Assessing the impact of SARS-CoV-2 prevention measures in schools by means of agent-based simulations calibrated to cluster tracing data

How to safely maintain schools open during a pandemic is still controversial. We aim to identify those measures that effectively control the spread of SARS-CoV-2 in schools. By control we mean that each source case infects less than one other person on average. Here, we analyze Austrian data on 616 clusters involving 2,822 student-cases and 676 teacher-cases with the aim to calibrate an agent-based epidemiological model in terms of cluster size and transmission risk depending on age and clinical presentation. With this model, we quantify the impact of preventive measures such as room ventilation, reduction of class size, wearing of masks during lessons, and school entry testing by SARS-CoV2-antigen tests. We find that 40% of all clusters involved no more than two cases, and 3% of the clusters only had more than 20 cases. The younger the students, the more likely we found asymptomatic cases and teachers as the source case of the in-school transmissions. Different school types require different combinations of measures to achieve control of the infection spreading: In primary schools, it is necessary to combine at least two of the aforementioned measures. In secondary schools, where contact networks of students and teachers become increasingly large and dense, a combination of three measures is needed. A sensitivity analysis indicated that the cluster size might increase up to three-fold in secondary schools for virus variants with an increased transmissibility by 50%, and that poorly executed or enforced mitigation measures might increase the cluster size by a factor of more than 30. Our results suggest that school-type-specific combinations of measures, when strictly adhered to, allow for a controlled opening of schools even under sustained community transmission of SARS-CoV-2. However, large clusters might still occur on an infrequent, however, regular basis. It is shown explicitly that strict adherence to the measures is a necessary condition for successful control.

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Modelling the impact of reopening schools in early 2021 in the presence of the new SARS-CoV-2 variant and with roll-out of vaccination against COVID-19

10.21203/rs.3.rs-267359/v1 ◽

2021 ◽

Author(s):

Jasmina Panovska-Griffiths ◽

Robyn Stuart ◽

Cliff Kerr ◽

Katherine Rosenfeld ◽

Dina Mistry ◽

...

Keyword(s):

Secondary Schools ◽

Primary Schools ◽

Vaccination Strategy ◽

Transmission Blocking ◽

Social Distancing ◽

New Variant ◽

The Uk ◽

And Control ◽

The Impact ◽

Roll Out

Abstract Background Following the resurgence of the COVID-19 epidemic in the UK in late 2020 and the emergence of the new variant of the SARS-CoV-2 virus, B.1.1.7, a third national lockdown was imposed from January 5, 2021. Following the decline of COVID-19 cases over the remainder of January 2021, it is important to assess the conditions under which reopening schools from early March is likely to lead to resurgence of the epidemic. This study models the impact of a partial national lockdown with social distancing measures enacted in communities and workplaces under different strategies of reopening schools from March 8, 2021 and compares it to the impact of continual full national lockdown remaining until April 19, 2021. Methods We used our previously published model, Covasim, to model the emergence of B.1.1.7 over September 1, 2020 to January 31, 2021. We extended the model to incorporate the impacts of the roll-out of a two-dose vaccine against COVID-19, assuming 200,000 daily doses of the vaccine in people 75 years or older with vaccination that offers 95% reduction in disease acquisition and 10% reduction of transmission blocking. We used the model, calibrated until January 25, 2021, to simulate the impact of a full national lockdown (FNL) with schools closed until April 19, 2021 versus four different partial national lockdown (PNL) scenarios with different elements of schooling open: 1) staggered PNL with primary schools and exam-entry years (years 11 and 13) returning on March 8, 2021 and the rest of the schools years on March 15, 2020; 2) full-return PNL with both primary and secondary schools returning on March 8, 2021; 3) primary-only PNL with primary schools and exam critical years (Y11 and Y13) going back only on March 8, 2021 with the rest of the secondary schools back on April 19, 2021 and 4) part-Rota PNL with both primary and secondary schools returning on March 8, 2021 with primary schools remaining open continuously but secondary schools on a two-weekly rota-system with years alternating between a fortnight of face-to-face and remote learning until April 19, 2021. Across all scenarios, we projected the number of new daily cases, cumulative deaths and effective reproduction number R until April 30, 2020. Results Our calibration across different scenarios is consistent with the new variant B.1.1.7 being around 60% more transmissible. Strict social distancing measures, i.e. national lockdowns, are required to contain the spread of the virus and control the hospitalisations and deaths during January and February 2021. The national lockdown will reduce the number of cases by early March levels similar to those seen in October with R also falling and remaining below 1 during the lockdown. Infections start to increase when schools open but if other parts of society remain closed this resurgence is not sufficient to bring R above 1. Reopening primary schools and exam critical years only or having primary schools open continuously with secondary schools on rotas will lead to lower increases in cases and R than if all schools open. Under the current vaccination assumptions and across the set of scenarios considered, R would increase above 1 if society reopens simultaneously, simulated here from April 19, 2021.Findings Our findings suggest that stringent measures are necessary to mitigate the increase in cases and bring R below 1 over January and February 2021. It is plausible that a PNL with schools partially open from March 8, 2021 and the rest of the society remaining closed until April 19, 2021 may keep R below 1, with some increase evident in infections compared to continual FNL until April 19, 2021. Reopening society in mid-April, with the vaccination strategy we model, could push R above 1 and induce a surge in infections, but the effect of vaccination may be able to control this in future depending on the transmission blocking properties of the vaccines.

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Elective Bariatric and Metabolic Surgery during the COVID-19 Pandemic: Experience from Taiwan

10.21203/rs.3.rs-32513/v1 ◽

2020 ◽

Author(s):

Darwin Salonga ◽

Chetan Parmar ◽

Ming-Che Hsin ◽

Chia-Chia Liu ◽

Yen-Chou Chen ◽

...

Keyword(s):

Healthcare Worker ◽

Metabolic Surgery ◽

Respiratory Infections ◽

Mitigation Measures ◽

Unknown Etiology ◽

Strict Adherence ◽

Telephone Consultation ◽

Time Period ◽

The Impact

Abstract Background: This study review the impact of an evolving pandemic on our elective operations, the timely and necessary precautions made by our government and institution to prevent and contain its spread.Methods: We performed a retrospective review of all Elective Bariatric and Metabolic Surgery done at our center from 1st January to 30th April 2020 compared to the same time period last year. A summary of the pathway for patients presenting to the hospital and healthcare worker surveillance was done.Results: Total of 99 patients underwent elective operations from 1st January - 30th April 2020. There were 59 females and 40 males with an average BMI of 35.20 kg/m2 and 40.68 kg/m2 respectively. Compared from the same period last year with a total 117 patients, a decline of 18 elective operations (-15.38%) was noted. All patients were properly screened for COVID-19. There was no reported case of post-operative fever of unknown etiology and/or upper respiratory infections developing COVID-19. There were no reported mortality. No surgeons or any healthcare worker in our center reported with COVID-19. We continue to do and offer elective operations, offer online and telephone consultation and follow up.Conclusion: Elective operations do not need to be postponed if you have early mitigation measures of a pandemic spread, prompt implementation of protocols and strict adherence to these measures.

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A Study Protocol to Determine Heat-Related Health Impacts among Primary Schoolchildren in South Africa

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155531 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5531

Author(s):

Shalin Bidassey-Manilal ◽

Caradee Yael Wright ◽

Thandi Kapwata ◽

Joyce Shirinde

Keyword(s):

South Africa ◽

Primary Schools ◽

Climate Models ◽

Neuropsychological Test ◽

Panel Study ◽

Weather Conditions ◽

Well Being ◽

Mitigation Measures ◽

Hot Weather ◽

The Impact

Climate models predict that the global average temperature of Earth will rise in the future. Studies show that high classroom temperatures can affect the ability of the student to learn and function. It is important to understand the impact that heat will have on the health, wellbeing, and academic performance of learners, as they spend a significant amount of time in classrooms compared to any other environment. A follow-up panel study among 20 public primary schools in the Gauteng province (South Africa) will be carried out, in which Grade 4 learners will be selected to complete an hourly heat-health symptom questionnaire. A Cambridge Neuropsychological Test Automated Battery (CANTAB) test will be used to determine their memory and attention span. A nursing practitioner will measure body weight, height, and temperature. Lascar data loggers will be used to measure indoor classroom temperature. School principals will complete a questionnaire on existing school coping mechanisms and policies in place that help deal with hot weather conditions. This is the first study to quantitatively assess the effects of heat on learners’ health, well-being and school performance in South Africa. The outcomes of this study will enable policymakers and public officials to develop appropriate school heat adaptation and mitigation measures and will assist in channeling their resources where it is most needed.

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The impact of school reopening on the spread of COVID-19 in England

Philosophical Transactions of the Royal Society B Biological Sciences ◽

10.1098/rstb.2020.0261 ◽

2021 ◽

Vol 376 (1829) ◽

pp. 20200261

Author(s):

Matt J. Keeling ◽

Michael J. Tildesley ◽

Benjamin D. Atkins ◽

Bridget Penman ◽

Emma Southall ◽

...

Keyword(s):

Secondary Schools ◽

Primary Schools ◽

Reproduction Number ◽

Health Impact ◽

Transmission Model ◽

Older Children ◽

Developmental Needs ◽

Social Distancing ◽

The Uk ◽

The Impact

By mid-May 2020, cases of COVID-19 in the UK had been declining for over a month; a multi-phase emergence from lockdown was planned, including a scheduled partial reopening of schools on 1 June 2020. Although evidence suggests that children generally display mild symptoms, the size of the school-age population means the total impact of reopening schools is unclear. Here, we present work from mid-May 2020 that focused on the imminent opening of schools and consider what these results imply for future policy. We compared eight strategies for reopening primary and secondary schools in England. Modifying a transmission model fitted to UK SARS-CoV-2 data, we assessed how reopening schools affects contact patterns, anticipated secondary infections and the relative change in the reproduction number, R . We determined the associated public health impact and its sensitivity to changes in social distancing within the wider community. We predicted that reopening schools with half-sized classes or focused on younger children was unlikely to push R above one. Older children generally have more social contacts, so reopening secondary schools results in more cases than reopening primary schools, while reopening both could have pushed R above one in some regions. Reductions in community social distancing were found to outweigh and exacerbate any impacts of reopening. In particular, opening schools when the reproduction number R is already above one generates the largest increase in cases. Our work indicates that while any school reopening will result in increased mixing and infection amongst children and the wider population, reopening schools alone in June 2020 was unlikely to push R above one. Ultimately, reopening decisions are a difficult trade-off between epidemiological consequences and the emotional, educational and developmental needs of children. Into the future, there are difficult questions about what controls can be instigated such that schools can remain open if cases increase. This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.

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Vaccination efforts in Brazil: scenarios and perspectives under a mathematical modeling approach

10.1101/2021.02.22.21252208 ◽

2021 ◽

Author(s):

Thomas Nogueira Vilches ◽

Felipe Alves Rubio ◽

Rafael Augusto Forti Perroni ◽

Gabriel Berg de Almeida ◽

Carlos Magno Castelo Branco Fortaleza ◽

...

Keyword(s):

Vaccination Rate ◽

Disease Prevalence ◽

Mitigation Measures ◽

Agent Based ◽

Oxford University ◽

Paulo State ◽

Vaccination Strategies ◽

Disease Outcomes ◽

Using Data ◽

The Impact

AbstractAn agent-based model is proposed to access the impact of vaccination strategies to halt the COVID-19 spread. The model is parameterized using data from São Paulo State, Brazil. It was considered the two vaccines that are already approved for emergency use in Brazil, the CoronaVac vaccine developed by the Chinese bio-pharmaceutical company Sinovac and the Oxford-AstraZeneca vaccine (ChadOx1) developed by Oxford University and the British laboratory AstraZeneca. Both of them are two-dose schemes, but the efficacy and the interval between doses are different. We found that even in the worst scenario, in which the vaccine does not prevent infection either severe symptoms, the number of deaths decreases from 122 to 99 for CoronaVac application and to 80 for ChadOx1 administration. The same patterns have been seen in hospitalizations. Nevertheless, we show that when a low risk perception occurs, the reduction values decrease between 2% to 4%. Moreover, the increase of disease prevalence also jeopardizes immunization, showing the importance of the mitigation measures maintenance. On the other hand, doubling the vaccination rate would be able to significantly decrease the disease outcomes, reducing deaths by up to 74.4%. In conclusion, vaccination, along with non-pharmaceutical measures, is key to the control of COVID-19 in Brazil.

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Modelling the impact of reopening schools in early 2021 in the presence of the new SARS-CoV-2 variant and with roll-out of vaccination against COVID-19

10.1101/2021.02.07.21251287 ◽

2021 ◽

Author(s):

J. Panovska-Griffiths ◽

R.M. Stuart ◽

C.C. Kerr ◽

K. Rosenfield ◽

D. Mistry ◽

...

Keyword(s):

Secondary Schools ◽

Primary Schools ◽

Vaccination Strategy ◽

Transmission Blocking ◽

Social Distancing ◽

New Variant ◽

The Uk ◽

And Control ◽

The Impact ◽

Roll Out

BackgroundFollowing the resurgence of the COVID-19 epidemic in the UK in late 2020 and the emergence of the new variant of the SARS-CoV-2 virus, B.1.1.7, a third national lockdown was imposed from January 5, 2021. Following the decline of COVID-19 cases over the remainder of January 2021, it is important to assess the conditions under which reopening schools from early March is likely to lead to resurgence of the epidemic. This study models the impact of a partial national lockdown with social distancing measures enacted in communities and workplaces under different strategies of reopening schools from March 8, 2021 and compares it to the impact of continual full national lockdown remaining until April 19, 2021.MethodsWe used our previously published model, Covasim, to model the emergence of B.1.1.7 over September 1, 2020 to January 31, 2021. We extended the model to incorporate the impacts of the roll-out of a two-dose vaccine against COVID-19, assuming 200,000 daily doses of the vaccine in people 75 years or older with vaccination that offers 95% reduction in disease acquisition and 10% reduction of transmission blocking. We used the model, calibrated until January 25, 2021, to simulate the impact of a full national lockdown (FNL) with schools closed until April 19, 2021 versus four different partial national lockdown (PNL) scenarios with different elements of schooling open: 1) staggered PNL with primary schools and exam-entry years (years 11 and 13) returning on March 8, 2021 and the rest of the schools years on March 15, 2020; 2) full-return PNL with both primary and secondary schools returning on March 8, 2021; 3) primary-only PNL with primary schools and exam critical years (Y11 and Y13) going back only on March 8, 2021 with the rest of the secondary schools back on April 19, 2021 and 4) part-Rota PNL with both primary and secondary schools returning on March 8, 2021 with primary schools remaining open continuously but secondary schools on a two-weekly rota-system with years alternating between a fortnight of face-to-face and remote learning until April 19, 2021. Across all scenarios, we projected the number of new daily cases, cumulative deaths and effective reproduction number R until April 30, 2020.ResultsOur calibration across different scenarios is consistent with the new variant B.1.1.7 being around 60% more transmissible. Strict social distancing measures, i.e. national lockdowns, are required to contain the spread of the virus and control the hospitalisations and deaths during January and February 2021. The national lockdown will reduce the number of cases by early March levels similar to those seen in October with R also falling and remaining below 1 during the lockdown. Infections start to increase when schools open but if other parts of society remain closed this resurgence is not sufficient to bring R above 1. Reopening primary schools and exam critical years only or having primary schools open continuously with secondary schools on rotas will lead to lower increases in cases and R than if all schools open. Under the current vaccination assumptions and across the set of scenarios considered, R would increase above 1 if society reopens simultaneously, simulated here from April 19, 2021.FindingsOur findings suggest that stringent measures are necessary to mitigate the increase in cases and bring R below 1 over January and February 2021. It is plausible that a PNL with schools partially open from March 8, 2021 and the rest of the society remaining closed until April 19, 2021 may keep R below 1, with some increase evident in infections compared to continual FNL until April 19, 2021. Reopening society in mid-April, with the vaccination strategy we model, could push R above 1 and induce a surge in infections, but the effect of vaccination may be able to control this in future depending on the transmission blocking properties of the vaccines.

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The impact of school reopening on the spread of COVID-19 in England

10.1101/2020.06.04.20121434 ◽

2020 ◽

Cited By ~ 6

Author(s):

Matt J. Keeling ◽

Michael J. Tildesley ◽

Benjamin D. Atkins ◽

Bridget Penman ◽

Emma Southall ◽

...

Keyword(s):

Secondary Schools ◽

Primary Schools ◽

Model Simulation ◽

Age Groups ◽

Health Impact ◽

Good Evidence ◽

Transmission Model ◽

Critical Threshold ◽

Older Children ◽

The Impact

AbstractBackgroundIn the UK, cases of COVID-19 have been declining since mid-April and there is good evidence to suggest that the effective reproduction number has dropped below 1, leading to a multiphase relaxation plan for the country to emerge from lockdown. As part of this staggered process, primary schools are scheduled to partially reopen on 1st June. Evidence from a range of sources suggests that children are, in general, only mildly affected by the disease and have low mortality rates, though there is less certainty regarding children’s role in transmission. Therefore, there is wide discussion on the impact of reopening schools.MethodsWe compare eight strategies for reopening primary and secondary schools in England from 1st June, focusing on the return of particular year groups and the associated epidemic consequences. This is assessed through model simulation, modifying a previously developed dynamic transmission model for SARS-CoV-2. We quantify how the process of reopening schools affected contact patterns and anticipated secondary infections, the relative change in R according to the extent of school reopening, and determine the public health impact via estimated change in clinical cases and its sensitivity to decreases in adherence post strict lockdown.FindingsWhilst reopening schools, in any form, results in more mixing between children, an increase in R and hence transmission of the disease, the magnitude of that increase can be low dependent upon the age-groups that return to school and the behaviour of the remaining population. We predict that reopening schools in a way that allows half class sizes or that is focused on younger children is unlikely to push R above one, although there is noticeable variation between the regions of the country. Given that older children have a greater number of social contacts and hence a greater potential for transmission, our findings suggest reopening secondary schools results in larger increases in case burden than only reopening primary schools; reopening both generates the largest increase and could push R above one in some regions. The impact of less social-distancing in the rest of the population, generally has far larger effects than reopening schools and exacerbates the impacts of reopening.DiscussionOur work indicates that any reopening of schools will result in increased mixing and infection amongst children and the wider population, although the opening of schools alone is unlikely to push the value of R above one. However, impacts of other recent relaxations of lockdown measures are yet to be quantified, suggesting some regions may be closer to the critical threshold that would lead to a growth in cases. Given the uncertainties, in part due to limited data on COVID-19 in children, school reopening should be carefully monitored. Ultimately, the decision about reopening classrooms is a difficult trade-off between increased epidemiological consequences and the emotional, educational and developmental needs of children.

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Influence of Selected Institutional Factors on the Impact of Constituency Development Fund in Financing Education in Public Secondary Schools in Ndaragwa Constituency, Kenya

Journal of Education and Development ◽

10.20849/jed.v2i3.502 ◽

2018 ◽

Vol 2 (3) ◽

pp. 13

Author(s):

Joseph Gicheru Ndei ◽

John Kanjogu Kiumi ◽

Peter Githae Kaboro

Keyword(s):

Secondary Schools ◽

School Type ◽

Development Fund ◽

Education Access ◽

Ex Post ◽

Alpha Level ◽

Ex Post Facto ◽

The Impact ◽

Financing Education

Access to secondary education in public secondary schools in Kenya has not been fully achieved due to rising costs in education. The Kenya government has therefore devised policies to help address issues of education access and retention through establishment of cost subsidies. The Constituency Development Fund (CDF) was established in 2003 through an Act of Parliament. The main objective was to mitigate the imbalance in regional development and provide people at the grassroots an opportunity to make expenditure choices that maximize their welfare in line with their needs and preferences. A key focus of CDF was to provide a devolved system of financing education. However, the extent to which CDF has succeeded in achieving this noble aim has not been evaluated. The focus of this study therefore was to find out the extent to which CDF as a means of financing education has succeeded in improving physical facilities, enhancing enrolment and reducing dropout rates in secondary schools in Ndaragwa Constituency, Kenya and to determine whether the impact is related to school type, enrolment, age and sponsorship. The study adopted an Ex-post facto research design where data were collected using self-administered questionnaires to 25 principals. Data were analyzed through descriptive and inferential statistics. Hypotheses were tested using ANOVA and t-test at an alpha level of 0.05. The study established that there is no significant relationship between the impact of CDF in financing education and school type, enrolment, age and sponsorship. Based on the findings, the study recommends that CDF framework should be revised in order to assist schools to address pertinent issues facing them and to improve the quality of education in all secondary schools in Kenya.

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Contribution of Schools to Covid-19 Pandemic: Evidence from Czechia

10.1101/2021.09.28.21264244 ◽

2021 ◽

Author(s):

Cyril Brom ◽

Jakub Drbohlav ◽

Martin Šmíd ◽

Milan Zajíček

Keyword(s):

Primary Schools ◽

School Attendance ◽

Risk Mitigation ◽

Mitigation Measures ◽

Primary Method ◽

Growth Reduction ◽

Age Cohorts ◽

School Year ◽

Upper Secondary ◽

The Impact

AbstractPurposeIt is unclear how much opening of schools during Covid-19 pandemic contributes to new SARS-CoV-2 infections among children. We investigated the impact of school opening with various mitigation measures (masks, rotations, mass testing) on growth rate of new cases in child cohorts ranging from kindergartens to upper secondary in Czechia, a country heavily hit by Covid-19, since April 2020 to June 2021.MethodsOur primary method is comparison of the reported infections in age cohorts corresponding to school grades undergoing different regimes. When there is no opportunity for such a comparison, we estimate corresponding coefficients from a regression model. In both the cases, we assume that district-level infections in particular cohorts depend on the school attendance and the external environment in dependence on the current overall risk contact reduction.ResultsThe estimates of in-cohort growth rates were significantly higher for normally opened schools compared to closed schools. When prevalence is comparable in the cohorts and general population, and no further measures are applied, the in-cohort growth reduction for closed kindergartens is 29% (SE=11%); primary: 19% (7%); lower secondary: 39% (6%); upper secondary: 47% (6%). For secondary education, mitigation measures reduce school-related growth 2-6 times.ConclusionConsidering more infectious SARS-CoV-2 variants and the ‘long covid’ risk, mitigation measures in schools, especially in secondary levels, should be implemented for the next school year. Some infections, however, are inevitable, even in kindergartens (where mitigation measures are difficult to implement) and primary schools (where they may not work due to low adherence).

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The Impact of Facilitation on the Quality of Deliberation and Attitude Change

Small Group Research ◽

10.1177/1046496419861439 ◽

2019 ◽

Vol 50 (5) ◽

pp. 623-653

Author(s):

Metka Kuhar ◽

Matej Krmelj ◽

Gregor Petrič

Keyword(s):

Attitude Change ◽

Primary Schools ◽

School Discipline ◽

Real Life ◽

Perceived Quality ◽

Necessary Condition ◽

Group Deliberation ◽

Life Context ◽

The Impact

Many researchers claim that facilitation is a determining factor, if not a necessary condition, for successful deliberative discussion, but little research has applied randomized experimental designs to empirically test such claim. This article analyzes the effect of professionally facilitated versus non-facilitated discussions in a real-life context on participants’ attitudes and the perceived quality of group deliberation, controlling for various individual- and group-level variables. We conducted 26 deliberative discussions with 226 teachers from 13 primary schools on the topic of school discipline measures. We assessed the teachers’ post-discussion perceptions of the perceived quality of the group deliberation and their attitudes toward school discipline measures pre- and post-discussion. The results show the facilitation’s significant influences on attitude change and the perceived quality of the group deliberation. Quality of deliberation is also influenced by heterogeneity of restorative attitudes in discussion groups, whereas attitude change is to a large extent determined also by pre-discussion attitudes.

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