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COVID-19 Evidence Alerts
from McMaster PLUSTM

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Primary Prevention Viner RM, Russell SJ, Croker H, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 2020 May;4(5):397-404. doi: 10.1016/S2352-4642(20)30095-X. Epub 2020 Apr 6.
Abstract

In response to the coronavirus disease 2019 (COVID-19) pandemic, 107 countries had implemented national school closures by March 18, 2020. It is unknown whether school measures are effective in coronavirus outbreaks (eg, due to severe acute respiratory syndrome [SARS], Middle East respiratory syndrome, or COVID-19). We undertook a systematic review by searching three electronic databases to identify what is known about the effectiveness of school closures and other school social distancing practices during coronavirus outbreaks. We included 16 of 616 identified articles. School closures were deployed rapidly across mainland China and Hong Kong for COVID-19. However, there are no data on the relative contribution of school closures to transmission control. Data from the SARS outbreak in mainland China, Hong Kong, and Singapore suggest that school closures did not contribute to the control of the epidemic. Modelling studies of SARS produced conflicting results. Recent modelling studies of COVID-19 predict that school closures alone would prevent only 2-4% of deaths, much less than other social distancing interventions. Policy makers need to be aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered. Other less disruptive social distancing interventions in schools require further consideration if restrictive social distancing policies are implemented for long periods.

Ratings
Discipline / Specialty Area Score
Public Health
Infectious Disease
Comments from MORE raters

Public Health rater

With unknowns of the Covid 19 pandemic and in attempts to identify mitigation measures, this study is helpful in adding a perspective to the body of science. However, the results should be interpreted with caution as uncover the dynamics of Covid 19 w.r.t transmission, infectivity in children and younger population. Needless to say, even if school going population may not be directly affected, their impact on transmitting the disease to the vulnerable population at home or outside, cannot be ignored. Most of the discussion section is a view point piece that also needs to be viewed accordingly.

Public Health rater

This is a useful attempt even though constrained by knowledge gaps. The lack of knowledge on the epidemiology and transmission dynamics corona virus COVIC19 makes it difficult draw quality conclusion on the usefulness of school closure. Moreover, findings might be different in Lower and Middle Income countries were student populations are mostly at boarding schools and under limited space to allow for social distancing.

Public Health rater

This is the kind of research the world needs in such desperate times to formulate evidence based social and public health policies.