Many countries have opened schools without seeing a spike in infection among teachers and students — but few have attempted the experiment with infections rising as fast as they are in Arizona.

A host of countries in Europe and elsewhere closed schools briefly last spring when the pandemic first hit, but reopened in a month or two after social distancing, mask use and business shutdowns had dramatically slowed the spread, according to a review of research published in the journal Science.

The United States faces a very different situation as school districts plan for the resumption of in-person learning, under the threat of state and federal financial penalties if they don’t. Arizona has one of the nation’s fastest-growing COVID-19 caseloads.

Giant school districts in California have already announced they will offer only online and distance learning classes in the upcoming fall semester, despite studies showing that students lost an average of about seven months of learning because of last year’s school shutdowns. Low-income students like those in most rural districts lost even more ground.

Generally, the studies have found that elementary school students are much less likely to get infected. Those who contract the virus are much less likely to spread the infection to one another or to teachers. This could reflect the limited number of other students they interact with during the day or it could reflect a still poorly understood resistance to the virus among children.

High school students have faced much different levels of risk in these international studies. They’re much more likely to get infected and then to spread it to one another, teachers and people in the community, according to the research.

Using masks, limiting class sizes and limiting how much students mix with one another on campus can all limit the risk, especially for high school students.

However, the countries who successfully reopened school without evidence of spread on campus or into the community generally had largely controlled the spread in the community and could do widespread testing and contact tracing, both on and off campus.

So here’s a summary of studies on school reopening:

Masks work

China, South Korea, Japan and Vietnam all safely re-opened schools after reducing the rate of infection in the community. All four countries required near-universal mask wearing on campus. All of those countries have a much higher level of public acceptance of masks, thanks to air pollution and the use of a mask to contain things like the flu.

Canada, Denmark, Norway and the United Kingdom also required masks on campus, with only a few documented outbreaks in schools.

Children less vulnerable

Several studies suggest that children younger than 18 are between one-third and one-half as likely to contract the virus as adults, with the youngest children the most resistant. No one’s sure why, but it may have to do with differences in the immune systems of children — since the COVID-19 virus interacts with the immune system in ways scientists are still unraveling.

Virus spreads in

French high schoolOne study involved a French high school where two teachers were infected with SARS-CoV-2 for several weeks in February before they realized it. Scientists in late March administered antibody tests to all the students and staff. They discovered that 38% of the students, 43% of the teachers and 59% of the non-teaching staff had been infected. Most didn’t know they’d contracted the virus.

The researchers then tested for past exposure to the virus in three elementary schools. They found only three children who had been infected and concluded they’d all gotten infected from family members. Researchers couldn’t document any cases where one child had infected other children.

High school outbreaks

An undetected infection spread readily among high school and middle school students in Israel, New Zealand and Canada. In one campus in Israel, 153 students and 25 staff were infected in late May and early June. In New Zealand, an outbreak at a high school infected 96 people, but researchers couldn’t find a single case in the neighboring elementary school. On the other hand, in one elementary school classroom in Canada, nine of 11 students became infected after a student brought the virus into the class from a family contact.

Measures that work

Many countries that reopened schools without fueling new outbreaks took precautions to avoid mixing students together. The Netherlands cut class sizes in half, but didn’t otherwise enforce social distancing among students younger than 12. Denmark assigned students to pods for class and recess and didn’t let pods mingle. Belgium moved some classes to churches to allow social distancing.

Even before schools closed, researchers found few clusters linked to schools, according to a study by epidemiologists from the London School of Hygiene and Tropical Medicine.

Germany sees limited

school spreadAfter Germany reopened schools with precautions that included masks, small class sizes and social distancing, new infections among children increased from about 10% of new cases to about 20%. However, the increase could reflect wider testing and a decline in cases among the elderly, who were taking more precautions.

Israel sees rise in

campus infectionsIsrael reopened schools last spring with a variety of protections, including use of masks and frequent testing. A single case would result in a school shutdown for a single case. The school tested and quarantined all close contacts before reopening. In roughly two months, they found infections among 503 students and 167 staff after temporary closures of 355 schools. That’s only about 7% of the nation’s 5,000 schools. Several of those outbreaks occurred after school officials relaxed mask-wearing requirements after sweltering hot weather made the masks uncomfortable.

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