The SARS-CoV-2 pandemic has impacted the medical, economic, social, and political landscape worldwide. Despite public health measures to contain the virus, including masks, hand hygiene, school closures, and stay-at-home orders, COVID-19 was the third leading cause of death in the US in 2020. Although early data suggested that children accounted for only 2% of COVID-19 cases, more recent reports have indicated that 13% of diagnosed cases in the US have occurred in children. Additionally, the number of COVID-19 hospitalizations among children is similar to that observed in a typical influenza season, and COVID-19 deaths in children exceed the total observed in any single influenza season. In March 2020, in an attempt to curb the exponential growth of the COVID-19 pandemic, kindergarten through 12th-grade schools closed in all 50 US states, affecting 57 million students. The effects of these school closures have been far reaching, including marked social disruption and psychological and educational impact. Nevertheless, the resumption of in-person learning has proven controversial, as officials and communities weigh the risks of potential transmission of SARS-CoV-2 in schools against the benefits of in-person learning. To adequately assess these risks, it is important to address 3 key questions: (1) What is the role of children in community transmission of infectious pathogens? (2) What is the role of children specifically in SARS-CoV-2 transmission? and (3) What can be done to get children safely back in daycare, preschool, and school?
Clinical Practice Guidelines