Using the WHO-INTEGRATE framework to develop a COVID-19 guideline for schools, Germany

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Policy

Background:

• The COVID-19 pandemic highlighted the need for reliable, globally applicable recommendations for safe school operations.
• Lack of clear guidance impacted continuous schooling and student well-being worldwide.

Purpose of the Study:

• To develop a living, evidence- and consensus-based guideline for reducing SARS-CoV-2 transmission in schools.
• To provide a structured decision-making process for school safety measures with a societal perspective.

Main Methods:

• Applied the WHO-INTEGRATE evidence-to-decision framework for guideline development.
• Convened a multisectoral panel to review synthesized evidence on nine school measures.
• Conducted moderated consensus conferences for recommendation development and revision.

Main Results:

• The first version of the guideline was published in February 2021.
• Dissemination garnered significant media attention and awareness among state education ministries.
• Nine out of 16 German state education ministries recognized the guideline, with five using it to inform directives.

Conclusions:

• The WHO-INTEGRATE framework supported comprehensive assessment of school measures and their societal impact.
• Rapid application of the framework was feasible but could be further optimized.
• The guideline served as a valuable resource for German states in managing school operations during the pandemic.