A global assessment of the impact of school closure in reducing COVID-19 spread

Wu, Joseph T.; Mei, Shujiang; Luo, Sihui; Leung, Kathy; Liu, Di; Lv, Qiuying; Liu, Jian; Li, Yuan; Weng, Jianping; Feng, Tiejian; Zheng, Xueying; Leung, Gabriel M.

doi:10.21203/rs.3.rs-53593/v1

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…The appendix contains full details (pp 2–4, 8, 9, 10–16). 5 , 6 We used Hong Kong as a case study and assume that, before vaccination, the population is completely susceptible to SARS-CoV-2 infection. Serological studies have shown that, even in countries worst hit by the first global wave of COVID-19 pandemic, pre-vaccination seroprevalence at the population level (thus the estimated cumulative infection attack rates) was lower than 20%.…”

Section: Methodsmentioning

confidence: 99%

Effects of adjusting public health, travel, and social measures during the roll-out of COVID-19 vaccination: a modelling study

Leung

2021

The Lancet Public Health

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Background Since the emergence of the COVID-19 pandemic in late 2019, various public health and social measures (PHSMs) have been used to suppress and mitigate the spread of SARS-CoV-2. With mass vaccination programmes against COVID-19 being rolled out in many countries in early 2021, we aimed to evaluate to what extent travel restrictions and other PHSMs can be relaxed without exacerbating the local and global spread of COVID-19. Methods We adapted an existing age-structured susceptible-infectious-removed model of SARS-CoV-2 transmission dynamics that can be parameterised with country-specific age demographics and contact patterns to simulate the effect of vaccination and PHSM relaxation on transmission. We varied assumptions by age-specific susceptibility and infectiousness, vaccine uptake, contact patterns, and age structures. We used Hong Kong as a case study and assumed that, before vaccination, the population is completely susceptible to SARS-CoV-2 infection. We applied our model to 304 jurisdictions (27 countries and 277 sub-national administrative regions from eight countries). We assumed that PHSMs have suppressed the effective reproductive number ( R e ) to fall between 1·0 and 9·0 locally before the commencement of vaccination programmes. We evaluated the levels of PHSMs that should be maintained during the roll-out of COVID-19 vaccination to avoid a large local outbreak of COVID-19, with different assumptions about vaccine efficacy, vaccination coverage, and travel restrictions. We assumed that the maximum capacity of the health system, in terms of daily hospital admissions, is 0·005% of the population size. Findings At vaccine efficacy of 0·80 in reducing susceptibility to SARS-CoV-2 infection, 0·50 in reducing SARS-CoV-2 infectivity, and 0·95 in reducing symptomatic COVID-19 diseases, vaccination coverage would have to be 100% for all individuals aged 30 or older to avoid an outbreak, when relaxing PHSMs, that would overload the local health-care system, assuming a pre-vaccination R e of 2·5. Testing and quarantine of at least 5 days would have to be maintained for inbound travellers to minimise the risk of reintroducing a local outbreak until high vaccination coverages are attained locally and overseas in most countries. Interpretation Gradual relaxation of PHSMs should be carefully planned during the roll-out of vaccination programmes, and easing of travel restrictions weighed against risk of reintroducing outbreaks, to avoid overwhelming health systems and minimise deaths related to COVID-19. Funding Health and Medical Research Fund and the General Research Fund.

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Section: Methodsmentioning

confidence: 99%

Effects of adjusting public health, travel, and social measures during the roll-out of COVID-19 vaccination: a modelling study

Leung

2021

The Lancet Public Health

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“…Different shapes of population pyramids and contact matrices between age groups that vary substantially between countries can translate into large variability of effect. 16 It remains unclear whether school closures work, and whether they work sufficiently to warrant the anticipated negative outcomes for children in education. With the availability of location-based functions on handheld devices and contact tracing apps, public health authorities should enhance understanding of population mobility and mixing patterns in order to more precisely target nonpharmaceutical interventions, including school closures, in future.…”

Section: School Closuresmentioning

confidence: 99%

Learning from crisis: building resilient systems to combat future pandemics

2021

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COVID-19 has accelerated medical research in the quest to understand this new pandemic threat, to answer public health questions, and to develop a vaccine that could allow a return to "normal" life. A spotlight has illuminated how evidence becomes policy, and the interface of politics and science, which encompasses ecological, financial, and social risks, among others. In a lecture delivered for the Academy of Medical Sciences on Nov 2, 2020, we examined the threat of future pandemics in the light of COVID-19, reviewing how to prepare, how to build resilient health systems, and what we can learn from coronavirus to combat pandemics of the future.

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“…Thus, there has been broad variation in types and the usage of pandemic response measures across societies, in particular regarding schools (Blum and Dobrotić 2020;Landivar et al 2021;McGowan 2020). Two years into the Covid-19 pandemic, the scientific evidence on the role of schools in and the effects of school closures on the spread of SARS-CoV-2 remains mixed and inconclusive (Stage et al 2021;Walsh et al 2021;Wu et al 2022). Given this lack of clear epidemiological guidance on best Covid-19 pandemic practices for schools, other factors, such as economic, political, or ideational considerations, have likely influenced how political actors have managed school operations during the pandemic, leading to the observed heterogeneous pandemic policies related to schools, and other public and private institutions (Béland et al 2021).…”

Section: Introductionmentioning

confidence: 99%