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Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies

OBJECTIVES: To systematically reivew the observational evidence of the effect of school closures and school reopenings on SARS-CoV-2 community transmission. SETTING: Schools (including early years settings, primary schools and secondary schools). INTERVENTION: School closures and reopenings. OUTCOME...

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Autores principales: Walsh, Sebastian, Chowdhury, Avirup, Braithwaite, Vickie, Russell, Simon, Birch, Jack Michael, Ward, Joseph L, Waddington, Claire, Brayne, Carol, Bonell, Chris, Viner, Russell M, Mytton, Oliver T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375447/
https://www.ncbi.nlm.nih.gov/pubmed/34404718
http://dx.doi.org/10.1136/bmjopen-2021-053371
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author Walsh, Sebastian
Chowdhury, Avirup
Braithwaite, Vickie
Russell, Simon
Birch, Jack Michael
Ward, Joseph L
Waddington, Claire
Brayne, Carol
Bonell, Chris
Viner, Russell M
Mytton, Oliver T
author_facet Walsh, Sebastian
Chowdhury, Avirup
Braithwaite, Vickie
Russell, Simon
Birch, Jack Michael
Ward, Joseph L
Waddington, Claire
Brayne, Carol
Bonell, Chris
Viner, Russell M
Mytton, Oliver T
author_sort Walsh, Sebastian
collection PubMed
description OBJECTIVES: To systematically reivew the observational evidence of the effect of school closures and school reopenings on SARS-CoV-2 community transmission. SETTING: Schools (including early years settings, primary schools and secondary schools). INTERVENTION: School closures and reopenings. OUTCOME MEASURE: Community transmission of SARS-CoV-2 (including any measure of community infections rate, hospital admissions or mortality attributed to COVID-19). METHODS: On 7 January 2021, we searched PubMed, Web of Science, Scopus, CINAHL, the WHO Global COVID-19 Research Database, ERIC, the British Education Index, the Australian Education Index and Google, searching title and abstracts for terms related to SARS-CoV-2 AND terms related to schools or non-pharmaceutical interventions (NPIs). We used the Cochrane Risk of Bias In Non-randomised Studies of Interventions tool to evaluate bias. RESULTS: We identified 7474 articles, of which 40 were included, with data from 150 countries. Of these, 32 studies assessed school closures and 11 examined reopenings. There was substantial heterogeneity between school closure studies, with half of the studies at lower risk of bias reporting reduced community transmission by up to 60% and half reporting null findings. The majority (n=3 out of 4) of school reopening studies at lower risk of bias reported no associated increases in transmission. CONCLUSIONS: School closure studies were at risk of confounding and collinearity from other non-pharmacological interventions implemented around the same time as school closures, and the effectiveness of closures remains uncertain. School reopenings, in areas of low transmission and with appropriate mitigation measures, were generally not accompanied by increasing community transmission. With such varied evidence on effectiveness, and the harmful effects, policymakers should take a measured approach before implementing school closures; and should look to reopen schools in times of low transmission, with appropriate mitigation measures.
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spelling pubmed-83754472021-08-20 Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies Walsh, Sebastian Chowdhury, Avirup Braithwaite, Vickie Russell, Simon Birch, Jack Michael Ward, Joseph L Waddington, Claire Brayne, Carol Bonell, Chris Viner, Russell M Mytton, Oliver T BMJ Open Epidemiology OBJECTIVES: To systematically reivew the observational evidence of the effect of school closures and school reopenings on SARS-CoV-2 community transmission. SETTING: Schools (including early years settings, primary schools and secondary schools). INTERVENTION: School closures and reopenings. OUTCOME MEASURE: Community transmission of SARS-CoV-2 (including any measure of community infections rate, hospital admissions or mortality attributed to COVID-19). METHODS: On 7 January 2021, we searched PubMed, Web of Science, Scopus, CINAHL, the WHO Global COVID-19 Research Database, ERIC, the British Education Index, the Australian Education Index and Google, searching title and abstracts for terms related to SARS-CoV-2 AND terms related to schools or non-pharmaceutical interventions (NPIs). We used the Cochrane Risk of Bias In Non-randomised Studies of Interventions tool to evaluate bias. RESULTS: We identified 7474 articles, of which 40 were included, with data from 150 countries. Of these, 32 studies assessed school closures and 11 examined reopenings. There was substantial heterogeneity between school closure studies, with half of the studies at lower risk of bias reporting reduced community transmission by up to 60% and half reporting null findings. The majority (n=3 out of 4) of school reopening studies at lower risk of bias reported no associated increases in transmission. CONCLUSIONS: School closure studies were at risk of confounding and collinearity from other non-pharmacological interventions implemented around the same time as school closures, and the effectiveness of closures remains uncertain. School reopenings, in areas of low transmission and with appropriate mitigation measures, were generally not accompanied by increasing community transmission. With such varied evidence on effectiveness, and the harmful effects, policymakers should take a measured approach before implementing school closures; and should look to reopen schools in times of low transmission, with appropriate mitigation measures. BMJ Publishing Group 2021-08-17 /pmc/articles/PMC8375447/ /pubmed/34404718 http://dx.doi.org/10.1136/bmjopen-2021-053371 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Epidemiology
Walsh, Sebastian
Chowdhury, Avirup
Braithwaite, Vickie
Russell, Simon
Birch, Jack Michael
Ward, Joseph L
Waddington, Claire
Brayne, Carol
Bonell, Chris
Viner, Russell M
Mytton, Oliver T
Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
title Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
title_full Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
title_fullStr Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
title_full_unstemmed Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
title_short Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
title_sort do school closures and school reopenings affect community transmission of covid-19? a systematic review of observational studies
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375447/
https://www.ncbi.nlm.nih.gov/pubmed/34404718
http://dx.doi.org/10.1136/bmjopen-2021-053371
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