) for infection, we will be able to limit any ongoing spread in the community. </p>
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Read more:
<a href="https://theconversation.com/covid-19-what-closing-schools-and-childcare-centres-would-mean-for-parents-and-casual-staff-133768">COVID-19: what closing schools and childcare centres would mean for parents and casual staff</a>
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<p>What we are seeing with our rapid increase in numbers is not an uncontrolled epidemic in Australia. It is more a reflection of what has been the uncontrolled community spread of the infection in places like the US and Italy. This is reflected in returned travellers who were in recent months part of those communities and who were or are now quarantined.</p>
<h2>Australia’s situation is different to other countries</h2>
<p>Most of Europe and the United States introduced widespread school closures. This is because they didn’t control community spread <a href="https://www.nytimes.com/2020/03/10/us/coronavirus-testing-delays.html">until very late</a>, and the virus had already been circulating widely without them realising due to less or delayed testing . This is not the case for Australia where there is still little community spread.</p>
<p>There have <a href="https://www.bbc.com/news/business-51639488">not been extended</a> national school closures in some countries where there has been good control with a reversal of the curve and fewer and fewer new cases, such as South Korea and Singapore. </p>
<p>These countries and others have had <a href="https://en.unesco.org/themes/education-emergencies/coronavirus-school-closures">localised school closures</a> in many areas. But this usually occurred where frequent community spread was detected. This may also be what is needed in some areas in Australia.</p>
<p>Data <a href="https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf">released by the Imperial College, London</a> found:</p>
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<p>in the UK and US context, suppression will minimally require a combination of social distancing of the entire population (and especially for those over 70 years of age), home isolation of cases and household quarantine of their family members.</p>
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<p>Most models have been done so far on the assumption the coronavirus spreads in a similar way to influenza (the normal flu). But this doesn’t appear the case. COVID-19 appears to cause many less infections in children than occurs with influenza. While we don’t know the exact infection rates in children, <a href="https://www.cdc.gov/flu/about/keyfacts.htm">symptomatic infections appear</a> to be much lower than what would be expected with influenza .</p>
<p>The Imperial College model assumes household contact rates for student families will increase by 50% during the time schools close. Contacts in the community increase by 25% during closure. </p>
<p>These increased community interactions, such as with grandparents and the community in general, may be why there are worrying findings from their model during the first three months with school closures.</p>
<p>Their model shows that if school closures themselves were our only intervention, that would only have a modest impact on decreasing the demand for hospital beds (14%) and be the least effective of all their modelled interventions. </p>
<h2>But what about teachers?</h2>
<p>Children do get infected but at a much lower rate than other age groups. Some teachers might be at risk, such as those over 60 years old with heart conditions. Those teachers should be be at home anyway and practising even more social distancing than the general population, along with all those over the age of 70 years old. </p>
<p>Higher risk groups <a href="https://theconversation.com/coronavirus-why-should-we-stay-1-5-metres-away-from-each-other-134029">should be decreasing their current contacts</a> and trying to use the 2 meter distancing as well as not letting anyone unwell, such as those with a cold symptoms (including their children and grandchildren) visit. </p>
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Read more:
<a href="https://theconversation.com/no-australia-is-not-putting-teachers-in-the-coronavirus-firing-line-their-risk-is-very-low-134021">No, Australia is not putting teachers in the coronavirus firing line. Their risk is very low</a>
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<p>Closing schools will not likely decrease the spread of the virus by much, but the spread in our community will be associated with lots of potentially long term and detrimental outcomes on children’s education. It will also impact the ability of society to function and deliver essential and other important services. It may even increase deaths from COVID-19 based on some modelling.</p><img src="https://counter.theconversation.com/content/134538/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Collignon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Strict quarantine measures have been shown to be more effective in reducing the spread of COVID-19 than closing schools.Peter Collignon, Professor of Infectious Diseases and Microbiology, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1334252020-03-13T12:02:31Z2020-03-13T12:02:31ZCoronavirus, kids and school closings: A public health expert answers 4 questions<figure><img src="https://images.theconversation.com/files/320305/original/file-20200312-111223-zzg3r5.jpg?ixlib=rb-1.1.0&rect=17%2C25%2C5724%2C3603&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The front gate of New Rochelle High School in New Rochelle, N.Y. The school was closed March 11, 2020 as part of efforts to contain spread of coronavirus.</span> <span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Virus-Outbreak-Containment-Area/32b5d4410f1c432baae285487eafd5c9/2/0">AP Photo/Chris Erhmann</a></span></figcaption></figure><p><em>Leer en <a href="https://theconversation.com/coronavirus-los-ninos-y-las-escuelas-experta-en-salud-publica-contesta-4-preguntas-134314">español</a></em></p>
<p><em>Editor’s note: The World Health Organization has declared a <a href="https://www.cnn.com/2020/03/11/health/coronavirus-pandemic-world-health-organization/index.html">coronoavirus pandemic</a>, and more cases have been announced in several states. Public health scholar <a href="https://scholar.google.com/citations?user=U2cTSqkAAAAJ&hl=en&oi=ao">Aubree Gordon</a> explains why schools across the nation are closing.</em> </p>
<h2>1. Can children get COVID-19?</h2>
<p>Children can catch the virus, SARS-CoV-2, which causes COVID-19, the disease that has infected more than 121,000 and caused more than 4,000 deaths. However, for reasons that we public health officials and physicians do not understand, most <a href="https://www.washingtonpost.com/health/2020/03/10/coronavirus-is-mysteriously-sparing-kids-killing-elderly-understanding-why-may-help-defeat-virus/">children do not seem to get very sick</a> from the infection. In fact, some children may not display any symptoms at all. </p>
<p>In China, where the best clinical data are available, fewer infections were documented in children and teenagers than in older people. This same pattern was seen during the <a href="https://doi.org/10.1097/01.inf.0000247136.28950.41">2002-2003 outbreaks of SARS coronavirus</a>, a virus that is closely related to SARS-CoV-2. </p>
<p>It is not clear whether children may be less susceptible to the virus, meaning that they are less likely to catch it, or if they just have milder symptoms than adults on average, and thus are less likely to be detected as cases. It’s also important to note that there have been no reports of fatal cases of COVID-19 in children under the age of 10. In older children and teenagers, there has only been a single documented death to my knowledge. So, kids are much less likely to get COVID-19 than adults and if they do catch it, they typically have mild illness.</p>
<h2>2. What role do schools play?</h2>
<p>Respiratory viral diseases are spread when people come into contact with one another. This means that any place where people gather in close proximity can lead to viral transmission. </p>
<p><a href="https://www.sciencemag.org/news/2020/03/does-closing-schools-slow-spread-novel-coronavirus?utm_campaign=news_daily_2020-03-10&et_rid=304162689&et_cid=3239727">One of the best ways</a> that we have to help control epidemics or pandemics of viruses like influenza is to close schools. This is because children tend to be very susceptible to common human respiratory viruses. They shed, or pass on, virus at higher levels and for longer than adults, which makes them more likely to transmit the disease. And they typically have poorer hygiene habits than adults. </p>
<p>Thus, most countries’ pandemic plans include plans for school closures. But, it’s important to note that school closures are not guaranteed to reduce transmission. Timing of the closure is very important. Closures early in the epidemic are more likely to be effective, and they may be ineffective if children just gather in other locations.</p>
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<img alt="" src="https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/320288/original/file-20200312-111232-rfy9oq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">New York City Mayor Bill De Blasio, New York City School’s Chancellor Richard Carranza and others greet students as they exit their first day of school Setp. 5, 2019. Carranza and De Blasio have said closing schools is a last resort. Mpi43/MediaPunch/IPX.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Mayor-Bill-De-Blasio-visits-NYC-Schools/512dbdb7036b41ff9f3ce8d1ca754982/66/0">AP Photo/Mpi43/MediaPunch /IPX</a></span>
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<h2>3. Why close schools if children do not get very sick with COVID-19?</h2>
<p>While SARS-CoV-2 appears to rarely cause severe disease in children, it is still possible that children play an important role in transmission. It is important to note that people who have symptoms of respiratory diseases, such as coughing and sneezing, are generally considered to be more infectious than those who are not showing symptoms. That is because the virus spreads when a person coughs or sneezes.</p>
<p>COVID-19 transmits very efficiently, and people do not have pre-existing immunity. Without controls, a large proportion of the population will become infected in any area where the virus circulates. And because of the severity of this virus in older adults, this would cause substantial severe illness and death. </p>
<p>In areas where large outbreaks occur, the health system may become overwhelmed, leading to an increasing fatality rate for COVID-19 and an increase in deaths from all causes. The severity of the situation thus requires communities to do what they can to limit transmission.</p>
<h2>4. If closing schools might help, why not just close them all now?</h2>
<p>It is important to remember that there are a lot of economic and social costs that come with school closures. When schools are closed, children miss out on learning. Extended closures may lead to children falling behind. They also cause an increase in worker absenteeism when parents have to stay home with their kids. That in turn affects the economy as a whole and may undermine key services, such as health care and law enforcement. </p>
<p>From a social perspective, low-income and single-parent households are particularly affected. Employers may not grant paid sick time to workers, leaving parents to choose between leaving children in less-than-ideal care or unsupervised, or not being able to pay for basic needs. </p>
<p>Schools often also serve as an important social support, <a href="https://theconversation.com/americas-poorest-children-wont-get-nutritious-meals-with-school-cafeterias-closed-due-to-the-coronavirus-133341">providing hot meals</a> and needed services to low-income and <a href="http://theconversation.com/coronavirus-could-hit-homeless-hard-and-that-could-hit-everyone-hard-133214">homeless</a> children. Indeed, for this exact reason, New York City leaders have announced that they see <a href="https://www.nytimes.com/2020/03/07/nyregion/nyc-schools-coronavirus.html">school closures as a last resort</a>. Thus, the decision to close schools and when to close them is very complicated and will depend on a number of factors.</p>
<p>[<em>You’re smart and curious about the world. So are The Conversation’s authors and editors.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=youresmart">You can read us daily by subscribing to our newsletter</a>.]</p><img src="https://counter.theconversation.com/content/133425/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aubree Gordon receives funding from the National Institutes of Health. </span></em></p>So far, children have not been as sickened by the coronavirus as adults. So why do officials talk about closing schools? And what does this mean for you as a parent? A public health expert explains.Aubree Gordon, Professor of Public Health, University of MichiganLicensed as Creative Commons – attribution, no derivatives.