A growing body of evidence indicates that school closures place children and teens at considerable risk for a wide array of physical, emotional, and social harms that far outweigh the risk that they will catch or spread COVID-19. In an open letter published in June, more than 1500 members of the United Kingdom’s Royal College of Paediatrics and Child Health (RCPCH) warned that continued closures risk “scarring the life chances of a generation of young people.”  And the American Academy of Pediatrics has come out forcefully in favor of schools reopening for in-person learning this fall.

The following is an outline of important data regarding the relationship of school closures, COVID-19, and student health. It will be updated as more information becomes available.

Children and teens are much less likely than adults to contract COVID-19

  • MassGeneral: Children appear to have lower attack rates than adults; if exposed to COVID-19 are less likely to become infected.
  • Center for Disease Control (CDC) data show that infants, young children, and teenagers combined have accounted for roughly 5% of coronavirus cases in the U.S.
  • International research confirms that the percentage of children among the confirmed COVID-19 patients is low, ranging from 1% in young children to 6% in older children.
  • In the Netherlands, children aged 0-17 years represent only 1.3% of all reported patients with COVID-19, although they comprise 20.7% of the population.

Children and teens who contract COVID-19 are not likely to become seriously ill

  • MassGeneral: Among children with COVID-19 disease, severe/critical illness and death are rare.
  • Scott W. Atlas, MD, Hoover Institute: “Children under 18 have virtually zero risk of death from [COVID-19], they have virtually zero risk of a serious illness from this.”
  • CDC: Infants, young children and teenagers combined account for 0.06% of all reported deaths from COVID-19. 
  • CNN: The vast majority of children who contract COVID-19 experience mild symptoms and recover easily. 
  • JAMA Pediatrics: Between March 14 and April 3 only 48 children were admitted to 14 pediatric intensive care units in the U.S., and 83% had an underlying condition.
  • Hospitalizations and hospitalization rates for people under the age of 18 remain low. Massachusetts hospitalizations and hospitalizations rates as of June 29, 2020: 
  • JAMA Oncology: Although recent studies have found that adults with cancer have a higher rate of death from COVID-19 than those without cancer, pediatric cancer patients are NOT more likely to acquire COVID-19 than their peers — nor are they more likely than their peers to develop severe illness if they catch it.
  • The Lancet: Although there is a possible emerging inflammatory syndrome associated with COVID-19, similar to Kawasaki disease, the association with Kawasaki disease is small, and the chances of kids’ contracting this new form of the disease appears to be extremely low.
  • Scott W. Atlas, MD, Hoover Institute: Kawasaki disease is “typically treatable and never has been regarded previously as a risk so serious that schools must be shuttered.”
  • The Lancet:  “[I]t is crucial to reiterate—for parents and health-care workers alike—that children remain minimally affected by SARS-CoV-2 infection overall.”

Kids are not super-spreaders

School are not likely to be settings for outbreak clusters and are not likely to be significant sources of transmission

It is doubtful whether school closures this spring helped save lives or even slowed the spread of the virus.

  • JAMA Pediatrics: Data from mainland China, Hong Kong, and Singapore suggest that school closures did not help to control the epidemic
  • JAMA Pediatrics: Modeling studies indicate that, while school closures are an effective means to control the spread of influenza (where attack rates are higher in children than in adults), school closures do not seem to help reduce the spread of COVID-19 (where children are unlikely to spread the virus to adults).
  • The Lancet: School closures may lead to a greater number of deaths than they prevent.
  • Mother Jones: closures have (a) little effect and (b) are not worth the major negative impact they have on students and parents.
  • Mother Jones reports on a study that indicates suggests school closures may have no effect on reducing the spread of the virus and may even increase its spread. This is in contrast to other measures, such as restaurant bans, which do seem effective in slowing the spread. Mother Jones produced the below graphic to summarize the data:

Daycare centers and schools that are open have not seen a spike in cases

  • NPR: “YMCA of the USA and New York City’s Department of Education have been caring for, collectively, tens of thousands of children [of essential workers] since March, and both tell NPR they have no reports of coronavirus clusters or outbreaks.”
  • ProPublica: “We called [New Jersey’s] Department of Health to see if COVID-19 had been spreading within the child care centers that had opened April 1 to serve children of essential workers. There have been no reports of outbreaks of two or more cases, an official said.”
  • Brown University economist Emily Oster: As of Tuesday, June 22, just over 1% of staff and 0.16% of children at 916 day care centers, serving more than 20,000 children, were confirmed infected with the coronavirus.
  • International data is consistent with these findings. A study conducted in Iceland showed that child care facilities and schools were not the source of chains of infection.
  • On June 10, an article in Early Learning Nation noted that, “[t]wenty-two European Union member states have now re-opened child cares and schools in some capacity, and none have had COVID cases spike as a result. In fact, no nation in the entire world reports child cares or elementary schools as significant sources of transmission.” 

Virtual learning has significant drawbacks

School closures exacerbate educational disparities 

Kids are suffering emotionally and physically from school closures

  • Loneliness, anxiety and depression: 
    • Research from China indicates that kids confined to their homes to slow the spread of COVID-19 experienced higher levels of anxiety and depression than previously reported.
    • The absence of in-person peer interaction and the disappointment of canceled events and extracurriculars contributes to increased isolation and loneliness.
    • The increased screen time that inevitably occurs when schools are closed has been linked to increases in anxiety and depression. 
    • Studies show that young people may be at risk of depression and anxiety for up to 9 years after their period of social isolation ends.
  • Developmental delay:
    • “[S]ocial distancing can interfere with the basic developmental needs of teenagers—who are evolutionarily wired to become increasingly independent from parents and increasingly dependent on their peers.”
    • “[T]he absence of in-person peer interaction can negatively affect youths’ social skills, including reduced comprehension of nonverbal emotional cues.”
  • Physical Danger
    • School closures and lockdowns put some children at greater risk of online exploitation.
    • School closures also put some children at greater risk for family abuse and/or neglect
  • Increased obesity:   
    • Research indicates that children experience unhealthy weight gain primarily when they are out of school during the summer months, not during the school year. 
    • “[C]hildren and adolescents’ lifestyle behaviors, such as physical activity (PA) and sedentary behavior (SB) may have been drastically impacted due to the prolonged school closures and home confinement during the COVID-19 pandemic.” 
    • “[A]vailable data show that online video game usage is already soaring. Screen time is associated with experiencing overweight/obesity in childhood, likely because of the dual issues of sedentary time and the association between screen time and snacking.” 

What do the experts say?

This post has been updated as of July 8, 2020 with emerging evidence and perspectives.