Studies assessing SARS-CoV-2 transmission in educational settings, reported secondary cases and parallel non-pharmaceutical interventions, until January 2021
| Study | Country | Timeframe | Age range* | Setting | No. of symptomatic paediatric index cases | No. of asymptomatic paediatric index cases | Secondary cases in the school settings† | Parallel non-pharmaceutical interventions in the community setting |
| Child care settings | ||||||||
| Lopez et al20 | USA, Utah | April–July 2020 | 0.2–16 | 3 childcare facilities (3 clusters) | 0 child (3 adults) | Transmission was documented from 12 secondary paediatric cases (3 asymptomatic) to at least 12/46 non-facility contacts (confirmed or probable cases) | Quarantine for 14 days of cases+contacts; in 2 facilities: daily screening and staff members were using masks. | |
| Yoon et al26 | South Korea | February–March 2020 | 4 | 1 childcare centre | 1 (information about symptoms not reported) | 0/190 | Adult staff wore masks, but mask wearing by children were not consistent. After the index case-patient was identified, the centre was closed. All potentially exposed persons were quarantined at home for 14 days. | |
| Combined childcare-school settings | ||||||||
| Heavey et al16 | Ireland | March 2020 | 10–15 | Schools | 2 | 1 | 0/822 school contacts 0/73 other contacts | Exposure before school closure. Schools closed, contacts were quarantined. |
| Danis et al17 | France | January to February 2020 | 9 | 3 schools | 1 | 0 | 0/86 school contacts 1/6 hospitalised contacts | Not reported. |
| Yung et al62 | Singapore | February to March 2020 | 2.8–15 | 3 schools | 2 | 0 | 0/42 symptomatic contacts | Contacts were quarantined. Targeted measures at the school level. |
| Macartney et al21 | Australia, New South Wales | 25 January to 10 April 2020 | <18 | 15 schools and 10 childcare settings (3 clusters) | 12 (information about symptoms not reported) | 3/752 (3: 2 children and 1 adult) | Contacts were quarantined. | |
| Stein-Zamir et al22 | Israel | May 2020 | 12–18 | 1 high school (1 cluster) | 2 | 0 | 178/1312 (178: 153 children and 25 staff) | Closed spaces with poor ventilation, high temperatures, crowded spaces and close contact with no masks. |
| Link-Gelles et al23 | USA, Rhode Island | June–July 2020 | <18 | 666 educational settings (4 clusters) | 33 confirmed and 19 probable cases in 29 settings | 17 cases in 4/666 educational settings | Class distancing, the use of face masks for adults, universal symptom screening daily and disinfection. | |
| Ehrhardt et al24 | Germany, Baden-Württemberg | May–August 2020 | <18 | Schools and childcare facilities (11 clusters) | 137 (information about symptoms not reported) | 11/>2300, estimation of 1 secondary case per roughly 25 infectious school days | Masks, social distancing, hygiene, ventilation, smaller class sizes, cancelled activities, exclusion of sick children. | |
| Brandal et al28 | Norway, Oslo and Viken counties | August–November 2020 | 5–13 | Primary schools (2 clusters) | 13 (information about symptoms not reported) | 3/292 (3: 2 children and 1 adult) | National guideline-based infection control measures, that is, hygiene, physical distancing, symptomatic children to stay at home. Masks not worn in schools. | |
| Gold et al19 | USA, Georgia | December 2020–January 2021 | 5–13 | 8 primary schools (9 clusters) | 1 (information about symptoms not reported) | 5/contacts traced not reported | Physical distancing and masks; imperfect compliance noted. | |
| Larosa et al27 | Italy, Reggio Emilia | September–October 2020 | <18 | 8 preschools, 10 primary 18 secondary (9 clusters) | 43 | 0 | 17/1198 (17 children and 0 adults) | Mandatory surgical masks for children except when seated and not speaking; physical distancing measures. |
| Yoon et al25 | South Korea | Up to July 2020 | <18 | 6 preschools 13 primary, 6 secondary, 14 high schools (2 clusters) | 44 (information about symptoms not reported) | 2/≥13 100 | School closure continued until 6/4/2020. Social distancing strategies and mask wearing when schools opened with rigorous contact tracing and rapid testing on any suspected cases. | |
| Summer camps | ||||||||
| Pray et al29 | USA, Wisconsin | July–August 2020 | 14–24 | 1 overnight camp | 1 | 0 | 115/151 confirmed or probable cases | Documentation of a negative pre-arrival RT-PCR result, 7-day pre-arrival quarantine and outdoor programming. |
| Blaisdell et al30 | USA, Maine | June–August 2020 | 7–18 | 4 overnight camps | 0 | 1 | No secondary transmission identified | Pre-arrival quarantine, pre-arrival and post-arrival testing and symptom screening, cohorting, use of face coverings, physical distancing, enhanced hygiene measures, cleaning and disinfecting and maximal outdoor programming. |
*Except when the age refers to only one paediatric case and age range is n/a.
†Measured from the date of last contact.
‡Probable cases.
n/a, not available.