
8 On the other hand, because viral loads may be similar in symptomatic and asymptomatic carriers of COVID-19, including children, 9, 10 there may be a high risk for transmission to other children and adults through asymptomatic children in settings serving large numbers of children, such as child care and schools. Although there is a relatively low risk of multisystem inflammatory syndrome in children, children appear to be far less likely than adults to be infected with COVID-19 and more likely to be asymptomatic or paucisymptomatic. Central to the debate over child care and school reopening is the uncertainty regarding whether children are efficient transmitters of COVID-19. Pediatricians are key informers to parents about safety issues regarding child care and school attendance during the pandemic. 1, 5, 6 Furthermore, child care and school closures may result in several negative consequences, such as child care providers’ loss of jobs and wages, parents’ inability to return to work, and children’s diminished educational, social, and nutritional opportunities. 4 However, several studies have indicated that school and child care closures may have had little impact on slowing the spread of COVID-19. Precautionary closure of child care programs was reasonable, given considerable evidence that these programs may be significant vectors for viral spread.

3 These school and child care closures have been controversial regarding their benefits versus their costs.

2 When schools closed in the United States, so did many child care programs, demonstrated by the loss of >35% of jobs in the child care industry between February and April 2020. 1 Within 3 weeks, the number had grown to 194 countries, impacting 91% of the world’s school-aged children. Within 1 week of the World Health Organization’s declaration of a pandemic, 107 countries had implemented national school closures.

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on child care and schools.
