Previous pandemics  did not take into account how closure of schools would impact our healthcare work capacity (referring to healthcare workers who would have to miss work to take care of their children). 
Will the increased need for childcare increase net mortality? 
At what point will the strain on labour supply undo the benefits that school closures have? 
- Approx 15% of healthcare workers (14.8-15.2 CI) are in need of child care during a school closure
-Estimating that school closures bring a 15% reduction in COVID cases 
-Estimating a baseline mortality rate of 2% 

-With these estimates, a 15% decrease in the health-care labour force would need to decrease the survival probability (per health-care worker lost) by 17.6% for school closure to increase cumulative mortality
-If infection mortality rate increased from 2.00% to 2.35% in conjunction with a 15% reduction in healthcare labour, school closures would lead to more deaths than they prevent

Impact of School Closures for COVID-19 on the US Health-care workforce and net mortality

- The benefits of school closure need to be weighed against the detriments of absent workers from the healthcare system. 
- For example, in the UK, it is estimated that about 30% of the healthcare workforce is the main carer for their children at home. Combined with an estimation of 10% absenteeism due to sickness in staff and 5% for other reasons during a pandemic, 45% of the healthcare workforce being absent can have very harmful effects. 

Santa Clara University

- Economic Costs from Absenteeism 
- Effects on child hunger
- More children left to self-care
- Socioeconomic factors to consider
- School closure effects on the healthcare workforce

Downsides of School Closures 

Cauchemez, S., Ferguson N.M., Wachtel C., Tegnell A., Saour G., Duncan B., Nicoll A. (2009, August). Closure of schools during an influenza pandemic. The Lancet Infectious Diseases, 9(473-81). 

Closure of schools during an influenza pandemic

- In a survey, 25% of 664 adults who cared for children 17 years or younger stated at least one child receives free breakfast or lunch at school or daycare. Of this 25%, 34% of these respondents said if they could not get them during a 3-month school closure, problems would arise. 

Effects on child hunger 

School closure effects on the healthcare workforce

- In the USA, it was estimated that the economic cost of school closure would be 6% of the GDP, or $2.7 million per 1000 people (data from 2009).
- However, because health costs may rise from more cases if school closures aren’t implemented, school closures may still be a cost-effective strategy

Economic costs from parents who have to stay home to support their kids during school closures

- Children from low-income families are more likely to be left alone, and will suffer from more behavioral and social problems.
- Studies show that declines in performance in education after summer break are greater for children from low-income and minority groups, and this will likely not be different for school closures due to a pandemic. 
- It was found that 93% of 91 low-income households would have serious financial problems if they had to stay home during a 3-month school closure.

Socioeconomic disparity in outcomes of school closure for low-income families

- Self-care (children being left at home on their own) is associated with increased underage drinking, drug use and adverse peer pressure. 
- Some studies have concluded that parents will overestimate their child’s ability to self-care. 

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