Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 17;11(8):e053371.
doi: 10.1136/bmjopen-2021-053371.

Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies

Sebastian Walsh  1 , Avirup Chowdhury  2 , Vickie Braithwaite  2 , Simon Russell  3 , Jack Michael Birch  2 , Joseph L Ward  3 , Claire Waddington  4 , Carol Brayne  5 , Chris Bonell  6 , Russell M Viner  3 , Oliver T Mytton  2
Affiliations

Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies

Sebastian Walsh et al. BMJ Open. .

Abstract

Objectives: To systematically reivew the observational evidence of the effect of school closures and school reopenings on SARS-CoV-2 community transmission.

Setting: Schools (including early years settings, primary schools and secondary schools).

Intervention: School closures and reopenings.

Outcome measure: Community transmission of SARS-CoV-2 (including any measure of community infections rate, hospital admissions or mortality attributed to COVID-19).

Methods: On 7 January 2021, we searched PubMed, Web of Science, Scopus, CINAHL, the WHO Global COVID-19 Research Database, ERIC, the British Education Index, the Australian Education Index and Google, searching title and abstracts for terms related to SARS-CoV-2 AND terms related to schools or non-pharmaceutical interventions (NPIs). We used the Cochrane Risk of Bias In Non-randomised Studies of Interventions tool to evaluate bias.

Results: We identified 7474 articles, of which 40 were included, with data from 150 countries. Of these, 32 studies assessed school closures and 11 examined reopenings. There was substantial heterogeneity between school closure studies, with half of the studies at lower risk of bias reporting reduced community transmission by up to 60% and half reporting null findings. The majority (n=3 out of 4) of school reopening studies at lower risk of bias reported no associated increases in transmission.

Conclusions: School closure studies were at risk of confounding and collinearity from other non-pharmacological interventions implemented around the same time as school closures, and the effectiveness of closures remains uncertain. School reopenings, in areas of low transmission and with appropriate mitigation measures, were generally not accompanied by increasing community transmission. With such varied evidence on effectiveness, and the harmful effects, policymakers should take a measured approach before implementing school closures; and should look to reopen schools in times of low transmission, with appropriate mitigation measures.

Keywords: COVID-19; epidemiology; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
Figure 2
Figure 2
Main findings, stratified by risk of bias. (A) The studies’ response to the question: Did school closures reduced community transmission? (Yes, No, Mixed). (B) The studies’ response to the question: Did school reopenings increase community transmission? (Yes, No, Mixed).
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. UNESCO . Global monitring of school closures caused by COVID-19 [Internet]. Education:From disruption to recovery, 2020. Available: https://en.unesco.org/covid19/educationresponse [Accessed 18 Dec 2020].
    1. Unicef . Framework for reopening schools, 2020.
    1. UNESCO . Adverse consequences of school closures [Internet], 2020. Available: https://en.unesco.org/covid19/educationresponse/consequences [Accessed 18 Dec 2020].
    1. Viner R, Russell S, Saulle R. Impacts of school closures on physical and mental health of children and young people: a systematic review. medRxiv 2021:1;2021.02.10.21251526http://medrxiv.org/content/early/2021/02/12/2021.02.10.21251526.abstract
    1. ECDC . COVID-19 in children and the role of school settings in COVID-19 transmission. Stockholm, 2020.

Publication types