Abstract
There are contrasting results concerning the effect of reactive school closure on SARS-CoV-2 transmission. To shed light on this controversy, we developed a data-driven computational model of SARS-CoV-2 transmission. We found that by reactively closing classes based on syndromic surveillance, SARS-CoV-2 infections are reduced by no more than 17.3% (95%CI: 8.0–26.8%), due to the low probability of timely identification of infections in the young population. We thus investigated an alternative triggering mechanism based on repeated screening of students using antigen tests. Depending on the contribution of schools to transmission, this strategy can greatly reduce COVID-19 burden even when school contribution to transmission and immunity in the population is low. Moving forward, the adoption of antigen-based screenings in schools could be instrumental to limit COVID-19 burden while vaccines continue to be rolled out.
Highlights
There are contrasting results concerning the effect of reactive school closure on SARS-CoV-2 transmission
The model allows the explicit simulation of the testing, isolation, and quarantine strategies along with the reactive classclosure strategy, as implemented in Italy in the fall of 2020 when historical SARS-CoV-2 lineages were in circulation
We provide a quantitative assessment of reactive class closures implemented in Italy in the fall of 2020, in combination with contact tracing and other social distancing measures, to provide a potential explanation of why the adopted strategy was not successful in preventing a second nationwide COVID-19 wave
Summary
There are contrasting results concerning the effect of reactive school closure on SARS-CoV-2 transmission. Since November 6, 2020, more restrictive measures were applied on a regional basis to further mitigate COVID-19 burden of the second wave[9], fueled in early 2021 by the more transmissible Alpha variant[10]. We developed a computational model of SARS-CoV-2 transmission to estimate the contribution of the reactive school closure strategies implemented in Italy when historical lineages were circulating in the fall of 2020 to mitigate the second major COVID-19 wave and understand the reason of their limited effect. We tested an alternative policy based on rapid antigen-based screening of students We found that this strategy may have a considerably larger mitigation effect on SARS-CoV-2 spread, which may be crucial while COVID-19 vaccines continue to be rolled out throughout 2021 and beyond
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