At the time of this writing, the evidence base for recommendations on the impact of school closures is weak. While children can be infected, suffer severe disease, and die, it is a rare outcome, particularly relative to older cohorts. The extent to which children contribute to transmission is not known, and studies within households suffer from bias because more symptomatic cases are more likely to be detected, and more symptomatic cases are more common in adults. Transmission patterns in schools may not reflect what happens in households.

If and when schools are reopened it will be important to consider distancing measures that can be implemented in the classroom and to protect teachers, custodial staff, and others at the school, who, as adults, are likely at higher risk of complications than the students. The family situations of students may also be important: If the primary caregiver is an older relative or a person otherwise at risk due to comorbidities, then attendance at school could present a risk that we should avoid. It will be necessary to continuously review the evidence in determining the safest way forward. Investing in distance learning tools and approaches is necessary, and should be pursued simultaneously, in the event schools cannot open safely, or need to be periodically closed in response to regional outbreaks.