As new cases of the Omicron variant surge, thousands of schools have delayed a return to in-person learning. Cities including Atlanta, Milwaukee, Cleveland and Detroit have switched to online learning or canceled school altogether. A notable and laudable exception — thanks to new Mayor Eric Adams — is New York City
Policymaking involves trade-offs. Here the decision is easy: the benefit of limiting in-person classes is far outweighed by the damage remote learning inflicts on children. As an editorial in The BMJ (British Medical Journal) concluded a year ago, “Closing schools is not evidence- based and harms children.”
Closure advocates assert they are protecting children from becoming infected and, in turn, protecting vulnerable people the kids come into contact with. Neither claim is true.
As I noted nearly a year ago, a Centers for Disease Control and Prevention report confirmed that K-12 schools are not associated with COVID-19 transmission from students within the schools or out into the community. Transmission in education and child-care settings is rare, especially if mitigation strategies, such as masking, distancing, and keeping students together in cohorts, are employed. As Adams opined, “The safest place for our children is in a school building.”
Even if they are infected, COVID-19 poses little risk to school-age children. They account for a vanishingly small percentage of US COVID-19 deaths. In the two years of the pandemic, just 708 kids between 5 and 17 have died out of 825,000 total COVID-19 deaths. The COVID-19 toll was comparable to the flu which killed 572 children ages 5-17 in 2017-2018 and 2018-19, the last two flu seasons prior to the pandemic.
Severe complications have been uncommon in kids and will be even less likely with the currently prevalent, but less virulent, Omicron variant. Children 5 to 17 currently account for just 0.8% of COVID-19 hospital admissions and as many as 40% of these are incidental COVID admissions — children without COVID symptoms admitted for other medical problems who tested positive on routine admission screening.
There have been 6,000 cases of MIS-C, a rare but serious inflammatory syndrome seen weeks after COVID-19 in children and adolescents. Most were hospitalized but nearly all fully recovered without long-term sequelae. Less than 1% died. The risk of persistent symptoms following infection in children — so-called “long COVID” — is uncertain, but appears to be quite low.
Children pose little risk
Students pose little risk to teachers and staff. Even before vaccines were available, the CDC determined that other adults, not students, are the primary sources of viral exposure among adults in schools. Studies in Wisconsin and Sweden found no increase in severe COVID-19 cases in teachers. Now most teachers and staff are vaccinated.
Schoolkids also pose little risk at home. Only 6% of people 65 and older — the most vulnerable group that accounts for 80% of COVID-19 fatalities — live in a household with a school-aged (ages 5-18) child. Only 7% of school-aged children live with a senior.
While the frequency of household transmission from children to adults is uncertain, it is likely uncommon. A study of 12 million adults in England found no difference in the risk of infection, hospital admission, ICU admission or death for adults over 65 from COVID-19 between homes with or without children. Adults 65 and younger living with children also had no increase in severe COVID-19 outcomes and those living with children 0 to 11 actually had fewer COVID-19 deaths than childless homes.
While the benefits of school closures are minimal, the costs are not. School closures have been associated with learning loss, reduced social interaction and development, reduced physical activity and mental health problems. Declines in students’ standardized math and English test scores in 2020-2021 were larger in districts with less in-person instruction, and were significantly larger in districts with poor and minority students. Closures negatively impact students’ educational attainment and future earnings, an effect that was largest in poor neighborhoods.
The current spate of school closures is based on fear, not science. Students have endured two years of harmful educational disruption. Enough is enough.
Joel Zinberg, MD, is a senior fellow at the Competitive Enterprise Institute, an associate clinical professor of surgery at the Icahn School of Medicine at Mount Sinai in Manhattan and the director of Paragon Health Institute’s Public Health and American Well-being Initiative.
