Abstract
BackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited.AimThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsIn February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted.ResultsA total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact.ConclusionEvidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.
Highlights
Gaining control of an infectious disease outbreak can require making difficult decisions, when infections are human-to-human transmissible
The majority (n = 10) were from the US [19,21,23,24,25,27,30,32,33,34]; four papers were from Australia [14,20,22,29] and the remaining papers were from Argentina [28], Japan [26], Russia [18], Taiwan [31] and the UK [17]
This review of 19 papers found that all studies reported children leaving the home during the closure period and/or being looked after by non-household members, thereby having social contact with others they could potentially infect if they themselves were infected
Summary
Gaining control of an infectious disease outbreak can require making difficult decisions, when infections are human-to-human transmissible. Children are often in close physical proximity at school, have less-than-perfect hygiene behaviours and have low prior immunity to many infections [1]. For this reason, school closures are often proposed as one way of delaying the spread of infection [2]. Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. Aim: This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Conclusion: Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling
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