Effectiveness of interventions to reduce COVID-19 transmission in schools.

Publisher: Elsevier Country of Publication: Netherlands NLM ID: 101484711 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-0067 (Electronic) Linking ISSN: 18780067 NLM ISO Abbreviation: Epidemics Subsets: MEDLINE

Original Publication: Amsterdam : Elsevier

COVID-19*/transmission ; COVID-19*/prevention & control ; COVID-19*/epidemiology ; Quarantine* ; Schools* ; Absenteeism* ; SARS-CoV-2*; Humans ; United States/epidemiology ; Child ; Adolescent ; Masks/statistics & numerical data ; COVID-19 Testing/statistics & numerical data ; Communicable Disease Control/methods

School reopenings in 2021 and 2022 coincided with the rapid emergence of new SARS-CoV-2 variants in the United States. In-school mitigation efforts varied, depending on local COVID-19 mandates and resources. Using a stochastic age-stratified agent-based model of SARS-CoV-2 transmission, we estimate the impacts of multiple in-school strategies on both infection rates and absenteeism, relative to a baseline scenario in which only symptomatic cases are tested and positive tests trigger a 10-day isolation of the case and 10-day quarantine of their household and classroom. We find that monthly asymptomatic screening coupled with the 10-day isolation and quarantine period is expected to avert 55.4% of infections while increasing absenteeism by 104.3%. Replacing quarantine with test-to-stay would reduce absenteeism by 66.3% (while hardly impacting infection rates), but would require roughly 10-fold more testing resources. Alternatively, vaccination or mask wearing by 50% of the student body is expected to avert 54.1% or 43.1% of infections while decreasing absenteeism by 34.1% or 27.4%, respectively. Separating students into classrooms based on mask usage is expected to reduce infection risks among those who wear masks (by 23.1%), exacerbate risks among those who do not (by 27.8%), but have little impact on overall risk. A combined strategy of monthly screening, household and classroom quarantine, a 50% vaccination rate, and a 50% masking rate (in mixed classrooms) is expected to avert 81.7% of infections while increasing absenteeism by 90.6%. During future public health emergencies, such analyses can inform the rapid design of resource-constrained strategies that mitigate both public health and educational risks.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)

Keywords: Asymptomatic screening; COVID-19; Epidemiological modeling; Public health response; School absenteeism; Vaccination

Date Created: 20240315 Date Completed: 20240615 Latest Revision: 20240615

20240616

10.1016/j.epidem.2024.100762

38489849