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

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introduction

The WHO declared the 2019 coronavirus disease outbreak (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), to be a pandemic on March 12, 2020.

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WHO
Opening address by the Director-General of WHO at the briefing on COVID-19.

On March 18, 2020, the United Nations Educational, Scientific and Cultural Organization estimated that 107 countries had implemented national school closures linked to COVID-19, affecting 862 million children and young people, about half of the world’s student population. This situation had worsened rapidly in 29 countries with national school closings a week earlier.

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United Nations educationScientific and cultural organization
Interruption of COVID-19 education and response.

School closings are based on evidence and hypotheses of influenza outbreaks that they reduce social contact between students and therefore interrupt transmission.

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  • Jackson C
  • Vynnycky E
  • Mangtani P

The relationship between school holidays and the transmission of influenza in England and Wales.

School closings can affect deaths during an epidemic, either positively, reducing transmission and the number of cases, or negatively, reducing the number of health care workers available to care for the sick. Studies of British children and young people indicate that the average number of daily social contacts during school holidays is about half that of the back-to-school days;

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  • Eames KT
  • Tilston NL
  • PJ white
  • Adams e
  • Edmunds WJ

The impact of illness and the impact of school closure on patterns of social contact.

,

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  • Eames KT
  • Tilston NL
  • Edmunds WJ

The impact of school holidays on the social mix patterns of schoolchildren.

however, contacts continue and the mix between children and adults and between children from different schools actually increases during the holidays and school closings.

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  • Eames KT
  • Tilston NL
  • PJ white
  • Adams e
  • Edmunds WJ

The impact of illness and the impact of school closure on patterns of social contact.

,

5

  • Eames KT
  • Tilston NL
  • Edmunds WJ

The impact of school holidays on the social mix patterns of schoolchildren.

,

6

  • Hens N
  • Ayele GM
  • Goeyvaerts N
  • et al.

Estimate the impact of school closings on social mix behaviors and the transmission of infections through close contact in eight European countries.

,

seven

  • Brooks SK
  • Smith l
  • Webster R
  • et al.

The impact of the unplanned school closure on children’s social contact: a quick look at the evidence.

Evidence for the effectiveness of school closings and other social distancing measures in schools comes almost entirely from influenza epidemics, in which transmission of the virus tends to be caused by children. It is unclear whether school measures are effective in coronavirus outbreaks – for example, due to severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS) and, more specifically, COVID- 19, for which the transmission dynamics appear to be different. .

Four systematic reviews

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  • Jackson C
  • Mangtani P
  • Vynnycky E

Impact of school closings on an influenza pandemic: review of the scientific evidence base.

,

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  • Jackson C
  • Mangtani P
  • Hawker J
  • Olowokure B
  • Vynnycky E

The effects of school closings on flu epidemics and pandemics: a systematic review of simulation studies.

,

ten

  • Bin Nafisah S
  • Alamery AH
  • Al Nafesa A
  • Aleid B
  • Brazanji NA

School closure during a new flu: a systematic review.

,

11

  • Rashid H
  • Ridda I
  • King C
  • et al.

Gathering evidence and advice on social isolation and other related measures to respond to an influenza pandemic.

the effects of school closings on influenza epidemics or pandemics suggest that school closings can be a useful control measure, although the effectiveness of mass school closings is often low. School closure strategies can be national, regional, local or reactive closure of individual schools in response to student infection rates. A systematic review,

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  • Jackson C
  • Mangtani P
  • Vynnycky E

Impact of school closings on an influenza pandemic: review of the scientific evidence base.

Commissioned by the UK Department of Health in 2014 to inform pandemic influenza preparations, included 100 epidemiological studies and 45 modeling studies and concluded that school closings can reduce the spread of pandemic influenza if they are instituted at the start of epidemics. School closings result in greater reductions in peaks than cumulative attack rates and, according to modeling studies, are likely to have the greatest effect if the virus has low transmissibility (reproductive number[[[[R]

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  • Jackson C
  • Mangtani P
  • Hawker J
  • Olowokure B
  • Vynnycky E

The effects of school closings on flu epidemics and pandemics: a systematic review of simulation studies.

modeling studies by the same authors have drawn similar conclusions.

A 2018 review

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  • Bin Nafisah S
  • Alamery AH
  • Al Nafesa A
  • Aleid B
  • Brazanji NA

School closure during a new flu: a systematic review.

out of 31 studies investigating whether school closings had a quantifiable effect on influenza transmission, school closings reduced the peak of the related epidemic by 29.7% on average and delayed the peak by a median 11 days. They also reported that closing schools earlier had predicted a further reduction in the peak of the epidemic, although these estimates did not come from formal meta-analyzes.

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  • Bin Nafisah S
  • Alamery AH
  • Al Nafesa A
  • Aleid B
  • Brazanji NA

School closure during a new flu: a systematic review.

A systematic review of 2015

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  • Rashid H
  • Ridda I
  • King C
  • et al.

Gathering evidence and advice on social isolation and other related measures to respond to an influenza pandemic.

social distancing practices, including school closings, for influenza pandemics have reported wide variation in reduction of transmission (1-50%), but noted that up to 70% of students may move social contacts to other non-school sites during closings, reduce the effect of closings. A systematic review 2020

12

  • Cowling BJ
  • A list
  • Ng TWY
  • et al.

Impact assessment of non-pharmaceutical COVID-19 and influenza interventions in Hong Kong: an observational study.

school closings and other social distancing measures during influenza outbreaks have also found convincing evidence that closures reduce transmission, especially among school-aged children (5 to 17 years of age). However, there was substantial evidence that transmission had increased again after schools reopened, and there was little consensus on the appropriate timing of closings, let alone the reopening of schools.

One of the ways that school closings are effective during outbreaks could be to force parents to work at home, thereby reducing work-related contact. However, reviews also noted the detrimental effects of school closings, including economic damage to working parents, health workers and other key workers forced to work for child care and for society due to the loss of parental productivity, the transmission of children to vulnerable grandparents, loss of education, prejudices to child protection, in particular among the most vulnerable pupils, and nutritional problems, in particular for children for whom free school meals are an important source of nutrition.

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  • Jackson C
  • Mangtani P
  • Vynnycky E

Impact of school closings on an influenza pandemic: review of the scientific evidence base.

,

ten

  • Bin Nafisah S
  • Alamery AH
  • Al Nafesa A
  • Aleid B
  • Brazanji NA

School closure during a new flu: a systematic review.

,

11

  • Rashid H
  • Ridda I
  • King C
  • et al.

Gathering evidence and advice on social isolation and other related measures to respond to an influenza pandemic.

Social isolation itself causes a series of psychological harms.

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  • Brooks SK
  • Webster RK
  • Smith LE
  • et al.

The psychological impact of quarantine and how to reduce it: a quick review of the evidence.

A quick review

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  • Brooks SK
  • Webster RK
  • Smith LE
  • et al.

The psychological impact of quarantine and how to reduce it: a quick review of the evidence.

found evidence that, during unscheduled school closings, children’s activities and contact decreased but did not stop, with evidence that this was especially true for older children and those whose parents were not ‘with the closings.

seven

  • Brooks SK
  • Smith l
  • Webster R
  • et al.

The impact of the unplanned school closure on children’s social contact: a quick look at the evidence.

The economic disadvantages of school closings are significant. British study

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  • Sadistic MZ
  • Adams ej
  • Edmunds WJ

Estimate the costs of closing schools to mitigate an influenza pandemic.

according to 2008, around 16% of the workforce are the main providers of care for dependent children and are at very high risk of absenteeism if schools are closed, a proportion that reaches 30% in the sectors of health and social services. Unpublished estimates in the United States suggest that 29% of health workers have childcare obligations.

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The impact of school closings for COVID-19 on US health workers and the net effects of mortality.

A 2010 economic modeling analysis

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  • Keogh-Brown MR
  • Smith RD
  • Edmunds JW
  • Beutels P

The macroeconomic impact of pandemic influenza: estimates from models from the United Kingdom, France, Belgium and the Netherlands.

school closings, as mitigation interventions during influenza epidemics suggested that 4 or 13 week closures minimized the rate of clinical attacks but significantly increased the economic cost to the nation, particularly by ‘forced absenteeism of working parents in the United Kingdom, France, Belgium and the Netherlands. Costs have been estimated at a maximum of 0.2 to 1% of the UK’s gross national product (GDP) for closing schools for 12-13 weeks,

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  • Sadistic MZ
  • Adams ej
  • Edmunds WJ

Estimate the costs of closing schools to mitigate an influenza pandemic.

or up to 3% of GDP for an 8-week shutdown in US studies.

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  • ST Brown
  • Tai JH
  • Bailey RR
  • et al.

Was the school closure for the H1N1 flu epidemic in 2009 worth the cost ?: A computer simulation of Pennsylvania.

The reviews did not summarize in detail the economic damage associated with the school closings, but economic modeling of an influenza epidemic in Hong Kong, China, suggested that the most profitable models were selective local closings rather than city-wide closures.

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Economic evaluation of individual school closure strategies: the Hong Kong H1N1 pandemic 2009.

In particular, regardless of the official closure of schools or other distancing policies, unofficial absenteeism of students and staff (whether due to illness or a precautionary measure) can be very high during epidemics . Staff absenteeism can lead to forced closings of local schools.

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  • Sobers-Grannum N
  • Springer k
  • Ferdinand E
  • St John J

Responding to the challenges of the H1N1 pandemic in a small island state: the Barbadian experience.

School dismissal – whereby all but the most vulnerable and health care children and other essential workers are sent home but the school remains open – has been suggested as a less stringent intervention than the school closure, although there is no evidence to support its use separately until complete closure.

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  • Fong MW
  • Gao H
  • Wong JY
  • et al.

Non-pharmaceutical measures for pandemic influenza in non-health care settings – social distancing measures.

There are many other potential social distancing actions available to schools that are less drastic than complete closure, although these have received little attention.

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  • Uscher-Pines L
  • Schwartz HL
  • Ahmed F
  • et al.

School practices to promote social distancing in kindergarten to grade 12 schools: review of policies and practices in the event of an influenza pandemic.

A systematic review 2018

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  • Uscher-Pines L
  • Schwartz HL
  • Ahmed F
  • et al.

School practices to promote social distancing in kindergarten to grade 12 schools: review of policies and practices in the event of an influenza pandemic.

of these strategies noted that potential practices include suspending the relevant classes or age groups, or modifying the structure of the school organization to reduce the mix of students (for example, by closing playgrounds, by canceling nonessential activities and meetings, keeping students in constant groups or classes, increasing spacing between students in classes, shortening the school week and staggering school start and noon times or break between groups or classes of the year). The review concluded that few studies have been done, but that a small number of modeling studies have supported the use of alternative strategies during influenza outbreaks.

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  • Lofgren AND
  • Rogers J
  • Senese M
  • Fefferman nh

Pandemic preparedness strategies for school systems: is closure the only way ?.

,

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  • Ridenhour BJ
  • Braun A
  • Teyrasse T
  • Goldsman D

Control the spread of disease in schools.

No British studies were included in this review.

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  • Uscher-Pines L
  • Schwartz HL
  • Ahmed F
  • et al.

School practices to promote social distancing in kindergarten to grade 12 schools: review of policies and practices in the event of an influenza pandemic.

In the 2009 H1N1 flu pandemic, Taiwan instituted class suspensions rather than school closings, made easier by keeping students in a classroom at home with a primary teacher and by moving other teachers around regularly between classes. Studies suggest that this approach was an effective measure of social distancing in this epidemic while reducing social disruption.

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  • Yen MY
  • Chiu AW
  • Schwartz J
  • et al.

From SARS in 2003 to H1N1 in 2009: lessons learned from Taiwan in preparation for the next pandemic.

To reduce the transmission of COVID-19, many countries had instituted a national or large-scale closure of schools by March 2020. These actions appear to be largely based on assumptions that the apparent benefits of influenza outbreaks are also likely to COVID-19. . There are several theoretical reasons why school closings may be less effective in COVID-19 than in influenza outbreaks. Children contribute more to influenza transmission than adults,

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  • Wallinga j
  • Teunis P
  • Kretzschmar M

Use of social contact data to estimate age-specific transmission parameters for respiratory infectious agents.

with low levels of immunity and high levels of transmission due to symptomatic illness. However, in the COVID-19 pandemic so far, children appear to form a much lower proportion of cases than expected in their population, although the evidence on this is mixed and some evidence suggests that children may be as likely to be infected as adults, but largely remain asymptomatic or have a mild form of the disease.

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Diagnosis, treatment and prevention of new coronavirus infection in children in 2019: expert consensus statement.

It is not yet known whether the low proportion of confirmed cases of COVID-19 in children in mainland China is related to reduced risk of infection, subclinical or milder infections, or specific population factors (e.g. , the one-child policy). Evidence for transmission of COVID-19 through child-to-child contact or through schools is not yet available, although family-based transmission plays an important role in the epidemic.

In previous coronavirus outbreaks, the data suggested that school transmission was very low or absent.

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Severe acute respiratory syndrome in children.

Since modeling studies of school closings for influenza outbreaks are based on assumptions that the proportion of cases transmitted to schools is relatively high,

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  • Nightmare S
  • Ferguson NM
  • Wachtel C
  • et al.

Schools closed during an influenza pandemic.

these models cannot be considered as informative regarding the efficacy of COVID-19. New epidemiological data suggest few signs of COVID-19 transmission in schools in China, although this may reflect the closure of schools during most of the epidemic. In particular, school closings began with the non-reopening of schools after the Chinese New Year holidays.

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Wu Z. COVID-19 outbreak in China and country responses. Retroviruses and opportunistic infections (CROI) 2020: special session SS-1: International Antiviral Society – USA; March 8-11, 2020.

Since April 3, 2020, Taiwan has been recognized for effectively reducing the spread of COVID-19,

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Response to COVID-19 in Taiwan: big data analysis, new technologies and proactive tests.

but with national policies that avoided generalized planned school closings and instead imposed initially local class closings, then temporary closings of local schools, based on low thresholds for infected cases in individual schools.

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Response to COVID-19 in Taiwan: big data analysis, new technologies and proactive tests.

Given the scarcity of information and the pressures on countries to consider closing schools to respond to the COVID-19 pandemic, we conducted a systematic literature review to answer the question: what do we know about the use and the effectiveness and the profitability of school closings and other practices of social distancing of schools on infection rates and transmission during coronavirus outbreaks?

The methods

We sought to include quantitative studies using various models to model or empirically assess the effects of school closings and other school distancing practices on infection rates and transmission during coronavirus epidemics. Our research was designed to include all studies providing data on schools or nurseries. We searched various electronic databases on March 9, 2020 and again on March 19, 2020, with no language restrictions. We searched PubMed using search terms and a database appropriate syntax: SARS [tw] OR “severe acute respiratory syndrome”[mh] OR “severe acute respiratory syndrome” OR “Middle East Coronavirus respiratory syndrome”[mh] OR “Middle East respiratory syndrome *”[tw] OR “MERS-CoV”[tw] OR Seas[tw] OR “Middle East respiratory syndrome *”[tw] OR “MERSCoV *”[tw] OR coronavirus[mh] OR Coronavirus infections[mh] OR coronavirus *[tw] OR “COVID-19″[tw] or “2019-nCoV”[tw] or “SARS-CoV-2″[tw]) AND (Schools[mh:noexp] OR schools, nursery[mh] OR “Nurseries”[mh] OR “Crèches, infants”[mh] OR school[tiab] OR schools[tiab] OR nursery schools[tiab] OR preschool[tiab] OR “preschool”[tiab] OR “nursery schools”[tiab] OR nursery[tiab] OR nurseries[tiab] OR maternal[tiab] OR maternal[tiab] OR “daycare” OR daycare AND child * OR infant *. We searched the WHO global search database on COVID-19 using the term “school”, which retrieved only one article which we excluded because it did not contain any search . Therefore, we did a new search using the search terms “child”, “children”, “childhood”, “infant”, “baby”, “babies”, “pediatric” and “pediatric”. We also searched the medRxiv preprint server for all articles using the search terms “SARS or MERS or coronavirus or COVID-19”. We did not find it useful to include search terms related to schools because the search tools were not sophisticated.

All articles have been sorted (by SJR, HC and JP) by title and abstract. We excluded opinion pieces, systematic reviews, studies of other viruses, academic settings, epidemiological studies that did not examine the effects of interventions (for example, prevalence of infection in schools ) and studies in other languages ​​without English translation. All identified full-text articles were reviewed by RMV. For each full-text article retrieved, we hand-searched the included references and examined the citation chain for further study. We have not attempted to assess the quality of the studies included in this review. We examined the results of preprinted articles separately from published peer-reviewed articles.

Discussion

This review provides the first summary of data on school closings and other social distancing practices in schools during coronavirus outbreaks. We were only able to include nine published studies and seven non-peer-reviewed studies. We decided to include unreviewed studies because the data would not be available otherwise on COVID-19, although the results have been interpreted with caution. With the exception of a modeling study, none of the included studies has been designed to specifically examine the effectiveness of school-leaving measures. Thus, the data provided on the effect of educational measures was of relatively low quality.

We have identified a remarkable shortage of relevant policy data on implementing social distance to school during coronavirus epidemics. This finding may not be surprising for the rapidly emerging COVID-19 pandemic, but previous coronavirus outbreaks such as SARS and MERS provide limited information on the effectiveness of school closings and no data. on profitability. No data on other less disruptive social distancing practices at school during coronavirus outbreaks have been identified.

Data from the SARS epidemic in mainland China, Hong Kong and Singapore suggest that school transmission played no significant role in the epidemic and that school closings and other activities such as surveillance of school temperatures did not help control the transmission of infections. These results may reflect an effect of school closings in the rapid stopping of transmission; however, this is unlikely since schools remained open for long periods at the start of the epidemic. Modeling studies of the SARS epidemic have produced different results. Although Becker and his colleagues

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  • Becker NG
  • Glass K
  • Li Z
  • Aldis GK

Control emerging infectious diseases like SARS.

believes school closings have resulted in potentially significant reductions in transmission, Liao and colleagues

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A dynamic probabilistic transmission model to assess the risks of indoor air infection.

felt that transmission in classrooms was weak.

School closures were quickly deployed in mainland China and Hong Kong in early 2020 as part of a broader set of control measures for COVID-19, so no data were available on the comparative effectiveness of interventions to close isolated schools. Authors of preprint studies

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The impact of transmission control measures during the first 50 days of the COVID-19 epidemic in China.

,

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  • Kwok KO
  • Li KK
  • Chan HHH
  • et al.

Community responses during the first phase of the COVID-19 epidemic in Hong Kong: risk perception, information exposure and preventive measures.

concluded that the school closings likely contributed to the control of COVID-19 in China as part of a very broad set of quarantine measures. However, they do not provide any data to support this claim and it could indeed be very difficult to disentangle the relative contribution of school closings.

COVID-19 pandemic modeling studies support the use of national school closures as part of a package of social distancing. However, the only study to examine school closings as a separate intervention warned that the impact was relatively marginal, given reasonable assumptions that contact with households and the community would increase as a result.

Little data is available in the literature on coronavirus outbreaks to guide countries in the use of school closings or other social distancing practices in schools during the COVID-19 pandemic. The available evidence is consistent with a wide range of school closure impacts, from little effect on reducing transmission to more substantial effects. However, the economic costs and potential disadvantages of closing schools are undoubtedly very high.

As the evidence for fighting coronavirus outbreaks is sparse, we need to turn to evidence of the benefits of school closings against epidemics and pandemics of influenza. School closings were widespread in some countries during influenza pandemics, and many studies report significant effects on reducing transmission and the size of the pandemic. However, there is considerable heterogeneity in the impact of school closings on transmission depending on the characteristics of transmission of the influenza serotype. Systematic reviews of influenza outbreaks suggest that school closings are likely to have the greatest effect if the virus has low transmissibility (R

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  • Jackson C
  • Mangtani P
  • Vynnycky E

Impact of school closings on an influenza pandemic: review of the scientific evidence base.

Although our information on SARS-CoV-2 remains incomplete, this does not appear to be the case for COVID-19 outbreaks. Reported R COVID-19 values ​​are high (≥2 · 5).

47

Immediate forecast and forecast of the potential national and international spread of the 2019-nCoV epidemic originating in Wuhan, China: a modeling study.

Although children seem to get the infection at the same rate as adults, they have mostly mild or asymptomatic forms of the disease and seem less likely to spread the virus through coughing or sneezing; however, a precise understanding is still lacking. In particular, analyzes using British clinical data from the 1957 Asian flu pandemic suggest that school closings would reduce the size of the epidemic by less than 10% when the R was similar to that of COVID-19 (i.e., 2 · 5–3 · 5).

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Analyzes of the 1957 (Asian) influenza pandemic in the United Kingdom and the impact of school closings.

Reviews also note that the benefits of closing the school may be less than was assumed or modeled, as social contact between children and between children and adults continues in the context of child care. informal children and non-school gatherings of children and young people.

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  • Rashid H
  • Ridda I
  • King C
  • et al.

Recueil de preuves et conseils sur l’éloignement social et d’autres mesures connexes pour répondre à une pandémie de grippe.

Cette conclusion est particulièrement préoccupante pour COVID-19, avec sa mortalité plus élevée chez les personnes âgées, étant donné qu’environ 40% des grands-parents du Royaume-Uni assurent régulièrement la garde de leurs petits-enfants.

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5 millions de grands-parents assument des responsabilités de garde d’enfants.

Le Directeur général de l’OMS a noté le 12 mars 2020 que «tous les pays doivent trouver un juste équilibre entre la protection de la santé, la prévention des perturbations économiques et sociales et le respect des droits de l’homme».

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WHO
Allocution d’ouverture du Directeur général de l’OMS lors de la réunion d’information de la mission sur COVID-19.

Actuellement, les preuves à l’appui de la fermeture nationale des écoles pour lutter contre le COVID-19 sont très faibles et les données sur les épidémies de grippe suggèrent que les fermetures d’écoles pourraient avoir des effets relativement faibles sur un virus avec une transmissibilité élevée au COVID-19 et un faible effet clinique apparent sur les écoliers. Dans le même temps, ces données montrent également que les fermetures d’écoles peuvent avoir de profondes conséquences économiques et sociales.

Il est urgent de poursuivre les recherches sur l’efficacité des fermetures d’écoles et d’autres pratiques de distanciation sociale des écoles pour éclairer les politiques liées à COVID-19. Nous avons également besoin de connaissances plus détaillées sur la façon dont COVID-19 affecte les enfants et les jeunes, car le rôle des mesures scolaires dans la réduction de la transmission de COVID-19 dépend de la sensibilité des enfants à l’infection et de leur infectiosité une fois infecté.

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  • Cowling BJ
  • Une liste
  • Ng TWY
  • et al.

Évaluation de l’impact des interventions non pharmaceutiques contre le COVID-19 et la grippe à Hong Kong: une étude observationnelle.

Cependant, les études d’observation pourraient ne pas être informatives si les fermetures sont nationales et mises en œuvre en même temps que d’autres mesures d’atténuation. Un meilleur apprentissage pourrait provenir de pays qui ont institué des fermetures ultérieures ou infranationales. Études de modélisation – en particulier celles paramétrisées pour COVID-19 chez les enfants et celles qui peuvent prendre en compte l’interaction avec d’autres facteurs contextuels (par exemple, le calendrier, les parents travaillant à domicile et un mélange social supplémentaire en raison des fermetures d’écoles) ou différentes stratégies (nationales against déploiement par étapes) —sont susceptibles d’être plus informatifs et sont nécessaires de toute urgence.

Ces résultats posent un dilemme pour les décideurs politiques qui cherchent des mesures pour protéger les populations. La fermeture des écoles présente une méthode apparemment de bon sens pour réduire considérablement la propagation de la maladie et les preuves des épidémies de grippe précédentes semblent convaincantes. Cependant, les décideurs doivent être conscients des preuves équivoques lorsqu’ils proposent ou mettent en œuvre des fermetures d’écoles nationales ou régionales pour COVID-19, étant donné les coûts très élevés des fermetures prolongées d’écoles pendant les pandémies. Les décisions concernant les fermetures, leur calendrier et leur durée impliquent une série de compromis entre des facteurs conflictuels, et une perte substantielle de personnel de santé pour les tâches de garde d’enfants pendant les fermetures pourrait réduire considérablement les avantages pour les systèmes de santé et les populations provoqués par les fermetures d’écoles.

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  • Maison T
  • Baguelin M
  • Van Hoek AJ
  • et al.

Modélisation de l’impact des fermetures réactives locales d’écoles sur la prestation de soins intensifs pendant une pandémie de grippe.

Néanmoins, dans un contexte de taux élevés d’absence du personnel pour cause de maladie, les systèmes scolaires seront mis à rude épreuve et les écoles ne restant ouvertes que pour les enfants des soins de santé et d’autres travailleurs essentiels pourraient être une meilleure stratégie qu’un processus aléatoire de fermeture des écoles et donc n’offrir aucun service de garde aux travailleurs essentiels.

L’ampleur et la rapidité des fermetures d’écoles sont sans précédent dans le monde. On ne sait pas combien de temps les pays peuvent maintenir des mesures de suppression strictes avant que la fatigue comportementale de la population ne se produise.

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  • Ferguson NM
  • Laydon D
  • Nedjati-Gilani G
  • et al.

Rapport 9: impact des interventions non pharmaceutiques (NPI) pour réduire la mortalité par COVID-19 et la demande de soins de santé.

Étant donné les prévisions selon lesquelles des mesures de distanciation sociale pourraient devoir être en place pendant plusieurs mois, voire des années,

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  • Ferguson NM
  • Laydon D
  • Nedjati-Gilani G
  • et al.

Rapport 9: impact des interventions non pharmaceutiques (NPI) pour réduire la mortalité par COVID-19 et la demande de soins de santé.

il est urgent d’identifier comment les pays peuvent retourner en toute sécurité les élèves à l’éducation et les parents au travail. L’éducation est l’un des prédicteurs les plus solides de la santé et de la richesse des futurs travailleurs d’un pays, et l’impact de la fermeture à long terme des écoles sur les résultats scolaires, les gains futurs, la santé des jeunes et la productivité nationale future n’a pas été quantifié.

Une fois que le nombre de cas de COVID-19 commencera à baisser, les mesures utilisées pour parvenir à la suppression pourraient évoluer avec le temps. Les écoles ont commencé à rouvrir dans certaines parties de la Chine,

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Éducation des Nations UniesOrganisation scientifique et culturelle
Interruption de l’éducation COVID-19 et réponse.

et il sera essentiel pour les études de surveiller l’effet de la réouverture des écoles sur le nombre de cas de COVID-19. Il sera également important d’examiner les pays qui n’ont pas mis en place de fermetures d’écoles. Taïwan a rouvert ses écoles fin février 2020, relativement tôt dans l’épidémie; il n’a pas encore déclenché de nouvelles fermetures à grande échelle, mais il a été reconnu qu’il avait efficacement minimisé la propagation du COVID-19. Les décideurs politiques et les chercheurs devraient également envisager d’autres interventions de distanciation sociale des écoles qui sont beaucoup moins perturbatrices que la fermeture complète des écoles et pourraient contribuer de manière substantielle à maintenir le contrôle de cette pandémie. Bien que des preuves solides ne soient pas disponibles pour l’efficacité de ces pratiques, elles peuvent être mises en œuvre avec beaucoup moins de perturbations, de coûts financiers ou de préjudices. Des études de modélisation et d’observation sont nécessaires de toute urgence pour guider la politique d’ouverture des écoles une fois la pandémie maîtrisée.

RMV a conceptualisé le document, examiné les articles en texte intégral, extrait les données et rédigé la première version du manuscrit. Les recherches et la sélection des documents ont été effectuées par SJR, HC et JP, qui ont été conseillés par CS. JW et OM ont également contribué à la sélection des articles. OM, CB et RB ont aidé à réviser le document et à considérer les implications politiques. Tous les auteurs ont contribué à la révision de la version finale du manuscrit.

Nous ne déclarons aucun intérêt concurrent.

Note éditoriale: le Lancet Le Groupe adopte une position neutre vis-à-vis des revendications territoriales dans le texte publié.

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