Unintended consequences of measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review

Kratzer, Suzie; Pfadenhauer, Lisa M.; Biallas, Renke L; Featherstone, Robin; Klinger, Carmen; Movsisyan, Ani; Rabe, Julia E; Stadelmaier, Julia; Rehfuess, Eva; Wabnitz, Katharina; Verboom, Ben

doi:10.1002/14651858.cd015397

Cited by 16 publications

(19 citation statements)

References 47 publications

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“…This, lead to remarkable Fig. 2 Forest plot of changes in youth clinically relevant depression symptoms comparing before and during COVID-19 pandemic reduction in social contacts with peers, a disruption of daily routines, and an increase in loneliness, which appear to have major effects on the pathogenesis of depression in youths [1,51,52]. Our review supports previous findings by showing an increase for general depression symptoms in children and adolescents when PHSM were more rigorous and schools were closed or partially closed.…”

Section: Discussionsupporting

confidence: 79%

“…Besides, almost 76 million school children in Europe [ 50 ] have been affected by full or partial school closures and other PHSM implemented in the school setting. This, lead to remarkable reduction in social contacts with peers, a disruption of daily routines, and an increase in loneliness, which appear to have major effects on the pathogenesis of depression in youths [ 1 , 51 , 52 ]. Our review supports previous findings by showing an increase for general depression symptoms in children and adolescents when PHSM were more rigorous and schools were closed or partially closed.…”

Section: Discussionmentioning

confidence: 99%

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Increase of depression among children and adolescents after the onset of the COVID-19 pandemic in Europe: a systematic review and meta-analysis

Ludwig-Walz

Dannheim

Pfadenhauer

et al. 2022

Child Adolesc Psychiatry Ment Health

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Background Research points to a high depression burden among youth during the COVID-19 pandemic; however, a lack of systematic evidence exists. We determine the change in depression symptoms among children and adolescents during COVID-19 compared to pre-pandemic baselines. By using country differences in pandemic-related restrictions and school closures in Europe as quasi-experimental design, we evaluate policy impacts on depression. Methods In this systematic review and meta-analysis, following the PRISMA statement, we searched six databases (MEDLINE, EMBASE, PsycINFO, Cochrane Central, Web of Science, WHO COVID-19) using a peer-reviewed search string up until March 18, 2022 with citation tracking and grey literature searches. No limitations regarding language and effect measures existed. We included studies that compared (1) general depression symptoms or (2) clinically relevant depression rates in children and adolescents (≤ 19 years) before and during the COVID-19 pandemic in Europe. The validated Oxford Stringency Index was used as indicator for pandemic-related restrictions. Screening for eligibility, extracting data from published reports and from unpublished data requested directly from study authors, assessing the study risk of bias and grading certainty of evidence using the GRADE approach, were all done in duplicate. Data were pooled in a random-effects model. PROSPERO: CRD42022303714. Results Of 7,422 nonduplicate records, 22 studies with data from 868,634 participants pre-pandemic and 807,480 during pandemic, met full inclusion criteria. For the comparison of depression symptoms before and during the COVID-19 pandemic, moderate certainty of evidence was observed for general depression symptoms (standardized mean difference, 0.21 [95%CI, 0.12–0.30]; I2 = 94%) and low certainty of evidence for clinically relevant depression rates (odds ratio, 1.36 [95%CI, 1.05–1.76]; I2 = 95%) for total population. Increase in general depression symptoms was higher for male adolescents, whereas increase in clinically relevant depression rates was higher for females. Effect estimates were significantly higher when pandemic-related restrictions were more stringent or school closure occurred. Conclusion An increase in depression symptoms occurred in a pre-pandemic vs. during-pandemic comparison within the COVID-19 pandemic, whereby pandemic-related restrictions (such as school closures) resulted in a considerable effect increase. Ensuring adequate supply of mental health recovery services and long-term monitoring is of high public health relevance.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Increase of depression among children and adolescents after the onset of the COVID-19 pandemic in Europe: a systematic review and meta-analysis

Ludwig-Walz

Dannheim

Pfadenhauer

et al. 2022

Child Adolesc Psychiatry Ment Health

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“…There is increasing evidence regarding the positive and negative effects of school-based measures for containing COVID-19 (Isphording et al, 2021 ; Kratzer et al, 2022 ; Lee et al, 2020 ), as well as growing calls to strengthen education systems’ preparedness for future pandemics, other disasters, and overlapping disasters (Lennox et al, 2021 ). However, as our findings reinforce, policy implementation remains a critical determinant of their efficacy in strengthening the preparedness of education systems (Lennox et al, 2021 ; Vincent-Lancrin et al, 2022 ).…”

Section: Future Research/practicementioning

confidence: 99%

‘Teachers are the guinea pigs’: teacher perspectives on a sudden reopening of schools during the COVID-19 pandemic

et al. 2023

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Primary and secondary education systems experienced substantial disruption during the COVID-19 pandemic. However, little is known about how public health policy has affected Australian teachers during the pandemic. This study examines teacher perspectives on a sudden change of policy, whereby schools were abruptly opened to students at the beginning of the pandemic. At the same time, strict social distancing rules applied to the remainder of the population. Qualitative data from 372 Western Australian schoolteachers were analysed using thematic analysis. Results highlight substantial impacts on teachers’ workloads and adverse effects on wellbeing. Perceptions that they were acting as guinea pigs and subjected to different social distancing rules than other citizens were particular stressors. Findings highlight substantial consequences of public health policies on the roles and wellbeing of teachers.

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“…The present results show that NPI in fact appeared to cause short time benefit on the spread of a highly transmissible variant but led to a dreadful scenario with many deaths afterwards. Considering the fact that NPI are accompanied by a multitude of social and economic costs [ 48 , 49 , 50 ], reasoning for far reaching NPI should be carefully balanced. At least in the warm season, measures as proposed in the Great Barrington Declaration [ 51 ] appear more appropriate in Europe than intensified NPI when dealing with a highly transmissible SARS-CoV-2 variant.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Germany and the United Kingdom Indicates That More SARS-CoV-2 Circulation and Less Restrictions in the Warm Season Might Reduce Overall COVID-19 Burden

Meintrup

Nowak-Machen

Borgmann

2022

Life

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(1) Background: Between March 2020 and January 2022 severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) caused five infection waves in Europe. The first and the second wave was caused by wildtype SARS-CoV-2, while the following waves were caused by the variants of concern Alpha, Delta, and Omicron respectively. (2) Methods: In the present analysis, the first four waves were compared in Germany and the UK, in order to examine the COVID-19 epidemiology and its modulation by non-pharmaceutical interventions (NPI). (3) Results: The number of COVID-19 patients on intensive care units and the case fatality rate were used to estimate disease burden, the excess mortality to assess the net effect of NPI and other measures on the population. The UK was more severely affected by the first and the third wave while Germany was more affected by the second wave. The UK had a higher excess mortality during the first wave, afterwards the excess mortality in both countries was nearly identical. While most NPI were lifted in the UK in July 2021, the measures were kept and even aggravated in Germany. Nevertheless, in autumn 2021 Germany was much more affected, nearly resulting in a balanced sum of infections and deaths compared to the UK. Within the whole observation period, in Germany the number of COVID-19 patients on ICUs was up to four times higher than in the UK. Our results show that NPI have a limited effect on COVID-19 burden, seasonality plays a crucial role, and a higher virus circulation in a pre-wave situation could be beneficial. (4) Conclusions: Although Germany put much more effort and resources to fight the pandemic, the net balance of both countries was nearly identical, questioning the benefit of excessive ICU treatments and of the implementation of NPI, especially during the warm season.

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Unintended consequences of measures implemented in the school setting to contain the COVID-19 pandemic: a scoping review

Cited by 16 publications

References 47 publications

Increase of depression among children and adolescents after the onset of the COVID-19 pandemic in Europe: a systematic review and meta-analysis

Increase of depression among children and adolescents after the onset of the COVID-19 pandemic in Europe: a systematic review and meta-analysis

‘Teachers are the guinea pigs’: teacher perspectives on a sudden reopening of schools during the COVID-19 pandemic

A Comparison of Germany and the United Kingdom Indicates That More SARS-CoV-2 Circulation and Less Restrictions in the Warm Season Might Reduce Overall COVID-19 Burden

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