WWhen government officials decided in March to close their schools, there was little evidence they had to work with. They knew that children easily became infected and spread the flu, and that school holidays and closures helped slow the spread of the flu. But they weren’t sure if the same was true of the Covid-19.
A study now published in the Journal of the American Medical Association on Wednesday shows that the closure of all state schools has been associated with a drastic reduction in Covid-19 cases and deaths. And when officials called this call was important: Those states that adopted the policy, even though few people tried positively, saw a correlated flatter case curve.
“It’s a great study. It is clear that the number has improved since the school closes, ”said Helen Boucher, head of the Department of Geography and Infectious Diseases at Tufts Medical Center, who was not involved in the study. However, she noted that we must be careful to draw too broad conclusions from one sweeping closure strategy: “School closures did not happen in a vacuum.”;
It is also still unclear what the chances are for children of all ages to become infected and transmit the virus, making it difficult to eradicate the reasons why school closures may have helped reverse the outbreak.
“It’s entirely possible and likely that people have changed their behavior because they thought,‘ Oh, my goodness, this new virus is so scary that they’re closing schools, ’” said pediatrician Katherine Auger, chair of the Cincinnati Children’s Outcomes. Hospital Medical Center and the first author of the new work.
“One thing we can’t dispel is the impact of the virus spreading in schools and the bigger change in the community because parents aren’t going to work now,” she added.
The findings become clear with the reopening of the school. This spring, Centers for Disease Control and Prevention issued guidelines for preventing the spread of viruses in schools, recommending that students be physically isolated, for example, by placing desks 6 feet away. For some schools, this seemed impossible given the number of students and classroom architecture. This meant that at least some of the training would take place online, which contradicted the presidential roses and the risky ideas of the renewal by many public health experts.
After Trump and Vice President Mike Pence criticized the guidelines and called on schools to completely overhaul, the CDC issued revised guidelines that raised fears that federal public health experts were hiding from political pressure.
The new study does not show cause and effect, only a link between school closures and the number of cases in that area. The authors warned that he could not submit a prescription in the fall either.
“Our study took place at a time when schools weren’t doing things like howling,” Auger explained. “It is really impossible to predict the old way of schools in the future of schools, assuming that they will follow the recommendations of experts.”
For her, this work supports a “flexible and nutritious” approach based on the American Academy of Pediatrics. The physical presence of children in schools not only promotes academic learning, but also essential cognitive and emotional development resulting from social interaction, the organization says. It also allows them to access a wide range of services, from free meals to adult glances that can show signs of abuse at home.
However, these benefits need to be weighed against the risks of Covid-19 to children, parents, grandparents and teachers, a threat that needs to be best controlled through rapid testing that most countries cannot provide.
In a new study, Auger and her team compared reality – in which in March. All 50 states closed schools – with a computer model where everything else remained the same as long as the schools remained open. They estimated how long it would take for school-acquired infections, and then patients would show up in hospitals and some of them would die.
Their forecast estimated that if schools had been open, there could have been about 424 more coronavirus infections and another 13 deaths per 100,000 population in 26 days.
This could be extrapolated to the American population, and the country could see another 1.37 million cases and another 40,600 deaths, explained Cincinnati Shah, director of hospital medicine at the Cincinnati Children’s Hospital Medical Center and one of the authors of this work.
“These numbers seem ridiculously high and it’s alarming to think that these numbers are only… in the first few weeks,” Shah said. “It’s bankers.” However, he warned that those numbers need to be drunk with salt. Although their statistical model attempts to determine the impact of schools remaining open or closed, this method cannot really establish any causal relationship.
The authors realized that their assessment of how long it would take for a school-acquired infection to turn into a symptomatic case of Covid-19 may be unfulfilled, and wondered if this could affect their results. However, by reversing those time lags, they still found a significant association between school closures and reduced workload and mortality.
Steffanie Strathdee, dean of global health at the University of California, San Diego, did just that, making this study compelling. “Incomplete data was used in this study, but a very elegant analysis was done,” she said. “If we were wrong, what is the other extreme, would that change the results? If these kids infected their parents, but it took a little longer or a little shorter, then what? “
The bottom line, she said, was that strategies such as school closures have an impact when it comes to the risks of Covid-19.
Auger’s team also analyzed whether the time to finish school was related to a change in the number of cases and deaths. “The biggest impact was on states that closed schools before their Covid numbers were high,” she said.
Although children appear to be less likely to develop illness than adults, there is evidence that schools may be important sites for coronavirus transmission. Younger children do not appear to transmit the virus as easily as adolescents and adolescents, although more research is needed to understand the various risks.
Shah, meanwhile, warned that people reading the study should not forget about the dangers of dropping out of school. “We can quantify the risk of Covido. It is much harder to assess the risk of not being in school for a long time, ”he said.
Both he and Auger stressed the importance of tailoring strategies to the needs and risks of coronavirus in each family and community, and that better, faster testing would lead to a safer strategy at school. “This is a real challenge and I think our study is one of the most important points of the puzzle as we think about it,” Shah said.