Due to rapidly evolving conditions, the question of how to safely operate schools and daycares remained a top priority throughout the COVID-19 pandemic. In response to growing and changing evidence, the National Collaborating Centre for Methods and Tools in Canada maintained a living rapid review on the role of schools and daycares in COVID-19 transmission to guide evidence-informed decision making. This Review presents the final iteration of this living rapid review. 31 sources were searched until Oct 17, 2022. In the final version, eligible studies reported data from Jan 1, 2021 onward on transmission of COVID-19 in school or daycare settings, the effect of infection prevention and control measures on transmission, or the effect of operating schools or daycares on community-level COVID-19 rates. As a rapid review, titles and abstracts were screened by a single reviewer with artificial intelligence integrated into later versions. Full-text screening, data extraction, and critical appraisal were completed by one reviewer and checked by a second reviewer. The Johanna Briggs Institute tools were used for critical appraisal. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach, and results were synthesised narratively. Three citizen partners provided input for the final interpretation. This final update includes 73 primary studies. Secondary attack rates were low within school settings when infection prevention and control measures were in place (moderate certainty). Masks might reduce transmission, test-to-stay policies might not increase transmission risk compared with mandatory quarantine, cohorting and hybrid learning might make little to no difference in transmission (low certainty), and the effect of surveillance testing within schools remained inconclusive (very low certainty). Findings indicate that school settings do not substantially contribute to community incidence, hospitalisations, or mortality (low certainty). This living review provides a synthesis of global evidence for the role of schools and daycares during COVID-19, which might be helpful in future pandemics.

中文翻译：

---

学校和日托中心在 COVID-19 传播中的具体作用是什么？实时快速审查的最终报告

由于情况迅速变化，如何安全运营学校和日托中心的问题仍然是整个 COVID-19 大流行期间的首要任务。为了应对不断增长和变化的证据，加拿大国家方法和工具合作中心对学校和日托中心在 COVID-19 传播中的作用进行了实时快速审查，以指导基于证据的决策。这篇评论呈现了这篇实时快速评论的最终版本。截至 2022 年 10 月 17 日，检索了 31 个来源。在最终版本中，符合条件的研究报告了 2021 年 1 月 1 日起有关学校或日托机构中 COVID-19 传播、感染预防和控制措施对传播的影响或运营学校或日托中心对社区层面的 COVID-19 发病率的影响。作为快速审稿，标题和摘要由一名审稿人筛选，并将人工智能集成到后续版本中。全文筛选、数据提取和批判性评估由一名审稿人完成，并由第二名审稿人检查。约翰娜·布里格斯研究所的工具用于严格评估。使用建议评估、制定和评价分级方法评估证据的确定性，并以叙述方式综合结果。三位公民合作伙伴为最终解释提供了意见。最终更新包括 73 项初步研究。当感染预防和控制措施到位时，学校环境中的二次感染率较低（中等确定性）。口罩可能会减少传播，与强制隔离相比，测试留校政策可能不会增加传播风险，分组和混合学习可能对传播几乎没有影响（低确定性），学校内监测测试的效果仍然不确定（非常大）。低确定性）。研究结果表明，学校环境对社区发病率、住院率或死亡率没有显着影响（低确定性）。这篇实时回顾综合了关于学校和日托中心在 COVID-19 期间的作用的全球证据，这可能对未来的大流行有所帮助。