Evaluating scenarios for school reopening under COVID19

Abstract

Background: Thousands of school systems have struggled with the decisions about how to deliver education safely and effectively amid the COVID19 pandemic. This study evaluates the public health impact of various school reopening scenarios (when, and how to return to in-person instruction) on the spread of COVID19.

Methods: An agent-based simulation model was adapted and used to project the impact of various school reopening strategies on the number of infections, hospitalizations, and deaths in the state of Georgia during the study period, i.e., February 18^th-November 24^th, 2020. The tested strategies include (i) schools closed, i.e., all students receive online instruction, (ii) alternating school day, i.e., half of the students receive in-person instruction on Mondays and Wednesdays and the other half on Tuesdays and Thursdays, (iii) alternating school day for children, i.e., half of the children (ages 0-9) receive in-person instruction on Mondays and Wednesdays and the other half on Tuesdays and Thursdays, (iv) children only, i.e., only children receive in-person instruction, (v) regular, i.e., all students return to in-person instruction. We also tested the impact of universal masking in schools.

Results: Across all scenarios, the number of COVID19-related deaths ranged from approximately 8.8 to 9.9 thousand, the number of cumulative infections ranged from 1.76 to 1.96 million for adults and 625 to 771 thousand for children and youth, and the number of COVID19-related hospitalizations ranged from approximately 71 to 80 thousand during the study period. Compared to schools reopening August 10 with a regular reopening strategy, the percentage of the population infected reduced by 13%, 11%, 9%, and 6% in the schools closed, alternating school day for children, children only, and alternating school day reopening strategies, respectively. Universal masking in schools for all students further reduced outcome measures.

Conclusions: Reopening schools following a regular reopening strategy would lead to higher deaths, hospitalizations, and infections. Hybrid in-person and online reopening strategies, especially if offered as an option to families and teachers who prefer to opt-in, provide a good balance in reducing the infection spread compared to the regular reopening strategy, while ensuring access to in-person education.

Keywords: Agent-based disease modeling; COVID19; Non-pharmaceutical interventions; Pandemic; Public health; School reopening.

Fig. 1

Description of school reopening strategies

Fig. 2

Base Scenario. All scenarios considered are built upon the base scenario along with the corresponding school reopening date. Compliance with shelter-in-place, voluntary quarantine, and voluntary shelter-in-place varies over time

Fig. 3

Impact of reopening date given a reopening strategy. Daily new COVID19 infections with different reopening dates under the regular, children only, alternating school day, and alternating school day for children reopening strategies

Fig. 4

Impact of reopening strategy given a reopening date. Daily new COVID19 infections with different reopening strategies under the reopening dates of Aug 10, Aug 17, Aug 24, Aug 31

Fig. 5

Impact of universal masking in school. Daily new COVID19 infections with different reopening strategies with or without universal masking in schools under the reopening date of Aug 10