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School closures reduced social mixing of children during COVID-19 with implications for transmission risk and school reopening policies.

  • Author(s): Head, Jennifer R;
  • Andrejko, Kristin L;
  • Cheng, Qu;
  • Collender, Philip A;
  • Phillips, Sophie;
  • Boser, Anna;
  • Heaney, Alexandra K;
  • Hoover, Christopher M;
  • Wu, Sean L;
  • Northrup, Graham R;
  • Click, Karen;
  • Bardach, Naomi S;
  • Lewnard, Joseph A;
  • Remais, Justin V
  • et al.
Abstract

School closures may reduce the size of social networks among children, potentially limiting infectious disease transmission. To estimate the impact of K-12 closures and reopening policies on children's social interactions and COVID-19 incidence in California's Bay Area, we collected data on children's social contacts and assessed implications for transmission using an individual-based model. Elementary and Hispanic children had more contacts during closures than high school and non-Hispanic children, respectively. We estimated that spring 2020 closures of elementary schools averted 2167 cases in the Bay Area (95% CI: -985, 5572), fewer than middle (5884; 95% CI: 1478, 11.550), high school (8650; 95% CI: 3054, 15 940) and workplace (15 813; 95% CI: 9963, 22 617) closures. Under assumptions of moderate community transmission, we estimated that reopening for a four-month semester without any precautions will increase symptomatic illness among high school teachers (an additional 40.7% expected to experience symptomatic infection, 95% CI: 1.9, 61.1), middle school teachers (37.2%, 95% CI: 4.6, 58.1) and elementary school teachers (4.1%, 95% CI: -1.7, 12.0). However, we found that reopening policies for elementary schools that combine universal masking with classroom cohorts could result in few within-school transmissions, while high schools may require masking plus a staggered hybrid schedule. Stronger community interventions (e.g. remote work, social distancing) decreased the risk of within-school transmission across all measures studied, with the influence of community transmission minimized as the effectiveness of the within-school measures increased.

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