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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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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 (firstname.lastname@example.org).
Published Online: May 13, 2020. doi:10.1001/jamapediatrics.2020.2068
Funding/Support: None reported.
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