Department of Pediatrics, Larner College of Medicine, University of Vermont, Burlington, VT, USA.
Translational Global Infectious Diseases Research Center, University of Vermont, Burlington, VT, USA.
BMC Public Health. 2020 Nov 16;20(1):1713. doi: 10.1186/s12889-020-09799-8.
Mathematical modeling studies have suggested that pre-emptive school closures alone have little overall impact on SARS-CoV-2 transmission, but reopening schools in the background of community contact reduction presents a unique scenario that has not been fully assessed.
We adapted a previously published model using contact information from Shanghai to model school reopening under various conditions. We investigated different strategies by combining the contact patterns observed between different age groups during both baseline and "lockdown" periods. We also tested the robustness of our strategy to the assumption of lower susceptibility to infection in children under age 15 years.
We find that reopening schools for all children would maintain a post-intervention R < 1 up to a baseline R of approximately 3.3 provided that daily contacts among children 10-19 years are reduced to 33% of baseline. This finding was robust to various estimates of susceptibility to infection in children relative to adults (up to 50%) and to estimates of various levels of concomitant reopening in the rest of the community (up to 40%). However, full school reopening without any degree of contact reduction in the school setting returned R virtually back to baseline, highlighting the importance of mitigation measures.
These results, based on contact structure data from Shanghai, suggest that schools can reopen with proper precautions during conditions of extreme contact reduction and during conditions of reasonable levels of reopening in the rest of the community.
数学模型研究表明,单纯的预防性学校关闭对 SARS-CoV-2 传播的总体影响很小,但在社区接触减少的背景下重新开放学校是一个尚未充分评估的独特情况。
我们使用上海的接触信息,改编了之前发表的模型,以在各种条件下对学校重新开放进行建模。我们通过结合基线和“封锁”期间不同年龄组之间观察到的接触模式,研究了不同的策略。我们还测试了我们的策略对假设 15 岁以下儿童感染易感性较低的稳健性。
我们发现,如果 10-19 岁儿童的日常接触减少到基线的 33%,那么为所有儿童重新开放学校将保持干预后 R < 1,前提是基线 R 约为 3.3。这一发现对儿童相对于成年人的感染易感性的各种估计(高达 50%)以及对社区其他地区同时重新开放的各种水平的估计(高达 40%)都是稳健的。然而,在学校环境中没有任何程度的接触减少的情况下全面重新开放学校,R 值几乎回到了基线,这突出了缓解措施的重要性。
这些基于上海接触结构数据的结果表明,在极端接触减少的情况下和在社区其他地区合理程度重新开放的情况下,学校可以在采取适当预防措施的情况下重新开放。