Conclusions
Overall, opening schools and keeping them open in the context of the Sars-CoV-2 pandemic is theoretically possible, although behaviourally challenging and unfeasible if educational facilities or testing services are inadequate. Based on the data synthesized here, we can establish that, contrary to other respiratory viruses, children are not the primary targets of Sars-CoV-2 infection, transmission and disease, and schools may avoid becoming infection hubs for them, their teachers, the educational staffs and their households. It also appears that the second wave of the Sars-CoV-2 virus spread in the WHO European region has been unrelated to school re-opening. The pandemic exit strategy should necessarily prioritize an increased vigilance towards signs of negative health outcomes of the public health emergency on the younger population. A redeployment of public resources in such a direction might soon become necessary: the urgency may shift away from COVID-19 and towards increased prevalence of non-communicable and mental health disorders in the general population. We urge public health institutions across the globe to continue planning rescue programs and school restructuring in the near future to overcompensate for all that has been lost now, to avoid the future blame of the increasingly labelledCovid generation for not having used today all the available evidences to protect their long-term global health.
In conclusion, the clear benefits justifying the indiscriminate use of school closures as first-resorts at times of intensified viral spread in the community may increasingly no longer be current. Larger and longer prospective studies with widespread screening and mechanistic genomic tracing are now needed for risk stratification for all virus variants of concern, in different socio-economic contexts, background demographics and school designs. It is our duty to encourage investments in this type of research and best-informed policymaking, and to discourage all generalizations and unverified assumptions in politicized debates for school closure or opening by the lay public.