The new research, led by University College London, calls for policymakers to be aware of the “equivocal” evidence around school closures in containing Covid-19 but says educational settings are “crucial” to how society is restarted after lockdown.
School-based interventions such as reducing the school week and staggering school start and break times should be considered if restrictive social distancing policies are to be implemented for long periods of time, the study says.
Countries that have closed schools, such as the UK, have to ask “hard questions” about when and how to open schools with such interventions potentially forming part of a strategy to allow pupils to return, it adds.
An international team has published its review paper in The Lancet Child & Adolescent Health, the first of its kind to look at the evidence and emerging data on the benefit of school closures and other school social distancing interventions in outbreaks such as severe acute respiratory syndrome (Sars), Middle East respiratory syndrome (Mers) and Covid-19.
Researchers from London, Cambridge and Sydney reviewed 16 studies on epidemics of Sars and Mers as well as one report on the Covid-19 pandemic.
They found data collected from the Sars epidemic in 2003 did not “generally support” a role for school closures with a draft model indicating, as an isolated measure, it would only reduce total deaths by around two to four per cent during a coronavirus outbreak in the UK.
The new study highlights that data from influenza outbreaks, which show benefits of school closures, cannot necessarily be applied to coronaviruses and that school closures have only small effects in infections with a high reproductive number, such as Covid-19, where children are not the main drivers of infection.
Professor Russell Viner, from UCL Great Ormond Street Institute of Child Health and president of the Royal College of Paediatrics and Child Health, said: “We know from previous studies that school closures are likely to have the greatest effect if the virus has low transmissibility and attach rates are higher in children. This is the opposite of Covid-19.
“Data on the benefit of school closures in the Covid-19 outbreak is limited but what we know shows that their impact is likely to be only small compared to other infection control measures such as case isolation and is only effective when other social isolating measures are adhered to.”
Viner warned the costs of national school closures were high, damaging children’s education and likely to cause their mental health to suffer, with vulnerable children potentially most affected.
Since 18 March, 107 countries have implemented national school closures in response to the Covid-19 pandemic.
However, the latest research review finds data from the Sars outbreak in China, Hong Kong and Singapore suggests that school closures did not contribute to control of the epidemic and modelling studies of Sars produced conflicting results.
“Policymakers need to be aware of the equivocal evidence when considering school closures for Covid-19 given the profound and long-lasting effect they will have on children – particularly the most disadvantaged,” Viner said.
With nearly 90 per cent of the world’s students – around a billion and a half young people – out of school, he said more data and “robust modelling studies” were urgently needed to help countries identify how to safely return students to education.
