Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic

Rozhnova, Ganna, van Dorp, Christiaan H, Bruijning-Verhagen, Patricia, Bootsma, Martin CJ, van de Wijgert, Janneke HHM ORCID: 0000-0003-2728-4560, Bonten, Marc JM and Kretzschmar, Mirjam E (2021) Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic. Nature Communications, 12 (1). 1614-.

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Abstract

<jats:p>Background: In autumn 2020, many countries, including the Netherlands, are experiencing a second wave of the COVID-19 pandemic. Health policymakers are struggling with choosing the right mix of measures to keep the COVID-19 case numbers under control, but still allow a minimum of social and economic activity. The priority to keep schools open is high, but the role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. We used a transmission model to estimate the impact of school contacts on the transmission of SARS-CoV-2 and to assess the effects of school-based measures, including school closure, on controlling the pandemic at different time points during the pandemic. Methods and Findings: The age-structured model was fitted to age-specific seroprevalence and hospital admission data from the Netherlands during spring 2020. Compared to adults older than 60 years, the estimated susceptibility was 23% (95%CrI 20-28%) for children aged 0 to 20 years and 61% (95%CrI 50%-72%) for the age group of 20 to 60 years. The time points considered in the analyses were (i) August 2020 when the effective reproduction number (R_e) was estimated to be 1.31 (95%CrI 1.15-2.07), schools just opened after the summer holidays and measures were reinforced with the aim to reduce R_e to a value below 1, and (ii) November 2020 when measures had reduced R_e to 1.00 (95%CrI 0.94-1.33). In this period schools remained open. Our model predicts that keeping schools closed after the summer holidays, in the absence of other measures, would have reduced R_e by 10% (from 1.31 to 1.18 (95%CrI 1.04-1.83)) and thus would not have prevented the second wave in autumn 2020. Reducing non-school-based contacts in August 2020 to the level observed during the first wave of the pandemic would have reduced R_e to 0.83 (95%CrI 0.75-1.10). Yet, this reduction was not achieved and the observed R_e in November was 1.00. Our model predicts that closing schools in November 2020 could reduce R_e from the observed value of 1.00 to 0.84 (95%CrI 0.81-0.90), with unchanged non-school based contacts. Reductions in R_e due to closing schools in November 2020 were 8% for 10 to 20 years old children, 5% for 5 to 10 years old children and negligible for 0 to 5 years old children. Conclusions: The impact of measures reducing school-based contacts, including school closure, depends on the remaining opportunities to reduce non-school-based contacts. If opportunities to reduce R_e with non-school-based measures are exhausted or undesired and R_e is still close to 1, the additional benefit of school-based measures may be considerable, particularly among the older school children.</jats:p>

Item Type:	Article
Uncontrolled Keywords:	Humans, Hospitalization, Models, Statistical, Bayes Theorem, Cross-Sectional Studies, Seroepidemiologic Studies, Age Factors, Models, Biological, Schools, Holidays, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Child, Child, Preschool, Infant, Infant, Newborn, Netherlands, Female, Male, Basic Reproduction Number, Young Adult, Pandemics, COVID-19, SARS-CoV-2
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User:	Symplectic Admin
Date Deposited:	30 Mar 2021 13:53
Last Modified:	18 Jan 2023 22:54
DOI:	10.1038/s41467-021-21899-6
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3118217

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• Model-based evaluation of school- and non-school-related measures to control the COVID-19 pandemic. (deposited 18 Mar 2021 09:02)
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