‘Not finding causal effect’ is not ‘finding no causal effect’ of school closure on COVID-19

In a paper recently published in Nature Medicine, Fukumoto et al. tried to assess the government-led school closure policy during the early phase of the COVID-19 pandemic in Japan. They compared the reported incidence rates between municipalities that had and had not implemented school closure in selected periods from March–May 2020, where they rigorously matched for potential confounders, and claimed that they found no causal effect on the incidence rates of COVID-19. However, the effective sample size (ESS) of their dataset had been substantially reduced in the process of matching due to imbalanced covariates between the treatment (i.e. with closure) and control (without) municipalities, which led to the wide uncertainty in the estimates. That said, the study title "No causal effect…" is a rather strong statement because the results are also consistent with a strong mitigating effect of school closure on incidence of COVID-19.

The impact of COVID-19 epidemic on development of micro, small and medium enterprises policy in East Kalimantan government

This article discusses the efforts of the East Kalimantan Government handling cases of development of micro, small, and medium enterprises (MSMEs) during the COVID-19. The handling strategy can be assessed by understanding the measures, steps, and policies formulated and implemented by the East Kalimantan government. A deliberative policy analysis approach was used to analyze this case. This approach analyzes the narratives and arguments of the authorities to understand decision-making and policy implementation. The writing of this article uses a qualitative approach by utilizing the descriptive analysis method. The data collection technique used is a literature study using books, journal articles, newspapers, online news, and traditional institutions' websites. First, this paper's essential findings are reallocation and refocusing of the Covid-19 Budget for the cost of economic stimulus to strengthen capital for affected businesses and small industry players. Second, relaxation and credit restructuring. Third, the temporary closure policy for cafes or restaurants is due to residents' ignorance or non-compliance with government calls regarding health protocols. As a result, efforts to deal with it have stalled because the wider community does not support it. Combining these three factors complicates the provincial government's efforts to deal with MSMEs' development during the COVID-19 pandemic in East Kalimantan. Policy recommendations for the recovery of MSMEs in East Kalimantan Province, namely increasing the role of Indagkop through fostering and educating MSMEs in utilizing technology to sell online and the one-door policy for MSMEs.

Promoting Factfulness in the Covid-19 pandemic-related policymaking: a map to understanding school closures

Introduction: In the era of data-driven decision-making, an unacceptable haziness and inconsistency surrounds the yearlong scientific and public debate on the school closure policy in the COVID-19 pandemic mitigation efforts. Aim: The present literature review stems out of the need for a clear scaffold collecting in one place all current evidence, as well as helping organizing incoming future evidence, concerning both the role of schools in driving the Sars-CoV-2 community spread and the cost-effectiveness of school closure in containing such spread. Methods: References for this review were initially identified through searches of PubMed, Scopus and Cochrane Library for articles published from March, 2020, to March, 2021 by use of the terms “Schools” “COVID-19” “pandemic” “clusters” “outbreak” “seroprevalence”. Further search was undertaken through Google Scholar and ResearchGate, and finally through Google. Results: School closure at times of high background prevalence of COVID-19 should not be considered a measure implemented to protect the health of children. Children had lower secondary attack rates than adults and that they infrequently represented the index case. One year of pandemic has been sufficient for the emergence of one indication of concern: a potentially increased burden of paediatric mental health disorders. Conclusions: A fact-based understanding of what is currently known on such a consequential policy is required to provide a basis of evidence for an advocacy of either school closure or school opening at times of high intensity community transmission of Sars-CoV-2.

Molecular Epidemiological Study of Hand, Foot, and Mouth Disease in a Kindergarten-Based Setting in Bangkok, Thailand

Hand, foot, and mouth disease (HFMD) is a contagious childhood illness and annually affects millions of children aged less than 5 years across the Asia–Pacific region. HFMD transmission mainly occurs through direct contact (person-to-person) and indirect contact with contaminated surfaces and objects. Therefore, public health measures to reduce the spread of HFMD in kindergartens and daycare centers are essential. Based on the guidelines by the Department of Disease Control, a school closure policy for HFMD outbreaks wherein every school in Thailand must close when several HFMD classrooms (more than two cases in each classroom) are encountered within a week, was implemented, although without strong supporting evidence. We therefore conducted a prospective cohort study of children attending five kindergartens during 2019 and 2020. We used molecular genetic techniques to investigate the characteristics of the spreading patterns of HFMD in a school-based setting in Bangkok, Thailand. These analyses identified 22 index cases of HFMD (symptomatic infections) and 25 cases of enterovirus-positive asymptomatic contacts (24 students and one teacher). Enterovirus (EV) A71 was the most common enterovirus detected, and most of the infected persons (8/12) developed symptoms. Other enteroviruses included coxsackieviruses (CVs) A4, CV-A6, CV-A9, and CV-A10 as well as echovirus. The pattern of the spread of HFMD showed that 45% of the subsequent enteroviruses detected in each outbreak possessed the same serotype as the first index case. Moreover, we found a phylogenetic relationship among enteroviruses detected among contact and index cases in the same kindergarten. These findings confirm the benefit of molecular genetic assays to acquire accurate data to support school closure policies designed to control HFMD infections.

Sufficient strategies for travel quarantine and testing

A major policy tool used by governments during the COVID-19 pandemic has been the imposition of quarantine and testing requirements on international travel, extending even to the extreme approach of closing national borders.However, both approaches have far-reaching socioeconomic implications. Therefore, we evaluated the implications of quarantine and testing compared to the reductions achieved by border closure on in-country imminent transmission based on country-specific prevalence, daily incidence, vaccine coverage, immunity, age-demographics, and travel flow. We considered travel quarantines of 0–14 days with and without RT-PCR or antigen testing for COVID-19 in 31 European countries. Our analysis demonstrates that for the vast majority of origin-destination country pairs, there are combinations of short-duration quarantine and testing that are as effective as border closure. Furthermore, for most origin-destination country pairs, travel with testing and no quarantine will reduce imminent in-country transmission more than would border closure. We find that the duration of quarantine is predominantly influenced by country prevalence and quantity of travel. With higher prevalence in the origin country compared to the destination country, the minimum duration of quarantine increases from zero to beyond fourteen days (at which point border closure would likely be practical). Asymmetry in travel flow can also cause an increase or decrease of infections within the destination country, respectively resulting in longer and shorter quarantines. We apply the same framework to genetic variants of concern to limit their spread as a consequence of travel; the widespread variant of concern B.1.1.7 yields similar sufficient quarantine and testing regimes, whereas the lower-frequency, geographically heterogeneous 501Y.V2 variant requires longer, more specific quarantines. We show that adaptation of our analytical framework to the European Union traffic-light country risk stratification provides a simplified policy tool. Lastly, we examined the effect of travel quarantine and testing or border closure policy on hospitalization in the destination country. We find that hospitalization rates in the destination country are far more sensitive to changes in the vaccine coverage than on the duration of the travel quarantine or the country of origin. Our analysis provides rigorous guidelines enabling travel between most countries during early and late phases of pandemic disease.

Effects from containment and closure policies to market quality: Do they really matter in Vietnam during Covid-19?

During the Covid-19 pandemic, the Vietnamese government has actively implemented various policies to achieve dual objectives: (i) to minimize the loss of life due to the infection; and (ii) to support economic growth. This paper is conducted to examine the effect of the government’s containment and closure policy on the stock market quality in Vietnam. Unlike other papers, we focus exclusively on market quality during the pandemic. We find that the policies appear to positively affect the market quality, except for closing-school policy (negative effect) and international travel (no effect). We argue that the government should sustain the policies until the wide availability of the vaccine to support the stock market quality in the near future.

Using a hybrid agent-based and equation based model to test school closure policies during a measles outbreak

Background In order to be prepared for an infectious disease outbreak it is important to know what interventions will or will not have an impact on reducing the outbreak. While some interventions might have a greater effect in mitigating an outbreak, others might only have a minor effect but all interventions will have a cost in implementation. Estimating the effectiveness of an intervention can be done using computational modelling. In particular, comparing the results of model runs with an intervention in place to control runs where no interventions were used can help to determine what interventions will have the greatest effect on an outbreak. Methods To test the effects of a school closure policy on the spread of an infectious disease (in this case measles) we run simulations closing schools based on either the proximity of the town to the initial outbreak or the centrality of the town within the network of towns in the simulation. To do this we use a hybrid model that combines an agent-based model with an equation-based model. In our analysis, we use three measures to compare the effects of different intervention strategies: the total number of model runs leading to an outbreak, the total number of infected agents, and the geographic spread of outbreaks. Results Our results show that closing down the schools in the town where an outbreak begins and the town with the highest in degree centrality provides the largest reduction in percent of runs leading to an outbreak as well as a reduction in the geographic spread of the outbreak compared to only closing down the town where the outbreak begins. Although closing down schools in the town with the closest proximity to the town where the outbreak begins also provides a reduction in the chance of an outbreak, we do not find the reduction to be as large as when the schools in the high in degree centrality town are closed. Conclusions Thus we believe that focusing on high in degree centrality towns during an outbreak is important in reducing the overall size of an outbreak.