WWhen government officials decided in March to close their schools, the evidence they had to work with was weak. They knew that children could easily catch and spread the flu – and that school holidays and deadlines helped slow it. However, they were not sure if the same was true for Covid-19.
A study published Wednesday in the Journal of the American Medical Association shows that the closure of all public schools was associated with a drastic drop in Covid-19 cases and deaths. And the point at which officials made this challenge was important: Those states that adopted the policy, while few people tested positive, correlated a flatter case curve.
“It̵7;s a nice study.” It is clear that with the abolition of schools, their number has improved, “said Helen Boucher, head of the geographic medicine and infectious diseases department at Tufts Medical Center, who did not participate in the research. However, she noted that we must be careful to draw too broad conclusions from a single piece of a comprehensive shutdown strategy: “School closures have not happened in a vacuum.”
It is still unclear how likely children of all ages are to get the virus and transmit it, making it difficult to tear out the reasons why school closures could help in the onset of the disease.
“It is quite possible – and likely – that people changed their behavior because they thought,” Oh, my God, this new virus is here and it’s so scary that they’re closing schools, “said Pediatrician Katherine Auger, Associate President of Cincinnati Results. Children’s Hospital Medical Center and the first author of a new article.
“One thing we can’t tease is how much the virus has had to spread in schools and make bigger changes in the community because parents aren’t working now,” she added.
Findings come in the middle of the balance sheet over the reopening of the school. This spring, the Centers for Disease Control and Prevention issued guidelines on the prevention of virus transmission in schools, recommending that students be physically distant from, for example, placing tables apart. For some schools, this seemed impossible due to the number of children enrolled and the architecture of the classrooms. This meant that at least some of the lessons would take place online, which runs counter to the president’s rosy – and many risky public health experts – ideas about reopening.
After Trump and Vice President Mike Pence criticized the guidelines and called on schools to reopen completely, the CDC issued revised guidelines that raised concerns that federal public health experts were under political pressure.
The new study does not show the cause and effect, only the relationship between school closures and the number of cases in the area. The authors warned that they also could not provide a flat prescription for the fall.
“Our study took place at a time when schools didn’t do things like camouflage,” Auger explained. “It’s really impossible to project the old way of education into the future of schools, provided they follow professional guidelines.”
Working for her supports the “flexible and agile” approach supported by the American Academy of Pediatrics. The organization said that children who are physically present in schools do not only encourage academic education and the necessary cognitive and emotional development that results from social interaction. It also allows them to receive a range of services, from free meals to the eyes of adults who may experience signs of abuse at home.
However, these benefits must be weighed against the risks of the Covid-19 system for children, parents, grandparents and teachers. This threat is best checked by rapid testing, which most countries cannot provide.
In a new study, Auger and her team compared the reality – in which all 50 states closed schools in March – with a computer model in which everything else remained while schools remained open. They calculated the time it would take to transmit infections acquired in schools and for these patients to show up in hospitals and for some of them to die.
Their projection found that if schools remained open, there could be approximately 424 additional coronavirus infections and 13 additional deaths per 100,000 population over 26 days.
Extrapolate to the fact that the American population and the country could record up to 1.37 million more cases and another 40,600 deaths, explained Samir Shah, director of hospital medicine at the Cincinnati Children’s Hospital and one of the authors of the article.
“These numbers seem ridiculously high and it’s incredible to think that these numbers are only … in the first few weeks,” Shah said. “It’s bonkers.” However, he warned that these numbers should be taken with a grain of salt. Although their statistical model attempts to determine the impact of schools that remain open or closed, this method cannot in fact create any causal relationship.
The authors realized that their estimate of how long an infection collected at school could take to turn into a symptomatic case of Covid-19 could be turned off and wondered if it could affect their outcomes. However, when they changed these time delays, they still found a significant correlation between school closures and the reduction in cases and mortality.
Steffanie Strathdee, a associate of the Dean of Global Health at the University of California, San Diego, convinced the study. “This study took imperfect data, but did a very elegant analysis,” she said. “If we were wrong, what is the other extreme, will it change the results? If these children infected their parents, but it took a little longer or a little shorter, then what? “
The point, she said, was that strategies such as school closures seem to be making changes to the risks associated with the Covid-19 program.
Auger’s team also analyzed whether the timing of school leaving was related to changing cases and deaths. “States that closed schools before their high numbers had the greatest effect,” she said.
Although children appear to be less ill than adults, there is evidence that schools may be important sites of coronavirus transmission. Younger children appear to be less likely to transmit the virus than adolescents and adolescents, but further research is needed to fully understand the various risks.
Shah, meanwhile, warned that people reading the study should not forget the risks of dropping out of school. “We can quantify Covid’s risk. It is much more difficult to quantify the risk of absenteeism for a long time, “he said.
He and Auger emphasized the importance of adapting strategies to the needs and risks of coronaviruses in each family and community, and that better and faster testing would allow for a safer school attendance strategy. “It’s a real challenge and I think our study is one of the very important pieces of the puzzle of how we think about it,” Shah said.