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

Walsh, S; Chowdhury, A; Braithwaite, V; Russell, S; Birch, JM; Ward, JL; Waddington, C; ... Mytton, OT; + view all (2021) Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies. BMJ Open , 11 (8) , Article e053371. 10.1136/bmjopen-2021-053371. Green open access

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Abstract

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.

Type: Article
Title: Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bmjopen-2021-053371
Publisher version: https://doi.org/10.1136/bmjopen-2021-053371
Language: English
Additional information: 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/.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10133771
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