Time Reallocation and the Cost and Benefit of School Closures during an Epidemic

2021 ◽  
Vol 16 (2) ◽  
pp. 263-306
Author(s):  
Jude Bayham ◽  
◽  
Gerardo Chowell ◽  
Eli P. Fenichel ◽  
Nicolai V. Kuminoff ◽  
...  

School closures are an important public health intervention during epidemics. Yet, the existing estimates of policy costs and benefits overlook the impact of human behavior and labor market conditions. We use an integrated assessment framework to quantify the public health benefits and the economic costs of school closures based on activity patterns derived from the American Time-Use Survey (ATUS) for a pandemic like COVID-19. We develop a policy decision framework based on marginal benefits and costs to estimate the optimal school closure duration. The results suggest that the optimal school closure depends on how people reallocate their time when schools are closed. Widespread social distancing behavior implemented early and for a long duration can delay the epidemic for years, buying time for the development of pharmaceutical interventions and yielding substantial net benefits. Conversely, school closure, with behavior targeted to adjust only to the school closure, is unlikely to provide substantial delay or sufficient net benefits to justify closing schools for pathogen control.

2020 ◽  
Author(s):  
Samantha Brooks ◽  
Louise Smith ◽  
Rebecca Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective. ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted. Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact. ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.


Author(s):  
Samantha K. Brooks ◽  
Louise E. Smith ◽  
Rebecca K. Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  

AbstractBackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective.ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted.Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact.ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.


2021 ◽  
Vol 9 ◽  
Author(s):  
Muhammad Syawal Amran ◽  
Khairul Azhar Jamaludin

School closures were implemented as a public health intervention to reduce the risk of infection from COVID-19. However, prolonged school closure is likely to impact adolescents' behavioral health due to the extreme change in routine. The current study aimed to explore adolescents' behavioral health experiences during the beginning of the outbreak of the COVID-19 pandemic. This study was done using qualitative methods to interview 15 adolescent participants (n =15) from low-income households in Malaysia. The study lasted for 2 months amidst the outbreak and data were collected via online based on focus group discussions. The results revealed that adolescents faced four main themes of experience during the COVID-19 pandemic: Alteration of sleep patterns, stress-related fatigue, dysfunctional eating patterns and lack of physical activity. This first-hand experience shows that knowledge and skills of adolescents' behavioral practices during outbreak deserves attention. This research stresses the role of family, schools, and media in addressing the health communication gap among adolescents to help them adapt in these new norms.


2020 ◽  
Vol 25 (13) ◽  
Author(s):  
Samantha K Brooks ◽  
Louise E Smith ◽  
Rebecca K Webster ◽  
Dale Weston ◽  
Lisa Woodland ◽  
...  

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited. Aim This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Methods In February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted. Results A total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact. Conclusion Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.


Author(s):  
Bernd Brüggenjürgen ◽  
Hans-Peter Stricker ◽  
Lilian Krist ◽  
Miriam Ortiz ◽  
Thomas Reinhold ◽  
...  

Abstract Aim To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). Methods We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. Conclusion Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures.


Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 415
Author(s):  
Sonia Chaabane ◽  
Sathyanarayanan Doraiswamy ◽  
Karima Chaabna ◽  
Ravinder Mamtani ◽  
Sohaila Cheema

School closures during pandemics raise important concerns for children and adolescents. Our aim is synthesizing available data on the impact of school closure during the coronavirus disease 2019 (COVID-19) pandemic on child and adolescent health globally. We conducted a rapid systematic review by searching PubMed, Embase, and Google Scholar for any study published between January and September 2020. We included a total of ten primary studies. COVID-19-related school closure was associated with a significant decline in the number of hospital admissions and pediatric emergency department visits. However, a number of children and adolescents lost access to school-based healthcare services, special services for children with disabilities, and nutrition programs. A greater risk of widening educational disparities due to lack of support and resources for remote learning were also reported among poorer families and children with disabilities. School closure also contributed to increased anxiety and loneliness in young people and child stress, sadness, frustration, indiscipline, and hyperactivity. The longer the duration of school closure and reduction of daily physical activity, the higher was the predicted increase of Body Mass Index and childhood obesity prevalence. There is a need to identify children and adolescents at higher risk of learning and mental health impairments and support them during school closures.


2021 ◽  
Author(s):  
Yen-Chang Chen ◽  
Yen-Yuan Chen

UNSTRUCTURED While health care and public health workers are working on measures to mitigate the COVID-19 pandemic, there is an unprecedentedly large number of people spending much more time indoors, and relying heavily on the Internet as their lifeline. What has been overlooked is the influence of the increasing online activities on public health issues. In this article, we pointed out how a large-scale online activity called cyber manhunt may threaten to offset the efficacy of contact tracing investigation, a public health intervention considered highly effective in limiting further transmission in the early stage of a highly contagious disease outbreak such as the COVID-19 pandemic. In the first section, we presented a case to show how personal information obtained from contact investigation and disclosed in part on the media provoked a vehement cyber manhunt. We then discussed the possible reasons why netizens collaborate to reveal anonymized personal information about contact investigation, and specify, from the perspective of public health and public health ethics, four problems of cyber manhunt, including the lack of legitimate public health goals, the concerns about privacy breach, the impact of misinformation, and social inequality. Based on our analysis, we concluded that more moral weight may be given to protecting one's confidentiality, especially in an era with the rapid advance of digital and information technologies.


2021 ◽  
Author(s):  
Marcelo Eduardo Borges ◽  
Leonardo Souto Ferreira ◽  
Silas Poloni ◽  
Ângela Maria Bagattini ◽  
Caroline Franco ◽  
...  

Among the various non–pharmaceutical interventions implemented in response to the Covid–19 pandemic during 2020, school closures have been in place in several countries to reduce infection transmission. Nonetheless, the significant short and long–term impacts of prolonged suspension of in–person classes is a major concern. There is still considerable debate around the best timing for school closure and reopening, its impact on the dynamics of disease transmission, and its effectiveness when considered in association with other mitigation measures. Despite the erratic implementation of mitigation measures in Brazil, school closures were among the first measures taken early in the pandemic in most of the 27 states in the country. Further, Brazil delayed the reopening of schools and stands among the countries in which schools remained closed for the most prolonged period in 2020. To assess the impact of school reopening and the effect of contact tracing strategies in rates of Covid–19 cases and deaths, we model the epidemiological dynamics of disease transmission in 3 large urban centers in Brazil under different epidemiological contexts. We implement an extended SEIR model stratified by age and considering contact networks in different settings – school, home, work, and elsewhere, in which the infection transmission rate is affected by various intervention measures. After fitting epidemiological and demographic data, we simulate scenarios with increasing school transmission due to school reopening. Our model shows that reopening schools results in a non–linear increase of reported Covid-19 cases and deaths, which is highly dependent on infection and disease incidence at the time of reopening. While low rates of within[&ndash]school transmission resulted in small effects on disease incidence (cases/100,000 pop), intermediate or high rates can severely impact disease trends resulting in escalating rates of new cases even if other interventions remain unchanged. When contact tracing and quarantining are restricted to school and home settings, a large number of daily tests is required to produce significant effects of reducing the total number of hospitalizations and deaths. Our results suggest that policymakers should carefully consider the epidemiological context and timing regarding the implementation of school closure and return of in-person school activities. Also, although contact tracing strategies are essential to prevent new infections and outbreaks within school environments, our data suggest that they are alone not sufficient to avoid significant impacts on community transmission in the context of school reopening in settings with high and sustained transmission rates.


2021 ◽  
Author(s):  
Aimee Code ◽  
Umar Toseeb ◽  
Kathryn Asbury ◽  
Laura Fox

Due to the COVID-19 pandemic and resultant school closures, social distancing measures, and restrictions placed on routine activities, the start of the academic year in September 2020 was a unique time for those transitioning to a new school. This study aimed to explore the experiences of parents who supported autistic children making a school transition in 2020, and to examine what impact parents perceived the COVID-19 pandemic had on their child’s school transition. Emphasis was placed on identifying facilitating factors that had benefitted school transitions, and barriers, which had negatively impacted these experiences. Semi-structured interviews were carried out with 13 parents of autistic children in the UK. Reflexive thematic analysis was carried out to identify themes in interview data. Parents reported a variety of experiences, and factors that were perceived as facilitatory to some were observed to be barriers by others. For some parents, the COVID-19 pandemic negatively impacted aspects of school transitions. For example, school closure in March 2020, being unable to visit their child’s new school, and social distancing measures were discussed as being barriers to an easy transition. However, other parents identified these factors as being facilitatory for their child or reported that these circumstances created opportunities to approach the school transition in a unique, improved manner. This paper sheds light on the heterogeneity of experiences and perceptions of parents of autistic children, and highlights the need to examine the impact of COVID-19 on school transitions, including practices which may be advantageous to retain.


2019 ◽  
Vol 116 (27) ◽  
pp. 13174-13181 ◽  
Author(s):  
Maria Litvinova ◽  
Quan-Hui Liu ◽  
Evgeny S. Kulikov ◽  
Marco Ajelli

School-closure policies are considered one of the most promising nonpharmaceutical interventions for mitigating seasonal and pandemic influenza. However, their effectiveness is still debated, primarily due to the lack of empirical evidence about the behavior of the population during the implementation of the policy. Over the course of the 2015 to 2016 influenza season in Russia, we performed a diary-based contact survey to estimate the patterns of social interactions before and during the implementation of reactive school-closure strategies. We develop an innovative hybrid survey-modeling framework to estimate the time-varying network of human social interactions. By integrating this network with an infection transmission model, we reduce the uncertainty surrounding the impact of school-closure policies in mitigating the spread of influenza. When the school-closure policy is in place, we measure a significant reduction in the number of contacts made by students (14.2 vs. 6.5 contacts per day) and workers (11.2 vs. 8.7 contacts per day). This reduction is not offset by the measured increase in the number of contacts between students and nonhousehold relatives. Model simulations suggest that gradual reactive school-closure policies based on monitoring student absenteeism rates are capable of mitigating influenza spread. We estimate that without the implemented reactive strategies the attack rate of the 2015 to 2016 influenza season would have been 33% larger. Our study sheds light on the social mixing patterns of the population during the implementation of reactive school closures and provides key instruments for future cost-effectiveness analyses of school-closure policies.


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