School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review

Abstract

In response to the coronavirus disease 2019 (COVID-19) pandemic, 107 countries had implemented national school closures by March 18, 2020. It is unknown whether school measures are effective in coronavirus outbreaks (eg, due to severe acute respiratory syndrome [SARS], Middle East respiratory syndrome, or COVID-19). We undertook a systematic review by searching three electronic databases to identify what is known about the effectiveness of school closures and other school social distancing practices during coronavirus outbreaks. We included 16 of 616 identified articles. School closures were deployed rapidly across mainland China and Hong Kong for COVID-19. However, there are no data on the relative contribution of school closures to transmission control. Data from the SARS outbreak in mainland China, Hong Kong, and Singapore suggest that school closures did not contribute to the control of the epidemic. Modelling studies of SARS produced conflicting results. Recent modelling studies of COVID-19 predict that school closures alone would prevent only 2-4% of deaths, much less than other social distancing interventions. Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods.

Impact of non-pharmaceutical interventions on documented cases of COVID-19

“…In our analysis, this NPI belonged to those with only a rather moderate estimated effect, amounting to a 10 % reduction. This finding is in line with prior literature in which the transmissibility of SARS-CoV-2 among children is regarded as comparatively small 11,23 . The preceding argument also provides a possible explanation for why our model attributes only a small reduction of cases to this NPI.…”

Impact of climate and public health interventions on the COVID-19 pandemic: a prospective cohort study

“…30,31 A recent rapid systematic review concluded that the evidence to support national closure of schools to combat COVID-19 is very weak and that data from influenza outbreaks suggest that school closures could have relatively small effects on SARS-CoV-2 owing to its high transmissibility and apparent low clinical effect on school children. 32 Our results suggest that school closures are likely to have a larger effect than suggested in this review, but the clustering of school closures with other public health interventions means that we were unable to reliably estimate the independent effect of this intervention on the COVID-19 pandemic. The effect of restrictions of mass gathering, measures of social distancing and school closures on viral transmission is understudied.…”

“…The effect of restrictions of mass gathering, measures of social distancing and school closures on viral transmission is understudied. [32][33][34] However, mathematical models and limited observational evidence suggest that they can interrupt disease transmissions. Our study provides evidence using global data from the COVID-19 pandemic, that these interventions are strongly associated with reduced epidemic growth.…”

The Effect of Stay-at-Home Orders on COVID-19 Cases and Fatalities in the United States

“…11 In contrast, school closures across East Asia were estimated to be much less effective. 12 With estimates that nearly half of transmissions occur from pre-symptomatic and asymptomatic individuals, epidemiological simulations suggest that quarantines of symptomatic individuals alone will be insufficient to halt the pandemic. 13 This has led to widespread adoption of population-wide policies to dramatically reduce social contact.…”