Coronavirus (COVID-19): Advisory Sub-Group on Education and Children’s Issues - evidence on children, schools, early learning and childcare settings and transmission- summary report

Transmission and schools

The evidence base continues to suggest that children and adolescents (in particular those under the age of 14) transmit the virus at lower rates than adults, are more likely to transmit among themselves than to adults, and that cases in education settings follow and mirror transmission rates in the community where adult to adult transmission is more common.

During the first and second waves of the pandemic, research showed limited spread of COVID-19 in schools. While outbreaks have been documented in pre-schools, primary schools, and secondary schools, there are also low secondary attack rates in these settings when appropriate mitigation measures are in place. The risk of students affecting family members is also diminished if effective combinations of in-school mitigation measures are in place. 

These findings are supported by a recent pre-print systematic review and meta-analysis by Viner et al  which found that school infection prevalence broadly reflected community infections.  This study also found that in-school transmission from children (pooled estimate 0.5% (95% CI 0.1-1.6)) is much lower than in households, where it is similar to adults 7.3% (pooled estimate 95% CI 2.5-21.8).  Where appropriate mitigation measures are in place, in school settings, there appears to be limited spread. 

A pre-print paper reporting the results of a cluster randomised trial assessing the impact of daily testing for contacts in English secondary schools and colleges reported low rates of symptomatic infection in contacts in both the control and intervention arms. The control arm was assigned to follow the usual policy of isolation of contacts for 10 days, and the intervention arm was assigned to a policy of offering contacts daily testing over 7 days to allow continued school attendance. The rate of symptomatic infection in contacts was 0.9% in the control arm and 1.3% in the intervention arm.