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. 2021 Feb 4;5(1):e000971.
doi: 10.1136/bmjpo-2020-000971. eCollection 2021.

Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

Geertruida Bekkering  1   2 , Nicolas Delvaux  1 , Patrik Vankrunkelsven  1   2 , Jaan Toelen  3   4 , Sigrid Aertgeerts  5 , Sofie Crommen  6 , Pedro De Bruyckere  7   8 , Ignaas Devisch  9 , Tinne Lernout  10 , Katrien Masschalck  11 , Nore Milissen  12 , Geert Molenberghs  13   14 , Annelies Pascal  15 , Oscar Plomteux  16 , Marc Raes  17   18 , Lise Rans  12 , Alexandra Seghers  19 , Lode Sweldens  20 , Jeroen Vandenbussche  21 , Guido Vanham  22 , Elke Wollants  23   24 , Bert Aertgeerts  1
Affiliations

Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

Geertruida Bekkering et al. BMJ Paediatr Open. .

Abstract

Background: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.

Methods: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.

Results: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.

Conclusion: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

Keywords: COVID-19; adolescent health; epidemiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Infographic. Population, comparison, recommendation.
Figure 2
Figure 2
Infographic. Comparison of benefits and harms.
Figure 3
Figure 3
Infographic. Data on benefits and harms.
See this image and copyright information in PMC

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