An examination of school reopening strategies during the SARS-CoV-2 pandemic

Abstract

The SARS-CoV-2 pandemic led to closure of nearly all K-12 schools in the United States of America in March 2020. Although reopening K-12 schools for in-person schooling is desirable for many reasons, officials understand that risk reduction strategies and detection of cases are imperative in creating a safe return to school. Furthermore, consequences of reclosing recently opened schools are substantial and impact teachers, parents, and ultimately educational experiences in children. To address competing interests in meeting educational needs with public safety, we compare the impact of physical separation through school cohorts on SARS-CoV-2 infections against policies acting at the level of individual contacts within classrooms. Using an age-stratified Susceptible-Exposed-Infected-Removed model, we explore influences of reduced class density, transmission mitigation, and viral detection on cumulative prevalence. We consider several scenarios over a 6-month period including (1) multiple rotating cohorts in which students cycle through in-person instruction on a weekly basis, (2) parallel cohorts with in-person and remote learning tracks, (3) the impact of a hypothetical testing program with ideal and imperfect detection, and (4) varying levels of aggregate transmission reduction. Our mathematical model predicts that reducing the number of contacts through cohorts produces a larger effect than diminishing transmission rates per contact. Specifically, the latter approach requires dramatic reduction in transmission rates in order to achieve a comparable effect in minimizing infections over time. Further, our model indicates that surveillance programs using less sensitive tests may be adequate in monitoring infections within a school community by both keeping infections low and allowing for a longer period of instruction. Lastly, we underscore the importance of factoring infection prevalence in deciding when a local outbreak of infection is serious enough to require reverting to remote learning.

Understanding the effectiveness of government interventions against the resurgence of COVID-19 in Europe

“…Indeed, schools in Europe's second wave operated under safety measures that some other organisations lacked: symptom screening, asymptomatic testing, contact tracing, sanitising, ventilation, distancing, reducing group sizes, and preventing the mixing of groups 41,45 . Our results are consistent with agent-based and compartmental modelling studies which predict large decreases in transmission in schools upon implementation of multiple safety measures 46,47 . Further, the effects of closures on transmission outside of the educational institutions might provide an additional explanation for the observed differences between the waves.…”

Impact of COVID-19 on School Populations and Associated Factors: A Systematic Review

“…The US Center for Disease Control (CDC) has outlined five main mitigation strategies for school reopening, including; (1) consistent and correct use of masks, (2) adherence to social distancing measures, (3) hand hygiene and respiratory etiquette, (4) cleaning and disinfection; and (5) contact tracing in collaboration with the local health department [ 84 ]. In order to reduce the capacity of classrooms during school reopening, an earlier study also suggested the multiple cohorts rotation approach, in which in-person and remote classes would be conducted in parallel [ 85 ]. Mitigation strategies on the impact of the COVID-19 pandemic on teacher quality of life is also imperative to be addressed.…”

Measures for infection prevention and control of SARS-CoV-2 in Belgian schools between December 2020 and June 2021: a prospective cohort study

“…Design and analysis issues apply, making it difficult to evaluate the impact of individual or combined measures (15). One study estimated that the combination of reduced class density, transmission mitigation measures (use of masks, desk shields, frequent surface cleaning, outdoor instruction), and early identification of active infections would reduce SARS-CoV-2 prevalence (16). Additionally, a study in Barcelona, Spain, found that transmission rates of SARS-CoV-2 among children were lower in summer schools applying IPC measures such as contact bubbles, hand hygiene, masks and outdoor activities, compared to the general population (17).…”