期刊名称：Proceedings of the National Academy of Sciences
印刷版ISSN：0027-8424
电子版ISSN：1091-6490
出版年度：2022
卷号：119
期号：37
DOI：10.1073/pnas.2203019119
语种：English
出版社：The National Academy of Sciences of the United States of America
摘要：Significance
Interventions to control coronavirus disease 2019 (COVID-19) in school settings often assume that simply limiting the number of students attending reduces the potential for disease spread. However, using a mathematical model parameterized with a detailed dataset of seasonal influenza in Japanese primary schools, we find that interventions that focus only on reducing the number of students in class at any moment in time (e.g., reduced class sizes and staggered attendance) may not be effective. We propose two approaches for pandemic management in school settings: a routine “preemptive” approach that attempts to keep the within-school reproduction number low by, for example, regular screening and cohorting and a “responsive” approach where fixed-period class closures are employed upon detection of a symptomatic case.
The global spread of coronavirus disease 2019 (COVID-19) has emphasized the need for evidence-based strategies for the safe operation of schools during pandemics that balance infection risk with the society’s responsibility of allowing children to attend school. Due to limited empirical data, existing analyses assessing school-based interventions in pandemic situations often impose strong assumptions, for example, on the relationship between class size and transmission risk, which could bias the estimated effect of interventions, such as split classes and staggered attendance. To fill this gap in school outbreak studies, we parameterized an individual-based model that accounts for heterogeneous contact rates within and between classes and grades to a multischool outbreak data of influenza. We then simulated school outbreaks of respiratory infectious diseases of ongoing threat (i.e., COVID-19) and potential threat (i.e., pandemic influenza) under a variety of interventions (changing class structures, symptom screening, regular testing, cohorting, and responsive class closures). Our results suggest that interventions changing class structures (e.g., reduced class sizes) may not be effective in reducing the risk of major school outbreaks upon introduction of a case and that other precautionary measures (e.g., screening and isolation) need to be employed. Class-level closures in response to detection of a case were also suggested to be effective in reducing the size of an outbreak.
