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Simulation-Based Estimation of SARS-CoV-2 Infections Associated With School Closures and Community-Based

David Naimark1,2,3,4,5, Sharmistha Mishra1,4,5,6,7, Kali Barrett1,2,8

  • 1Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

JAMA Network Open
|March 31, 2021
PubMed
Abstract

Insights

School closures had minimal impact on COVID-19 cases compared to community interventions. Reopening schools showed a small increase in cases, with most infections originating outside school settings.

Area of Science:

  • Epidemiology
  • Public Health Modeling

Background:

  • Resurgent COVID-19 cases necessitated nonpharmaceutical interventions, including school closures, impacting families.
  • Understanding the link between school closures and COVID-19 transmission is crucial for informed decision-making.

Purpose of the Study:

  • To estimate the association between school operational status (open vs. closed) and COVID-19 case numbers.
  • To compare the impact of school policies with community-based nonpharmaceutical interventions.

Main Methods:

  • Developed an agent-based transmission model using a synthetic population of 1,000,000 individuals in Ontario, Canada.
  • Simulated scenarios of school reopening versus remaining closed under various nonpharmaceutical intervention strategies.
  • Analyzed incident and cumulative COVID-19 cases between September 1 and October 31, 2020.

Main Results:

  • Less than 5% of infections among students and teachers were acquired within schools.
  • School reopening scenarios showed a small increase in incident cases (2040 difference) compared to community interventions (39,355 difference).
  • Cumulative cases were similar whether schools remained closed or reopened, especially when community interventions were implemented.

Conclusions:

  • Most COVID-19 cases linked to schools originated from community transmission, not within school settings.
  • Changes in COVID-19 case numbers due to school reopenings were minor compared to the effects of community-level interventions.
  • Modeling suggests community interventions are more impactful than school closures for controlling COVID-19 spread.

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