July 14 (UPI) -- With little data on the effects of COVID-19 in children -- and their role in virus transmission -- decisions on whether to open schools in the fall should be based on spread of the disease in local areas, experts said Tuesday.
Rulings on school reopenings should be left to local leaders because of variation in virus spread from community to community, Duke University specialists in child health, infectious diseases and public policy told reporters during a conference call.
The comments came one day after education leaders in two of the country's largest school districts -- Los Angeles and San Diego counties in California -- announced plans to hold classes online in the fall.
Limited data shows significant spread of the new coronavirus, SARS-CoV-2, among children, researchers say.
Health officials in Israel, however, have blamed a recent uptick in cases on the decision to reopen schools in May, according to a report published by public health experts at the University of Washington.
Israel closed schools again in early June after 244 infections were identified among children and staff across multiple schools, including 130 at one alone, the report said.
"We need to avoid broad, sweeping mandates requiring schools to open and children to attend in person," Dr. Charlene Wong, an assistant professor of pediatrics at the Duke School of Medicine, said Tuesday on the call.
"It's still early in the pandemic," said Wong, who plans to send her own kindergartner to school in the fall, should the local district decide to reopen.
Several states across the country have reported record highs in cases in the last two weeks, including Arizona, California, Florida and Texas. Wong said officials at the city or county level can best assess risks posed to children, teachers and staff members, as well as the potential social and economic effects of school decisions.
With one in five American children living in poverty, schools across the United States do more than educate, said Lisa Gennetian an associate professor of early learning policy studies in Duke's Sanford School of Public Policy, who was on the call.
Schools also offer childcare to working parents and serve as an important source of health services -- and food -- for young students in need, she said.
Parents face "understandable stress" because a decision on whether their child's school will reopen might influence their ability to go back to work and provide for their families, Wong said.
Reopening schools could also create "unpredictable needs for quarantining" as the school year progress, Wong said.
Children who have had close contact with someone who has been infected with the new coronavirus, either at school or at home, would likely need to quarantine for 14 days, she said.
"Will parents be able to take time off work or find a grandparent or nanny willing to watch a child potentially exposed to COVID-19?" Wong asked.
But, she said, remaining at home could have "lifelong consequences" for children, as school is not only vital for learning, but also socialization.
While evidence to date suggests that the new coronavirus "behaves differently" in children than in adults -- with children getting a milder form of the disease -- "a small proportion" of existing research on the virus focuses on children, Wong said.
In addition to data from Israel, evidence from several European countries suggests that the virus spread significantly among school-age children, the University of Washington report indicates.
This includes countries like Denmark and Germany, which closed schools in March and began phased reopenings later in the spring, and Sweden, which kept schools open, the report authors said.
Just two of 34 households with multiple lab-confirmed COVID-19 infections in Chicago, however, had cases of child-to-child transmission, and only two others had instances of child-to-adult transmission, a study published last month in the Journal of the Pediatric Infectious Diseases Society found.
Duke experts said that should districts choose to reopen in the fall, they should take steps to ensure teachers and staff members have adequate supplies of personal protective equipment.
They said, however, that if schools remain closed, legislators should ensure that access to online learning is available to all students, and that employers offer childcare services to workers.
"The only way to open schools safely is to have a comprehensive approach to reduce transmission within the community, and the United States is quite unique in that it could be the first country to reopen schools with rising infection rates in some places," Dr. Ibukun Christine Akinboyo, medical director of pediatric infection prevention at Duke University Medical Center, said Tuesday.
"I don't think its premature to have the conversation, but I also don't think it's wise to rush into any decisions," she said.