Estimating the impact of reopening schools on the reproduction number of SARS-CoV-2 in England, using weekly contact survey data
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Abstract
Background
Schools were closed in England on 4 January 2021 as part of increased national restrictions to curb transmission of SARS-CoV-2. The UK government reopened schools on 8 March. Although there was evidence of lower individual-level transmission risk amongst children compared to adults, the combined effects of this with increased contact rates in school settings and the resulting impact on the overall transmission rate in the population were not clear.
Methods
We measured social contacts of > 5000 participants weekly from March 2020, including periods when schools were both open and closed, amongst other restrictions. We combined these data with estimates of the susceptibility and infectiousness of children compared with adults to estimate the impact of reopening schools on the reproduction number.
Results
Our analysis indicates that reopening all schools under the same measures as previous periods that combined lockdown with face-to-face schooling would be likely to increase the reproduction number substantially. Assuming a baseline of 0.8, we estimated a likely increase to between 1.0 and 1.5 with the reopening of all schools or to between 0.9 and 1.2 reopening primary or secondary schools alone.
Conclusion
Our results suggest that reopening schools would likely halt the fall in cases observed between January and March 2021 and would risk a return to rising infections, but these estimates relied heavily on the latest estimates or reproduction number and the validity of the susceptibility and infectiousness profiles we used at the time of reopening.
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SciScore for 10.1101/2021.03.06.21252964: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources This resulted in 64% (51% - 81%, 95% confidence interval [CI]) susceptibility in children relative to adults, we assumed equal infectiousness between children and adults [16]; For the fifth profile (v), we used an independent estimate of relative susceptibility in children (31%, see results section), quantified by comparing reproduction numbers estimated from CoMix data and using a well-established time-series method developed by Abbott et. al [21], which uses a time-series of cases to determine the instantaneous reproduction number under an assumed generation interval and infection to … SciScore for 10.1101/2021.03.06.21252964: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources This resulted in 64% (51% - 81%, 95% confidence interval [CI]) susceptibility in children relative to adults, we assumed equal infectiousness between children and adults [16]; For the fifth profile (v), we used an independent estimate of relative susceptibility in children (31%, see results section), quantified by comparing reproduction numbers estimated from CoMix data and using a well-established time-series method developed by Abbott et. al [21], which uses a time-series of cases to determine the instantaneous reproduction number under an assumed generation interval and infection to reporting delay distribution. Abbottsuggested: (Abbott, RRID:SCR_010477)Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are a number of important limitations to this work: Contacts in different settings likely contribute differently to transmission, but we assumed all contacts make equal contributions to transmission, as these differences are not well quantified in the context of control measures. If contacts at school are lower risk than those outside of school the impact of reopening schools would be lower. The age-stratified susceptibility profile is likely to change over time as natural immunity is acquired in the population. The profiles we used each reflect a single point in time. Changes in the relative immunity in children would alter the relative impact of school contacts on overall transmission. We assume adult contacts revert to those observed when all schools were open, which is conservative, in reality, particularly for partial reopening scenarios, adult contacts may not fully return to the same levels. Furthermore, there may also be differences in adherence to restrictions between the two lockdowns, unrelated to school closure. However, the change in adults’ contacts between the two periods was relatively small. The proportion of children in school varied over time due to exclusion-based control measures during the autumn, though the proportion attending school remained high during the November lockdown (Supplementary Figures, Figure S3). Contacts of children are reported by parents, which may impact their reliability, particularly in school, where parents are unlikely to w...
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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