Objective: There is an urgent public need to readdress the school closure strategies. We aimed to describe the epidemiology of COVID-19 in schools and school-aged children to understand their roles in transmitting SARS-CoV-2 in Korea.
Design: Retrospective cohort study.
Setting: All schools in Korea PATIENTS: All school-aged children in Korea.
Interventions: None (observational study).
Main outcome measures: Incidence rate, proportion of affected schools.
Results: Between February and December 2020, the incidence rate was lower among school-aged children (63.2-79.8 per 100 000) compared with adults aged 19 and above (130.4 per 100 000). Household was the main route of transmission (62.3%), followed by community (21.3%) and school clusters (7.9%). Among the schools in Korea, 52% of secondary schools had COVID-19 cases, followed by 39% of primary schools and 3% of kindergartens.
Conclusions: We found that schools and school-aged children aged 7-18 years were not the main drivers of COVID-19 transmission. The major sources of transmission were households.
Keywords: COVID-19; child health; infectious disease medicine; paediatrics.
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