WChicken officials decided whether to close their schools back in March, and the evidence they had to work with was limited. They knew that children could easily catch and spread the flu – and school holidays and closures helped slow it down. But they weren’t sure if the same was true of Covid-19.
Now, a study published Wednesday in the Journal of the American Medical Association shows that the closure of all schools in the state has been associated with a sharp decline in the number and deaths of “Kovid-19”. And the point at which officials made this call mattered: Those states that adopted policies while few tested positive saw a correlated flatter case curve.
“It̵7;s a nice study. It is clear that with the closure of schools, the number has improved, – said Helen Butcher, head of geographical medicine and infectious diseases at Tufts Medical Center, who did not participate in the study. But she noted that we should be careful to draw too broad conclusions from a single slip of the closure strategy: “School closures did not take place in a vacuum.”
In addition, it is still unclear how likely children of all ages are exposed to and transmitted the virus, making it difficult to investigate the reasons why school closures may help carry the outbreak.
“It’s possible – and it’s possible – people have changed their behavior because they thought, ‘Oh my God, there’s this new virus, and it’s so scary that they’re closing schools,'” said pediatrician Catherine Auger, associate professor of results at Cincinnati Children’s Hospital. and the first author of a new article.
“One thing we can’t tease is how much of an effect it has had with the spread of the virus in schools, and with more change in the community because parents are no longer working,” she added.
The results appear in the midst of school transformations. This spring, the Centers for Disease Control and Prevention issued guidelines to prevent the transmission of viruses in schools, recommending, for example, that students move physically away, setting up, for example, 6-foot desks. For some schools, this seemed impossible, given the number of children enrolled and the architecture of the classrooms. This meant that at least some training would take place online, which contradicted the ruddy – and many health experts – risky perception of the president’s discovery.
After both Trump and Vice President Mike Pence criticized the guidelines and called for schools to be fully open, the CDC released revised guidelines, raising fears that federal health experts were under political pressure.
The new study does not show the causes and consequences, but only the relationship between school closures and the number of cases in a given area. The authors warned that he also could not give a prescription for the fall.
“Our study took place at a time when schools did not deal with such masks,” – said Auger. “It is impossible to design the old way to the future of schools, assuming that they will follow the recommendations of experts.”
For her, the work supports a “flexible and agile” approach, supported by the American Academy of Pediatrics. The presence of children who are physically in schools not only stimulates academic learning and important cognitive and emotional development that stems from social interaction, the organization said. It also allows them to receive a wide range of services – from free meals to the eyes of adults who may show signs of abuse at home.
But these benefits need to be weighed against the risks of Covid-19 to children, parents, grandparents and teachers – a threat that is best controlled by rapid tests that much of the country cannot provide.
In a new study, Auger and her team compared the reality – in which all 50 states closed schools in March – to a computer model in which everything else remained the same while schools remained open. They calculated the time it would take to transmit infections acquired in schools, and then these patients would appear in hospitals and some of them would die.
Their forecast showed that if schools remained open, there could be approximately 424 more coronavirus infections and 13 deaths per 100,000 population in 26 days.
Extrapolate this to the American population and the country, with 1.37 million more cases and 40,600 more deaths, said Samir Shah, director of hospital medicine at Cincinnati Children’s Hospital and one of the authors.
“These numbers seem ridiculously high, and it’s silly to think that these numbers are just … for the first few weeks,” Shah said. “These are bankers.” However, he warned that these figures should be taken with a grain of salt. Although their statistical model attempts to determine the impact of schools that remain open or closed, the method cannot actually establish any causal relationship.
The authors realized that their assessment of how long an infection could take at school to become a symptomatic case of Covid-19 could be turned off, and asked if it could affect their results. However, when they changed these time lags, they still found a significant correlation between school closures and a reduction in deaths and deaths.
For Stephanie Stratty, a lawyer with the Dean of Global Health at the University of California, San Diego, this is what made the study compelling. “This study took imperfect data, but did a very elegant analysis,” she said. “If we were wrong about being the other extreme, would that change the results? If these kids infected the parents, but it took a little longer or a little shorter, then what?”
The bottom line, she said, is that strategies such as school closures seem to matter when it comes to the risks of Covid-19.
Shjera’s team also analyzed whether the timing of school closures was linked to a change in cases and deaths. “The biggest effect was on the states that closed schools before they were large in Kovid,” she said.
Although children are probably less likely to get sick than adults, there is some evidence that schools may be important sites for coronavirus transmission. Younger children are less likely to transmit the virus than adolescents and adolescents, although more research is needed to fully understand the different risks.
Shah, meanwhile, warned that people who read the study should not forget about the risks of learning disruption. “We can quantify Covid’s risk. It is much more difficult to assess the risk of absence from school for a long period of time, “he said.
Both he and Oger stressed the importance of adapting strategies to the needs and risks of coronavirus in each family and community, and that better, faster testing would provide a safer return to school strategy. “This is a real challenge, and I think our research is one very important part of the puzzle in how we think about it,” Shah said.