“Our perception of risk and prevalence is driven by stories, events, anecdotes, rather than data” – Steven Pinker
Hoewel niet evidence-based als interventie zijn wereldwijd in de meeste landen de scholen gesloten tijdens de coronapandemie. In Nederland sloten de scholen voor het eerst sinds de Tweede Wereldoorlog, eerst op 16 maart 2020, daarna op 15 december 2020, en op 20 december 2021 opnieuw.
Data en onderzoek wijzen al sinds het begin van de pandemie in dezelfde richting: kinderen en scholen spelen een beperkte rol. Kinderopvang en scholen voor kinderen tot 16 jaar zijn in Zweden open gebleven tijdens de pandemie omdat volgens de Zweedse gezondheidsautoriteit het bewijs ontbrak dat scholen sluiten een significante impact zou hebben op de pandemie.
Duidelijk was daarentegen dat het sluiten van kinderopvang en scholen een negatieve impact zou hebben voor kinderen en de samenleving als geheel.
If you succeed [in school], your life will be good. If you fail, your life is going to be much worse. You’re going to live shorter. You’re going to be poorer. That, of course, is in the back of your head when you start talking about closing schools” – Anders Tegnell, Zweeds staatsepidemioloog
Wereldwijd zijn kinderen in de knel gekomen tijdens de coronapandemie.
Lewis, S.J.J., Munro, A.P.S., Smith, G.D., Pollock, A.M. (2021). Closing schools is not evidence based and harms children. The British Medical Journal, 23 Februari
Enkele quotes:
“School closures have been implemented internationally with insufficient evidence for their role in minimising covid-19 transmission and insufficient consideration of the harms to children.”
“The UN convention on the rights of the child and the duty on the government to respect, protect and fulfil those rights have largely been overlooked.(..) In the absence of strong evidence for benefits of school closures, the precautionary principle would be to keep schools open to prevent catastrophic harms to children”
“accumulating evidence shows that teachers and school staff are not at higher risk of hospital admission or death from covid-19 compared with other workers”
Onderzoeksliteratuur kinderen, scholen en COVID-19: twee jaar later
(een eerste versie van dit overzicht is gepubliceerd op 28 februari 2021 – update: 22 april 2023)
Sinds het voorjaar van 2020 zijn er over de gehele wereld vele studies verschenen rond kinderen, scholen en COVID-19. Hier volgt na een review van studies uit 2023 van Munro et al. (publicatiedatum 17 april) een overzicht van 50 studies uit het tijdvak 2020-2022.
2023
Munro, A., Buonsenso, D., González-Dambrauskas, S. et al. In-person schooling is essential even during periods of high transmission of COVID-19. BMJ Evidence-Based Medicine Published Online First: 17 April 2023.
“Given the emergence of the significant economic, social and health cumulative burden related to prolonged school closures, the argument to further deploy them is weak. Based on current evidence, we argue the harm of closing schools now clearly outweighs the benefits of reducing transmission”
2022
1. Valtyr, T., Bjornsdottir, K.L., Thorvardur, L., Haraldsson, A. (2022) SARS-CoV-2 Infections in Icelandic Children -Close Follow-Up of All Confirmed Cases in a Nationwide Study. The Pediatric Infectious Disease Journal, oktober
Data uit IJsland, waar elk kind 0-18 jaar met covid-19 is gevolgd in de periode van februari 2020 tot september 2021. Geen ernstige ziekte/hospitalisatie, mediaan klachten: 5 dagen, 65% raakte thuis besmet, 12,5% op school.
“This strongly indicates that spread is common from adults to children and that spread from other children was probably less common. This is in line with other reports where children are considered less likely to spread the infection”
“Although most experts agree that school and preschool closures should be avoided, if possible, many children have suffered from disrupted school activities aimed at halting the spread of the virus. The benefits of such closures remain unproven”
02. Geijerstam, af, A., Mehlig, K., Hunsberger, M., Åberg, M., Lissner, L. (2022) Children in the household and risk of severe COVID-19 during the first three waves of the pandemic: a prospective registry-based cohort study of 1.5 million Swedish men | BMJ Open, 14 juli
🔹 “Conclusion: Young children seem to have played a minor part in the community transmission of COVID-19, even though preschools remained open in Sweden. As this study shows, adult men living in the same household as children of this age group had a lower risk both of infection and severe sickness. Having children between 6 and 12 years in the household was associated with a small increase in odds of infection, but not with severe disease. Having teenagers in the household was associated with increased rates of infection as well as severe disease in their fathers. These associations are similar in magnitude to those reported in other settings where schools were closed“
03. Lichand, G., Doria, Cossi Fernandes, J.P., et al. (2022) Association of COVID-19 Incidence and Mortality Rates With School Reopening in Brazil During the COVID-19 Pandemic | JAMA, 11 februari
“Findings: In this cross-sectional study of 643 Brazilian municipalities including 18 761 schools, on average, there was no systematic association between school reopening and COVID-19 incidence or mortality in São Paulo State up to 12 weeks after reopening. There were no statistically significant differences between municipalities that authorized schools to reopen and those that did not for 1) weekly new cases or 2) weekly new deaths. Conclusions and Relevance: The findings from this study suggest that keeping schools open during the COVID-19 pandemic did not contribute to the aggregate disease activity”
2021
04. Juutinen, A., Sarvikiv, E., Laukkanen-Nevala, P. & Helve, O. (2021) Closing lower secondary schools had no impact on COVID-19 incidence in 13–15-year-olds in Finland. Epidemiology & Infection, 26 oktober
“Based on our analysis, closing lower secondary schools had no impact on COVID-19 incidence among 13–15-year-olds. No significant changes on COVID-19 incidence were observed in other age groups either. (..) Our study supports earlier findings that school closures had no added effect in controlling the COVID-19 pandemic in Finland”
05. Fukumoto, K., McClean, C.T., Nakagawa, K. (2021) No causal effect of school closures in Japan on the spread of COVID-19 in spring 2020. Nature Medicine, 27 oktober
”We do not find any evidence that school closures in Japan reduced the spread of COVID-19. Our null results suggest that policies on school closures should be reexamined given the potential negative consequences for children and parents”
06. Soriano-Arandes, A., Gatell, A., Serrano, P., et al. (2021) Household SARS-CoV-2 transmission and children: a network prospective study. Clinical Infectious Diseases, 15 september
“Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission“
Deze Catalaanse studie kreeg de Research Presentation Award (‘To promote collaborative and high quality research’) tijdens ESPID 2022 (The European Society for Paediatric Infectious Diseases) 9-13 mei 2022 in Athene – de jaarlijks meeting van experts op het gebied van pediatrische infectieziekten.
07. Fenton, L., Gribben, C., Caldwell, D., Colville, S., et al. (2021) Risk of hospital admission with covid-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study. The British Medical Journal, 2 september
“Conclusion: Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching” .
Commentaar BMJ: “Teachers and their household members were not at increased risk of hospital admission with covid-19 at any time during the 2020-21 academic year compared with similar working age adults, including during periods when schools were fully open, study finds”
08. Galow, L., Haag, L., Kahre, E., et al. (2021) Lower household transmission rates of SARS-CoV-2 from children compared to adults. Journal of Infection, 27 april
“the low rate of underage index cases and their lower SAR compared to adult index cases is consistent with previous studies. This supports existing evidence that children are not only less likely to develop severe disease courses but also are less susceptible and less likely to transmit SARS-CoV-2”
09. Bravata, D., Cantor, J.H., Sood, N., & Whaley, C.M. (2021) Back to School: The Effect of School Visits During COVID-19 on COVID-19 Transmission. National Bureau of Economic Research, april
“We find that increases in county-level in-person visits to schools lead to an increase in COVID-19 diagnoses among households with children relative to households without school-age children. However, the effects are small in magnitude. A move from the 25th to the 75th percentile of county-level school visits translates to a 0.3 per 10,000 household increase in COVID-19 diagnoses. This change translates to a 3.2 percent relative increase”
Voor een toelichting van deze studie: interview met twee van de auteurs Chris Whaley Neeraj Sood – The Trade-off of Schools – New NBER paper
10. Zimmerman, K., Akinboyo, I., Brookheart, M., et al. (2021) Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools. Pediatrics, 1 april
“Over 9 weeks, 11 participating school districts had >90 000 students and staff attend school in person. Among these students and staff, 773 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, health department staff determined an additional 32 infections were acquired within schools. No instances of child-to-adult transmission of SARS-CoV-2 were reported within schools. CONCLUSIONS: In the first 9 weeks of in-person instruction in North Carolina schools, we found extremely limited within-school secondary transmission of SARS-CoV-2, as determined by contact tracing”
11. Gandini, S., et al. A cross-sectional and prospective cohort study of the role of schools in the SARS-CoV-2 second wave in Italy | The Lancet, 26 maart
Interview met de eerste auteur van deze studie: “Should schools be closed or not? Gandini (Uni. Milan): “Research in 28 countries. The benefits of keeping them open outweigh the risks” | SIR, 17 maart 2021
12. Mulligan, C.B. (2021) The Incidence and Magnitude of the Health Costs of In-person Schooling during the COVID-19 Pandemic. National Bureau of Economic Research, maart
“Students and teachers at in-person school during 2020 were about 20 times more likely to be infected outside school than in school. (..) To put it another way, the fatality risk to self and living partners, which may include an elderly person, for one day taught in-person by the average nonelderly teacher is similar to the risk of driving 16 miles alone in a car. For the modal teacher, the equivalent is five miles”
13. Forbes, H., Morton, C.E., Bacon, S., et al. (2021) Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England. The British Medical Journal, 7 maart
“In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small”
14. Wood, R., Thomson, E., Galbraith, R., et al. (2021) Sharing a household with children and risk of COVID-19: a study of over 300 000 adults living in healthcare worker households in Scotland. The British Medical Journal, 17 februari
“In our large cohort, adults with young children were at lower risk of testing positive for SARS-CoV-2 and possibly also of developing COVID-19 requiring hospitalisation. Adults living with young children were not at increased risk of COVID-19, including during August–October 2020 when nurseries and schools were open for all children”
15. Ingelbeen, B., Peckeu, L., Laga, M., et al. (2021) Reducing contacts to stop SARS-CoV-2 transmission during the second pandemic wave in Brussels, Belgium. Eurosurveillance, 18 februari
“Our findings confirm transmission among and from teenagers, with intergenerational transmission apparent following school opening. Nonetheless, their relative role was limited: transmission events from 10–19-year-olds to other age groups remained fewer than those from adults, and the proportion of cases among 10–19-year-olds did not significantly change after school reopening”
16. Folkhälsomyndigheten (2021) Covid-19 most common among health care groups. Onderzoek Zweedse gezondheidsautoriteiten naar beroepsgroepen en risico op infectie covid-19, 11 februari
“When it comes to school staff, according to the report, they generally do not have a higher risk of infection than people in other occupational groups who have contact with many people, for example service professions. They also have no increased risk of developing serious disease with covid-19”
17. Dattner, I., Goldberg, Y., Katriel, G., et al. (2021) The role of children in the spread of COVID-19: Using household data from Bnei Brak, Israel, to estimate the relative susceptibility and infectivity of children. PLOS Computational Biology, 11 februari
“We estimate that the susceptibility of children (under 20 years old) is 43% (95% CI: [31%, 55%]) of the susceptibility of adults. The infectivity of children was estimated to be 63% (95% CI: [37%, 88%]) relative to that of adults”
18. Brookman, S., Cook, J., Zucherman, M., et al. (2021) Effect of the new SARS-CoV-2 variant B.1.1.7 on children and young people. The Lancet Child & Adolescent Health, 10 februari
“Importantly, we have found no evidence of more severe disease in children and young people during the second wave, indicating that infection with the B.1.1.7 variant does not result in an appreciably different clinical course to the original strain. These findings are in keeping with early national data. Severe acute respiratory COVID-19 remains an uncommon occurrence in children and young people”
19. RIVM, niet gepubliceerde studie (2021). Kinderen, school en COVID-19. Website RIVM (bijgewerkt: 25 februari)
“Vanaf 31 augustus 2020 tot en met 10 januari 2021 zijn ruim 390.000 mensen die werkzaam zijn in het onderwijs of kinderopvang getest. Van deze testen was 9% positief. Dit percentage is lager dan het totaal van 14% bij de ruim 3,7 miljoen volwassenen getest in de teststraten in deze periode”
20. The British Medical Journal (2021) Webinar Covid-19 and schools – known unknowns. BMJ, 28 januari
“Findings [from Scotland] have been reassuring for teachers, as there is now “strong evidence” that teachers are at a similar or lower risk of severe illness or dying from Covid-19, than the general working age population, “and that finding persists when schools are open”
21. Office for National Statistics (2021) Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020. ONS, 25 januari
Deze studie in de media: Schraer, R. (2021) Covid: Teachers ‘not at higher risk’ of death than average. BBC Health, 25 januari
“Rates of death involving COVID-19 in men and women who worked as teaching and educational professionals, such as secondary school teachers, were not statistically significantly raised when compared with the rates seen in the population among those of the same age and sex”
22. O’Leary, S.T. (2021) To Spread or Not to Spread SARS-CoV-2—Is That the Question? JAMA Pediatrics, 22 januari”With this large seroprevalence study demonstrating yet again what we have suspected for several months, the answer to that question could not be clearer: we must prioritize the reopening of childcare facilities and elementary schools to full time, in-person learning without exception”
23. Tönshoff B, Müller B., Elling R, et al. (2021) Prevalence of SARS-CoV-2 infection in children and their parents in southwest Germany. JAMA Pediatrics, januari 22
“The low seroprevalence of SARS-CoV-2 antibodies in young children in this study may indicate that they do not play a key role in SARS-CoV-2 spreading during the current pandemic”
24. Somekh, I., Shohat, T., Keinan-Boker, L., et al. (2021). Reopening Schools and the Dynamics of SARS-CoV-2 Infections in Israel: A Nationwide Study. Clinical Infectious Diseases, 18 januari
“This analysis does not support a major role of school reopening in the resurgence of the COVID-19 curve in Israel. Easing restrictions on large scale gatherings was the major influence on this resurgence”
25 Centers for Disease Prevention and Control (2021) COVID-19 Trends Among Persons Aged 0–24 Years — United States, March 1–December 12, 2020. CDC, 13 januari
“As of December 7, nearly two thirds (62.0%) of U.S. kindergarten through grade 12 (K–12) school districts offered either full or partial (hybrid with virtual) in-person learning. Despite this level of in-person learning, reports to CDC of outbreaks within K–12 schools have been limited, and as of the week beginning December 6, aggregate COVID-19 incidence among the general population in counties where K–12 schools offer in-person education (401.2 per 100,000) was similar to that in counties offering only virtual/online education (418.2 per 100,000)”
Deze studie in de media: Cortez, M.F. (2021) Covid-19 Outbreaks Aren’t Driven by In-Person Classes, CDC Says. Bloomberg, 13 januari
26. Brandal, L.T., Ofitserova, T.S. Meijerink, H., et al. (2021) Minimal transmission of SARS-CoV-2 from padiatric COVID-19 cases in primary schools, Norway, August to November 2020. Eurosurveillance, 7 januari
“This prospective study shows that transmission of SARS-CoV-2 from children under 14 years of age was minimal in primary schools in Oslo and Viken, the two Norwegian counties with the highest COVID-19 incidence and in which 35% of the Norwegian population resides”
“We prospectively examined transmission of SARS-CoV-2 from confirmed paediatric cases in Norwegian primary schools between August and November 2020. All in-school contacts were systematically tested twice during their quarantine period. With preventive measures implemented in schools (strengthened hygiene measures, physical distancing and a clear message to stay home if symptomatic, even with mild symptoms. Use of face masks is not recommended in schools in Norway), we found minimal child-to-child (0.9%, 2/234) and child-to-adult (1.7%, 1/58) transmission, supporting that under 14 year olds are not the drivers of SARS-CoV-2 transmission”
27. Ludvigsson, J.F., Engerström, L., Nordenhäll, C., Larsson, E. (2021) Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden. The New England Journal of Medicine, 6 januari
“Despite Sweden’s having kept schools and preschools open, we found a low incidence of severe Covid-19 among schoolchildren and children of preschool age during the SARS-CoV-2 pandemic. Among the 1.95 million children who were 1 to 16 years of age, 15 children had Covid-19, MIS-C, or both conditions and were admitted to an ICU, which is equal to 1 child in 130,000”
Persbericht: Low risk of severe COVID-19 in children. Karolinska Institutet, 6 januari
2020
28. Ulyte, A., Radtke, T., Abela, I., A., et al. (2020) Clustering and longitudinal change in SARS-CoV-2 seroprevalence in 2 school-children: prospective cohort study of 55 schools in Switzerland. medRxiv, 22 december
“Under a regimen of open schools with some preventive measures in place since August, clustering of seropositive cases occurred in very few classes and not across entire schools despite a clear increase in seropositive children during a period of high 68 transmission of SARS-CoV-2”
29. European Centre for Disease Prevention and Control (2020) COVID-19 in children and the role of school settings in transmission – first update. ECDC, 23 december
“There is a general consensus that the decision to close schools to control the COVID-19 pandemic should be used as a last resort. The negative physical, mental health and educational impact of proactive school closures on children, as well as the economic impact on society more broadly, would likely outweigh the benefits.(..) Educational staff and adults within the school setting are generally not seen to be at a higher risk of infection than other occupations”
30. Prahley, L. (2020) Exclusive: Kids catch and spread coronavirus half as much as adults, Iceland study confirms. National Geographic, 10 december
“This 40,000-person study found that children under 15 were about half as likely as adults to be infected, and only half as likely as adults to transmit the virus to others. Almost all the coronavirus transmissions to children came from adults”
31. Larosa, E., Djuric, O., Cassinadri, M., et al. (2020). Secondary transmission of COVID-19 in preschool and school settings in northern Italy after their reopening in September 2020: a population-based study. Eurosurveillance, 10 december
“Transmission within the schools of Reggio Emilia province, northern Italy, occurred in a non-negligible number of cases, particularly in the age group 10–18 years, i.e. in middle and high schools, while no secondary cases were detected in pre-school children, only one case in primary school and no secondary cases among teachers and staff”
32. Ismail, S.A., Saliba, C., Bernal, J.L., et al. (2020) SARS-CoV-2 infection and transmission in educational settings: a prospective, cross-sectional analysis of infection clusters and outbreaks in England. The Lancet Infectious diseases, 8 december
“SARS-CoV-2 infections and outbreaks were uncommon in educational settings during the summer half-term in England. The strong association with regional COVID-19 incidence emphasises the importance of controlling community transmission to protect educational settings. Interventions should focus on reducing transmission in and among staff”
33. Bismarck-Osten, C. von., Borusyak,K., Schönberg., U. (2020) The Role of Schools in Transmission of the SARS-CoV-2 Virus: Quasi-Experimental Evidence from Germany. Centre for Research and Analysis of Migration Department of Economics – University College London, 20 november
“Leveraging a difference-in-differences design with staggered adoption, we show that neither the summer closures nor the closures in the fall have had any significant containing effect on the spread of SARS-CoV-2 among children or any spill-over effect on older generations. We also do not find any evidence that the return to school at full capacity after the summer holidays increased infections among children or adults. Instead, we find the number of children infected increased during the last weeks of the summer holiday and decreased in the first weeks after schools reopen”
34. Christakis, D., et al. (2020) Estimation of US Children’s Educational Attainment and Years of Life Lost Associated With Primary School Closures During the Coronavirus Disease 2019 Pandemic. JAMA, 12 november
“These findings suggest that the decision to close US public primary schools in the early months of 2020 may be associated with a decrease in life expectancy for US children”
35. Viner, R.M., Mytton, O.T., is Bonell, C. (2020) Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis. JAMA, 25 september
“In this meta-analysis, there is preliminary evidence that children and adolescents have lower susceptibility to SARS-CoV-2, with an odds ratio of 0.56 for being an infected contact compared with adults. There is weak evidence that children and adolescents play a lesser role than adults in transmission of SARS-CoV-2 at a population level. This study provides no information on the infectivity of children”
36. Ludvigsson, J.F. (2020) The first eight months of Sweden’s COVID‐19 strategy and the key actions and actors that were involved. Acta Paediatrica, 20 september
“Sweden’s response was less invasive than many other countries, with no general lockdown. It focused on mitigation: slowing, but not stopping, the pandemic. Physical distancing was recommended in public spaces, but mandatory in bars, restaurants and at events. Visits to nursing facilities were banned. Kindergartens and schools for children up to 16 stayed open, but closed for older children for three months. There were no enforced quarantines for infected households or geographical regions, and facemasks were not recommended outside health care”
37. Ehrhardt J, Ekinci A, Krehl H., et al. (2020). Transmission of SARS-CoV-2 in children aged 0 to 19 years in childcare facilities and schools after their reopening in May 2020, Baden-Württemberg, Germany. Eus Surveillance, 10 september
“Our investigation suggests that child-to-child transmission in schools and childcare facilities is uncommon and not the primary cause of SARS-CoV-2 infection in children”
38. Japan’s Ministry of Education, Culture, Sports, Science and Technology (2020) Education in Japan beyond the crisis of COVID-19 -Leave No One Behind. MEXT, september
‘In the period from June 1, when schools began to fully reopen, to July 31, 242 out of 12 million students in 35,874 schools were reported to have been infected”
39. Macartney, K., Quinn, H.E., Pillsbury, E.J., et al. (2020) Transmission of SARS-CoV-2 in Australian educational settings: a prospective cohort study. The Lancet Child and Adolescent Health, 3 augustus
“SARS-CoV-2 transmission rates were low in NSW educational settings during the first COVID-19 epidemic wave, consistent with mild infrequent disease in the 1·8 million child population. With effective case-contact testing and epidemic management strategies and associated small numbers of attendances while infected, children and teachers did not contribute significantly to COVID-19 transmission via attendance in educational settings”
40. Folkhälsomyndigheten (2020) Covid-19 in schoolchildren – A comparison between Finland and Sweden. Zweedse gezondheidsautoriteiten, 7 juli
“In conclusion, closure or not of schools has had little if any impact on the number of laboratory confirmed cases in school aged children in Finland or Sweden”
41. Lavezzo, E. Franchin, C. Ciavarella, G., et al. (2020). Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo. Nature, 30 juni (updated 15 januari 2021)
“Recent studies have found that the clinical progression of infection in children is generally milder than in adults. We found that none of the children under 10 years of age who took part in the study tested positive for SARS-CoV-2 infection at either survey, despite at least 13 of them living together with infected family members. This agrees with a recent study conducted in Iceland and is particularly intriguing given the very high observed odds ratio for adults to become infected when living together with family members who are positive for SARS-CoV-2”
42. Yung CF, Kam KQ, Nadua KD, Chong CY, Tan NWH, Li J, et al. (2020). Novel coronavirus 2019 transmission risk in educational settings. Clinical Infectious Diseases, 25 juni
“Our investigations, especially in preschools, could not detect SARS-CoV-2 transmission despite screening of symptomatic and asymptomatic children. The data suggest that children are not the primary drivers of SARS-CoV-2 transmission in schools and could help inform exit strategies for lifting of lockdowns”
43. Gudbjartsson, D.F., Helgason, A., Jonsson, H., et al. (2020). Spread of SARS-CoV-2 in the Icelandic Population. The New England Journal of Medicine, 11 juni
“In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males”
Artikel over dit onderzoek: Coronavirus: Hunting down COVID-19
44. Hoek, van der, W., Backer, J.A., Bodewes, R., Friesema, I. (2020) De rol van kinderen in de transmissie van SARS-CoV-2. Nederlands Tijdschrift voor Geneeskunde, 3 juni
“Conclusie. De studie geeft geen aanwijzingen dat kinderen een belangrijke rol spelen in de transmissie van SARS-CoV-2. Kinderen kunnen weldegelijk geïnfecteerd raken, maar transmissie vindt vooral plaats tussen volwassen leeftijdsgenoten en van volwassen gezinsleden naar kinderen. Transmissie onder kinderen onderling of van kinderen naar volwassenen, zoals bij influenza bekend is, lijkt minder vaak voor te komen. Het lopende onderzoek in Nederland en het buitenland zal een nog beter inzicht geven in de rol van kinderen, kinderopvang en scholen in de transmissie van SARS-CoV-2″
45. Heavey, L., Casey, G., Kelly., C, Kelly, D., McDarby, G. (2020). No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020. Eurosurveillance, 28 mei
“The results moreover echo the experience of other countries, where children are not emerging as considerable drivers of transmission of COVID-19. (…) These findings suggest that schools are not a high risk setting for transmission of COVID-19 between pupils or between staff and pupils”
46. Ludvigsson, J.F. Children are unlikely to be the main drivers of the COVID‐19 pandemic – a systematic review. Acta Paediatrica, 19 mei
“Children accounted for a small fraction of COVID‐19 cases and mostly had social contacts with peers or parents, rather than older people at risk of severe disease. Data on viral loads were scarce, but indicated that children may have lower levels than adults, partly because they often have fewer symptoms, and this should decrease the transmission risk. Household transmission studies showed that children were rarely the index case and case studies suggested that children with COVID‐19 seldom caused outbreaks”
47. Munro, A.P.S., Saul, N. (2020) Children are not COVID-19 super spreaders: time to go back to school. The British Medical Journal, 5 mei
“At the current time, children do not appear to be super spreaders. (..) Governments worldwide should allow all children back to school regardless of comorbidities”
48. Thors, V., S. (2020) Iceland’s data on the infectivity of children cross-infection risk. European Association of Paediatrics, april
“Furthermore, we could also deduct that none of the 1800 cases were infected by a child < 10 years of age whereas infections from adults to children were quite common. With this knowledge in mind, there has been no closure of schools nor day-care centres although they have been running on a limited power also due to staff issues”
49. Australian Health Protection Principal Committee (AHPPC) coronavirus (COVID-19) statement on 17 March 2020
“The Committee’s advice is that pre-emptive closures are not proportionate or effective as a public health intervention to prevent community transmission of COVID-19 at this time”
50. Folkhälsomyndigheten. Ingen effektiv åtgärd att låta friska skolbarn stanna hemma (‘No effective measure to let healthy school children stay at home’). 1 maart 2020
“[Sweden’s] Public Health Authority assesses that suspending healthy school children is not an effective measure. It is unlikely that healthy children would cause the spread of infection. None of the outbreaks we have seen so far of the coronavirus have been linked to schools or children. There is also no reliable scientific evidence that suspending healthy school children or closing schools would reduce the risk of infection spreading in society even if school children were infected”
Studies naar het effect van schoolsluitingen
1. Walsh S., Chowdhury A., Russell S., et al. (2021) Do school closures reduce community transmission of COVID-19? A systematic review of observational studies. BMJ, 16 juli 2021
“Three studies, including the two at lowest risk of bias, reported no impact of school closures on SARS-CoV-2 transmission; whilst the other seven reported protective effects. Effect sizes ranged from no association to substantial and important reductions in community transmission”
2. Haug, N., Geyrhofer, L., Londei, A., et al. (2020) Ranking the effectiveness of worldwide COVID-19 government interventions. Nature Human Behaviour, 16 november 2020
“We showed that the most effective measures include closing and restricting most places where people gather in smaller or larger numbers for extended periods of time (businesses, bars, schools and so on). However, we also find several highly effective measures that are less intrusive”
NB: Er is geen onderzoek gedaan naar ‘schoolsluitingen’. Dat alle onderwijsinstellingen (inclusief universiteiten) onder één noemer gebracht worden is een beperking van deze studie.
Algemene kritiek: “International modelling studies which estimate that school closures have a meaningful effect on reducing transmission rates are all confounded by the near simultaneous introduction of multiple interventions (including lockdowns, curfews, closures of bars and restaurants). Moreover, they do not account for indirect effects of school closures which prevent parents from working outside the home” – Alisdair Munro, kinderarts en Clinical Research Fellow Paediatric Infectious Diseases (University Hospital Southampton)
Voor een uitgebreid literatuuroverzicht kinderen en Covid-19, ism UK Royal College of Paediatrics and Child Health:
Boast, A., Munro, A., Goldstein, H., et al. (2020, 2021) An evidence summary of Paediatric COVID-19 literature.
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