In-person schooling and COVID-19 transmission in Canada’s three largest cities
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Abstract
In North America and Europe, the Fall 2020 school term has coincided with the beginning of the second wave of the novel coronavirus (COVID-19) pandemic, sparking a heated debate about the role of in-person schooling for community transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This issue has immediate policy relevance for deciding how to operate schools safely as the pandemic unfolds, new variants of SARS-CoV-2 are circulating, and immunization coverage remains low. We contribute to this debate by presenting data on trends in COVID-19 weekly incidence among school-aged children 0-19 years old vis-à-vis other age groups during Fall 2020 in Canada’s three largest cities: Montréal, Toronto and Calgary. We interpret these trends in light of the different back-to-school policies and other public health measures implemented in the three cities over the observation period.
KEY POINTS
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School closures are an effective measure to reduce the overall incidence of the novel coronavirus (COVID-19). Nonetheless, there is a general consensus that the decision to close schools to control the spread of COVID-19 should be used as last resort because of the negative impact on children’s development and mental health, and since they are less likely to have severe COVID-19 outcomes than adults.
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Existing evidence highlights the importance of adopting appropriate mitigation strategies for limiting COVID-19 community spread when returning to in-person schooling. To understand the association between in-person schooling and COVID-19 transmission given different mitigation strategies, especially universal masking and distance learning, we compare how the second wave of COVID-19 has affected school-aged children age 0-19 years old vis-à-vis other age groups in Montréal, Toronto and Calgary during Fall 2020.
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The case of Montréal attests to the negative consequences of not implementing recommended migration strategies when reopening schools, even when public health measures such as gatherings restrictions are in place to maintain low levels of community transmission. On the contrary, school measures adopted in Toronto (optional distance learning and masking mandates), have limited the role of COVID-19 transmission among school-aged children for overall community transmission. In Calgary, this effect has been smaller, likely because public health measures to limit COVID-19 community spread were not introduced until early December 2020.
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Our findings have immediate policy relevance for deciding how to operate schools safely as the pandemic unfolds, new variants of SARS-CoV-2 are circulating, and immunization coverage remains low.
Article activity feed
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SciScore for 10.1101/2021.03.21.21254064: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has a number of limitations that should be borne in mind. First, this is a comparative case study, which is inherently limited to a degree due to the complexity of the variation in mitigation measures at all levels …
SciScore for 10.1101/2021.03.21.21254064: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has a number of limitations that should be borne in mind. First, this is a comparative case study, which is inherently limited to a degree due to the complexity of the variation in mitigation measures at all levels between them. We believe, however, that the comparisons are strong enough to support the inferences drawn here concerning the importance of school mitigation strategies in limiting COVID-19 transmission. This is especially because COVID-19 incidence is likely underestimated in children, especially at younger ages, in part because milder illness and a higher fraction of asymptomatic infections are associated with decreased testing and case finding (Fisman et al., 2021). The second study limitation is that, since data were not available for Montréal and Calgary, we could not assess trends in test positivity by age. Finally, we could not evaluate trends in COVID-19 incidence among teachers and school staff members, because in Canada cases are not routinely reported by occupations other than health care workers.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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