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An analysis of more than 130 studies of COVID and schools aims to reassure administrators that they can reopen classrooms without causing a surge in infections.

The strongest proof that schools can reopen without triggering COVID surges comes from schools themselves, Emily Oster, a professor of economics at Brown University who has been tracking the virus’ spread in schools, said during a press briefing Thursday.

“The best evidence to suggest we can do it is that is has happened in a lot of places,” Oster said.

Evidence from the U.S. and around the world shows that schools mirror the transmissions in surrounding communities but are not driving spread, said John Bailey, a visiting scholar at the American Enterprise Institute and author of the analysis, “”

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All of the research also shows how crucial masks, social distancing, improved ventilation and other safety precautions are in reducing the risks for students and teachers, Bailey said in a press briefing Thursday.

The growing concerns should now be learning loss, mental health issues and other challenges that are being exacerbated by continuing school closures, he added.

“We’re learning there are costs to the public health benefits achieved by closing schools,” Bailey said. “We need a sense of urgency with reopening schools … and we have evidence for the best ways of doing that.”

Many studies, from the U.S. and elsewhere, have also found that schools did not trigger surges in infections when classrooms reopen with extensive safety precautions in place.

For example, researchers at the National Center for Research on Education Access and Choice found COVID hospitalizations did not increase in places where transmission rates were low during summer 2020.

And a A CDC study of 17 rural Wisconsin schools—where all students wore masks, practiced social distancing, and were organized in small cohorts of 11-20 to minimize spread—linked in-school spread to only seven of 191 cases diagnosed in students and staff.

Studies have also shown the surveillance testing of asymptomatic students and staff have also been effective in reducing transmission.

Costs of school closures

Many studies are revealing the disproportionate impact school closures are having on students of color and children from lower-income households.

Students who families earn less have had consistently less live contact with their teachers during the pandemic, according to a U.S. Census Bureau analysis released in January.

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And while most students have suffered some learning loss, students of color have fallen furthest behind, other studies have shown.

Bailey also cited news reports to gauge the pandemic’s emotional tool on students. For example, suicides among children ages 12 to 17 increased 67% in Pima County, Arizona.

And UCSF Benioff Children’s Hospital in Oakland, Calif., reported a 66% increase in the number of suicidal children in the ER, a doubling of adolescents hospitalized for eating disorders, and a 75 percent increase in youth seeking mental health services who required immediate hospitalization.

“We are dealing with a health crisis,” Superintendent Jesus Jara, of Nevada’s Clark County School District , said during the briefing. “We are also dealing with an academic crisis and a mental health crisis.”