However, there are multiple close interactions between individuals from separate households in a school setting thus, interactions that occur in schools, even if each contact is lower risk, may contribute to SARS-CoV-2 spread. Elementary school children are at lower risk of severe illness than other age groups and their role in driving transmission in the community is cloudy 8, 9. Modeling studies and time series analyses from across the world differ in their assessment of the impact of reopening schools on community SARS-CoV-2 transmission 5, 6, 7. This decision was guided by data extrapolated from influenza transmission models, which suggested school closures as an effective measure for reducing the basic reproductive number of respiratory viral infections 1, 2, and early evidence suggesting that non-pharmaceutical public health interventions, including school closures, were associated with improved SARS-CoV-2 outbreak control 3, 4. Additional studies are needed to elucidate the underlying reasons for the observed regional differences more fully.ĭuring the first few months of the COVID-19 pandemic, primary and secondary schools in the United States were closed to in-person education as part of the national response to control the spread of SARS-CoV-2 (ref. Schools can reopen for in-person learning without substantially increasing community case rates of SARS-CoV-2 however, the impacts are variable.
In the South, there was a significant and sustained increase in cases per week among counties that opened in a hybrid or traditional mode versus remote, with weekly effects ranging from 9.8 (95% confidence interval (CI) = 2.7–16.1) to 21.3 (95% CI = 9.9–32.7) additional cases per 100,000 persons, driven by increasing cases among 0–9 year olds and adults. After controlling for case rate trends before school start, state-level mitigation measures and community activity level, SARS-CoV-2 incidence rates were not statistically different in counties with in-person learning versus remote school modes in most regions of the United States. We conducted an event study using a retrospective nationwide cohort evaluating the effect of school mode on SARS-CoV-2 cases during the 12 weeks after school opening (July–September 2020, before the Delta variant was predominant), stratified by US Census region. The role that traditional and hybrid in-person schooling modes contribute to the community incidence of SARS-CoV-2 infections relative to fully remote schooling is unknown.
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