Head Jennifer R, Andrejko Kristin L, Cheng Qu, Collender Philip A, Phillips Sophie, Boser Anna, Heaney Alexandra K, Hoover Christopher M, Wu Sean L, Northrup Graham R, Click Karen, Bardach Naomi S, Lewnard Joseph A, Remais Justin V
Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA.
Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA.
J R Soc Interface. 2021 Apr;18(177):20200970. doi: 10.1098/rsif.2020.0970. Epub 2021 Apr 14.
School closures may reduce the size of social networks among children, potentially limiting infectious disease transmission. To estimate the impact of K-12 closures and reopening policies on children's social interactions and COVID-19 incidence in California's Bay Area, we collected data on children's social contacts and assessed implications for transmission using an individual-based model. Elementary and Hispanic children had more contacts during closures than high school and non-Hispanic children, respectively. We estimated that spring 2020 closures of elementary schools averted 2167 cases in the Bay Area (95% CI: -985, 5572), fewer than middle (5884; 95% CI: 1478, 11.550), high school (8650; 95% CI: 3054, 15 940) and workplace (15 813; 95% CI: 9963, 22 617) closures. Under assumptions of moderate community transmission, we estimated that reopening for a four-month semester without any precautions will increase symptomatic illness among high school teachers (an additional 40.7% expected to experience symptomatic infection, 95% CI: 1.9, 61.1), middle school teachers (37.2%, 95% CI: 4.6, 58.1) and elementary school teachers (4.1%, 95% CI: -1.7, 12.0). However, we found that reopening policies for elementary schools that combine universal masking with classroom cohorts could result in few within-school transmissions, while high schools may require masking plus a staggered hybrid schedule. Stronger community interventions (e.g. remote work, social distancing) decreased the risk of within-school transmission across all measures studied, with the influence of community transmission minimized as the effectiveness of the within-school measures increased.
学校关闭可能会缩小儿童的社交网络规模,从而有可能限制传染病传播。为了评估加州湾区K-12学校关闭和重新开放政策对儿童社交互动及新冠病毒感染率的影响,我们收集了儿童社交接触的数据,并使用个体模型评估了对传播的影响。小学生和西班牙裔儿童在学校关闭期间的接触分别比高中生和非西班牙裔儿童更多。我们估计,2020年春季小学关闭避免了湾区2167例病例(95%置信区间:-985,5572),少于初中(5884例;95%置信区间:1478,11550)、高中(8650例;95%置信区间:3054,15940)和工作场所关闭(15813例;95%置信区间:9963,22617)所避免的病例数。在社区传播适度的假设下,我们估计,在没有任何预防措施的情况下重新开放四个月的学期,将增加高中教师的症状性疾病(预计另外有40.7%会出现症状性感染,95%置信区间:1.9,61.1)、初中教师(37.2%,95%置信区间:4.6,58.1)和小学教师(4.1%,95%置信区间:-1.7,12.0)。然而,我们发现,小学重新开放政策若将普遍戴口罩与班级分组相结合,可能会使校内传播极少,而高中可能需要戴口罩加错开的混合教学时间表。更强有力的社区干预措施(如远程工作、社交距离)降低了所有研究措施下校内传播的风险,随着校内措施有效性的提高,社区传播的影响降至最低。