Abstract
As countries in Europe implement strategies to control the COVID-19 pandemic, different options are chosen regarding schools. Through a stochastic age-structured transmission model calibrated to the observed epidemic in Île-de-France in the first wave, we explored scenarios of partial, progressive, or full school reopening. Given the uncertainty on children’s role, we found that reopening schools after lockdown may increase COVID-19 cases, yet protocols exist to keep the epidemic controlled. Under a scenario with stable epidemic activity if schools were closed, reopening pre-schools and primary schools would lead to up to 76% [67, 84]% occupation of ICU beds if no other school level reopened, or if middle and high schools reopened later. Immediately reopening all school levels may overwhelm the ICU system. Priority should be given to pre- and primary schools allowing younger children to resume learning and development, whereas full attendance in middle and high schools is not recommended for stable or increasing epidemic activity. Large-scale test and trace is required to keep the epidemic under control. Ex-post assessment shows that progressive reopening of schools, limited attendance, and strong adoption of preventive measures contributed to a decreasing epidemic after lifting the first lockdown.
Highlights
As countries in Europe implement strategies to control the COVID-19 pandemic, different options are chosen regarding schools
We proposed scenarios of partial, progressive or full reopening of schools, with differential opening of pre-school and primary schools vs. middle and high schools, following the plan illustrated by the French Government[6] during the first lockdown
By altering adoption of physical contacts—while maintaining the protocols on schools, workplace, and non-essential activities unchanged—our results indicate that a large spectrum of dynamics are possible, from a continuing decrease of epidemic activity to an increased viral circulation leading to a rise in ICU admissions
Summary
As countries in Europe implement strategies to control the COVID-19 pandemic, different options are chosen regarding schools. Countries in Europe adopted different strategies to progressively phase out the strict restrictions put in place to curb COVID-19 pandemic[1,2,3,4]. Epidemic data so far does not show the typical signature of widespread school outbreaks reported in past influenza pandemics, and responsible for driving transmission in the community[7,8,9] Such transmission could have gone unobserved because of (i) asymptomatic infections in children, (ii) testing restricted to symptomatic cases during the early phase of the outbreak, (iii) early school closure as reactive measure, or schools not in session because of holidays (e.g., in South Korea in January). A retrospective analysis of the Oise cluster in northern France showed evidence for large asymptomatic viral circulation in a high school, though initial case investigation and contact tracing had identified only two symptomatic cases (testing was not performed in absence of symptoms)[13]
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