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School Reopening—The Pandemic Issue That Is Not Getting Its Due

Educational Objective
To understand the importance of assessing how school closures affected the spread of COVID-19
1 Credit CME

The outcomes of pandemics are best understood in retrospect. Years from now, historians, epidemiologists, psychologists, and economists will provide extensive explanations of the damage done, mistakes made, and lessons learned. While in the thick of it, decisions must be made without the benefits that hindsight will provide, and those decisions can have considerable and lasting implications. It is also clear that certain vulnerable subpopulations have been asked to make greater sacrifices, as noted by Dooley et al1 in this issue of JAMA Pediatrics. Elderly people in institutions have given up all in-person visits; many adults in the workforce have been asked to forego their livelihood, together with all of the attendant hardships that brings; and millions of children have been kept home from school and transitioned rather abruptly to distance learning that no child, school district, or teacher was adequately prepared for. The decision to close schools was among the first action that many states took to stave the impending pandemic and was based on a strong theoretical foundation. Children are typically at greatest risk of infectious diseases, and they transmit them to each other and their families with considerable speed. Many drew parallels to the 100-year-old influenza epidemic, in which it was true that children played a central role in transmission. But in the 6 to 8 weeks since most schools in the US have closed, we have gathered new evidence about both children’s risks from the virus and their likelihood of transmitting it, as noted by Esposito and Principi2 in this issue of JAMA Pediatrics. We know only what we know today about the benefits and harms associated with school closure.

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Article Information

Corresponding Author: Dimitri A. Christakis, MD, MPH, Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, 2001 Eighth Ave, Ste 400, Seattle, WA 98121 (dimitri.christakis@seattlechildrens.org).

Published Online: May 13, 2020. doi:10.1001/jamapediatrics.2020.2068

Funding/Support: None reported.

References
1.
Dooley  DG , Bandealy  A , Tschudy  MM .  Low-income children and coronavirus disease 2019 (COVID-19) in the US.   JAMA Pediatr. Published online May 13, 2020. doi:10.1001/jamapediatrics.2020.2065Google Scholar
2.
Esposito  S , Principi  N .  School closure during the coronavirus disease 2019 (COVID-19) pandemic: an effective intervention at the global level?   JAMA Pediatr. Published online May 13, 2020. doi:10.1001/jamapediatrics.2020.1892Google Scholar
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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