Preparing for the Gradual Reopening of Daycare Centers and Schools

As part of the measures to control the COVID-19 epidemic, all schools in France were closed starting Monday, March 16, 2020. This measure affects more than 12 million students, from preschool through high school, not including those in early childhood care centers. Childcare services were maintained for the children of essential workers.

To best prepare for the gradual lifting of strict lockdown measures starting May 11, 2020, and the gradual reopening of daycare centers and schools, it is important to have a comprehensive overview of the current state of knowledge in order to address questions regarding the potential public health and societal impacts of this reopening.

Key Takeaways

• Pediatric cases of COVID-19 account for a small proportion (1–5%) of all COVID-19 cases reported worldwide; this is primarily due to the fact that infected children predominantly present with asymptomatic or mild forms of the disease. Severe cases and deaths among children are rare.

• The extent of children’s role in virus transmission remains poorly understood. While the circulation of the virus in this population is well documented based on current evidence, the potential contribution of children to its spread remains a subject of debate.

• Regarding social distancing measures, modeling studies indicate that the effect of school closures on mitigating the epidemic peak is limited, but that maintaining transmission at a controlled level requires the prolonged continuation of these closures. No studies are available evaluating the specific effect of reopening schools.

• Available recommendations indicate that school reopening must be accompanied by preventive measures to limit community transmission:

  • excluding symptomatic children or those who have been in contact with infected individuals,

  • adapting “barrier” measures and social distancing to the age of the children,

  • implementation of specific environmental measures.

• The operational implementation must involve all local stakeholders to adapt measures to specific on-the-ground needs; staff should be trained and have access to educational resources appropriate for the children’s age; social marketing or “nudge” strategies could be utilized.

• Creating an environment conducive to preventing the spread of the virus within schools must be consistent with the prevention measures implemented in children’s homes.

• Teaching children “barrier” measures appears to be a positive strategy for engaging them as promoters/advocates of prevention.

• Specific measures to prevent stigmatization and support mental health should be implemented.

• Analysis of parents’ and teachers’ opinions highlights their concerns regarding the reopening of daycare centers and schools.

• School closures and lockdowns—measures necessary for managing the epidemic—may have consequences for children’s physical and mental health and well-being both now and in the long term due to their impact on the psychosocial, social, and environmental determinants of health.

• These consequences will not be evenly distributed across the population, and a widening of social health inequalities—already significant among children—is to be expected

An overview of our European neighbors

This document also provides an overview of the experiences of other European countries.
Most European countries decided in March 2020 to close schools to reduce the transmission of SARS-CoV-2.
Only Sweden and Iceland allowed, under certain conditions, early childhood care facilities and elementary schools to remain open, while closing secondary schools.