The start of the school year is approaching, and the practical arrangements have been prepared by the Ministry of National Education and Youth^¹ in accordance with the guidelines issued by the Ministry of Solidarity and Health, based on the opinions issued by the High Council for Public Health—most recently on July 7, 2020²—as well as the regulatory provisions in effect as of the start of the school year.

In this context, Santé publique France presents the main findings of the report published in August 2020 by the European Centre for Disease Prevention and Control (ECDC) titled “COVID-19 in children and the role of school settings in COVID-19 transmission” regarding SARS-CoV-2 infection (the virus responsible for COVID-19) in children and the role of school settings in SARS-CoV-2 transmission.

The objective of this report is to provide:

• an overview of the epidemiology and characteristics of COVID-19 in children (ages 0–18) in the countries of the European Union, the European Economic Area, and the United Kingdom;

• an assessment of the role of schools and childcare facilities in the transmission of SARS-CoV-2.

The findings of this report are consistent with the conclusions of the rapid review “COVID-19 in Children: A Literature Review as of April 24, 2020, Ahead of the Announced Reopening of Daycare Centers and Schools,” published by Santé publique France on May 20, 2020.

However, this ECDC report updates these findings based on a literature review covering a more recent period.

Key takeaways

• A small proportion (<5%) of all reported COVID-19 cases in the EU/EEA and the United Kingdom involve children (people aged 18 and under). If diagnosed with COVID-19, children are much less likely to be hospitalized or to die than adults.

• In children, the infection is generally milder or asymptomatic, meaning that the infection may go unnoticed or undiagnosed.

• When they do have symptoms, children shed the same amount of virus as adults and are therefore just as contagious as adults. The infectiousness of asymptomatic children is unknown.

• Although very few clusters of COVID-19 in school settings have been documented, they do occur and can be difficult to detect due to the lack of symptoms in infected children.

• Most countries report a slightly lower seroprevalence among children than among adults, but these differences remain to be confirmed. More targeted studies on children are needed to better understand the dynamics of infection and antibody production.

• Investigations of cases in school settings suggest that child-to-child transmission in schools is rare and is not the primary cause of SARS-CoV-2 infection among children whose infection coincides with their time in school, particularly in preschool and elementary schools.

• If physical distancing and hygiene measures are implemented, it is unlikely that schools constitute environments more conducive to virus spread than work or recreational settings with similar population densities.

• The impact of school closures and reopenings on community transmission levels is the subject of conflicting reports. However, contact tracing around a case in schools and data from a number of EU countries suggest that school reopening has not been associated with an increase in community transmission.

• Available data also indicate that the closure of childcare facilities and schools alone is unlikely to be an effective control measure for limiting community transmission of COVID-19. Such closures are unlikely to increase protection for children, as most develop only very mild forms of COVID-19 or no symptoms at all.

• Decisions regarding the implementation of control measures in schools and the closure or reopening of these facilities must be consistent with other physical distancing and public health decisions within the community.

Source: COVID-19 in children and the role of school settings in COVID-19 transmission, August 6, 2020. Stockholm: ECDC; 2020).