A study of the spread of COVID-19 within New South Wales schools (10 high school, 5 primary) from March- mid April 2020 reveals that of a total of 6 initial cases in the primary schools (one student and five staff), only one of 168 close contacts was infected. Thus, there was a small outcome of infection among children and no instances of children infecting teachers.


Outcomes of Open Schools In Australia Amidst the COVID-19 Pandemic

On April 15, 2020, the Government of Denmark decided to send children under 11 back to school. School activities have been adapted to minimize transmission of the virus, and after a month of safety measures such as the creation of small groups of children for lessons and for playtime, frequent hand washing, 6-feet spacing of student’s desks and, when feasible, outdoor classes, the method seemed to be effective.


Outcomes of Re-opening Schools in Denmark Amidst the COVID-19 Pandemic

Local governments made the decision of whether they would reopen schools based on the number of COVID-19 cases in that area, with the national government recommending first- and sixth-graders be given priority. Schools have followed guidelines outlined by the Ministry of Health, such as daily temperature checks, maintenance of social distancing, and the wearing of face masks. 

Outcomes of Re-opening Schools in Japan Amidst the COVID-19 Pandemic

Israel declared complete closure of educational facilities on March 13, 2020 as a control measure for SARS-CoV-2 transmission. Limited reopening was permitted after May 3 for kindergartens and grades 1-3 and 11-12. All schools reopened on May 17, with public health requirements including daily health reports, good hygiene practices, facemask usage, social distancing, and minimal interactions. The first COVID-19 school outbreak emerged in a high school (Gymnasia Rehavia) on May 26, resulting in at least 130 cases among students and staff. The spike in cases in Israel following school re-opening has also been observed in South Korea and France. 

Outcomes of Open Schools In Israel Amidst the COVID-19 Pandemic

- Schools closed for 2 weeks right after the peak of the influenza outbreak 
- Examining the attack rates before and after closure showed that this was an effective strategy to lower the spread, but after a peak, there is going to be a reduction in cases anyway. 
- Taking a closer look, researchers found no significant effect of the closure of schools on the spread of the outbreak. 

Hong Kong school closure in March 2008 

- 4-week school closure was initiated across the city on February 1, 2020, which was approximately 1 week after the first cases of COVID-19 were identified in Hong Kong. 
- School closures coincided with other stringent social distancing measures, and school closures that were initially until March 2020 were extended to April 2020.
- Collectively these measures were considered to have reduced the R below 1, thus controlling the spread of the outbreak. 
- A preprint observational study by Cowling and colleagues noted that "social distancing measures implemented during the COVID-19 outbreak reduced community transmission by 44%, which was much greater than the estimated 10-15% reduction in influenza transmission" attributed to school closures during the 2009 H1N1 pandemic in Hong Kong. 
- There was no data available from the papers on the effect of school closures separate from other measures.



Outcomes of School Closures in Hong Kong due to the COVID-19 Pandemic

- As of April 3, 2020, Taiwan has been recognized to have effectively minimized the spread of COVID-19.
- Widespread planned school closures was avoided by mandating local class closures, and subsequently local temporary school closures, based on low thresholds for infected cases within individual schools.

Outcomes of School Closures and School Re-Openings in Taiwan during the COVID-19 Pandemic

- 2 preprint studies reported that school closures were initiated nationally across mainland China in late January 2020 after delaying the restart of schools following Chinese New year holidays. School closures were part of a broader series of control measures during the COVID-19 pandemic. 
- However, there is no data available on the effectiveness of school closures because there was little variation in the timing of closures (closures were reportedly applied in all Chinese cities uniformly) and school closures were part of a broad range of quarantine and social distancing measures.
- These studies concluded that a combination of quarantine and social distancing measures was effective in reducing the epidemic in Mainland China.
- Relative contribution of school closures was not assessed. 


Outcomes of School Closures in Mainland China during the COVID-19 Pandemic 

- Outcomes of School Closure and Management Practices during Coronavirus Outbreaks in the UK: A Systematic REVIEW 
- Outcome Prediction of Open Schools in England Amidst the COVID-19 Pandemic

Outcomes of School Closures & Reopening during the COVID-19 Pandemic in the UK

- Australia

- Denmark

- Japan

- England

- Israel

- Hong Kong  

- Mainland China

- Taiwan

- UK

Smith College

Syracuse University

University of Michigan - Ann Arbor

In an urgent attempt to curb the spread of SARS-CoV-2, K-12 schools across the U.S. have swiftly shut down and remained closed for approximately 2 months. As many countries have entered or are planning to enter a gradual reopening phase, clinical studies have found that children mainly have low transmission rates as well as asymptomatic to mild disease. As such, policymakers, healthcare systems, and educational institutions are considering reopening schools for fall 2020.



UPDATE: As of September 1, 2020, New York City schools are reopening September 16th with the first week being remote then after that there will be cohorts. Students get to choose if they want to be fully remote or in-person (hybrid). Students can go to remote learning anytime they choose if they do not feel comfortable being in the classroom once they are in. But, they are unable to go back into the classrooms once they are out. 

Re-opening Schools for Fall 2020 During COVID-19 Pandemic

- Improves children's mental health

- Reduces economic disparity

- In-person education is more effective than e-learning

Benefits to Re-opening Schools During Fall 2020 COVID-19 Pandemic

- Create the conditions for a successful reopening

- Social distancing through reallocation of spaces

- Division of classes into smaller groups of children

- Promotion of frequent and proper hand washing

- Ventilation of rooms

- Maximization of time spent outdoors

- Avoidance of shared materials

- Sanitation of spaces, furniture and toys

- Prompt identification of cases in the school environment and their tracing

- Large-scale viral nucleic acid and serologic testing

- Maintenance of safe physical education classes, structured recess, and after-school activities (such as safe athletics) 

- Listening to the concerns of families and teachers 

- Adapted curricula and teaching strategies to accommodate hybrids of in-person and remote learning

The Center for Disease Control and Prevention's Whole School, Whole Community, Whole Child model, the School Health Index model, and The American Academy of Pediatrics' considerations for re-opening may provide additional insight.

Safety Measures for Re-opening Schools

- Past school closures and their impacts 
- Downsides of school closures 
- Important aspects to consider in closing or reopening schools during a pandemic

Important takeaways of school closures from past influenza pandemics 

- How best to care for children with respiratory disease and multi-system inflammatory syndrome from COVID-19,
- The extent of transmission in school settings, 
- The relationship between school shutdowns on community spread, 
- The value of specific educational designs and interventions for disease transmission and learning. 
- Effects of remote learning programs
- Whether antibody levels are associated with immunity from further infection
- Return of children with chronic conditions
- Effects of school closure on children with special needs

Critical Questions for Reopening Schools

As research shows that younger children (likely 10 years and younger) have lower transmission rates of COVID-19, studies have also shown that a higher rate of transmission is seen among students aged 14-19 years old, which could have implications when considering the reopening of high schools, colleges, and universities. 

Comparison of Transmission Rates Based on Age Groups of Students

Outcomes of School Closures & Subsequent Re-opening/ Maintaining Open Schools by Country

Due to the novelty of COVID-19, many researchers have applied influenza pandemic preparedness plans of school closures to SARS-CoV-2 transmission prevention. In this study, the authors evaluate the impact of the COVID-19-related school closures on influenza A infection in Qatar. The study assesses the presence of respiratory viruses from nasopharyngeal swabs collected from Sidra Medicine, the main pediatric referral center in Qatar, before and after the first school closure on March 10.

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