School closures in spring saved lives, study asserts
In a new analysis, pediatric researchers have estimated that states’ decisions to close schools in the spring likely saved tens of thousands of lives from COVID-19 and prevented many more coronavirus infections.
The findings come amid a worldwide debate on whether, when and how to reopen schools, including for some 56 million U.S. students, kindergarten through high school.
Outside experts cautioned that the effect of school closings is extremely difficult to predict because of unknowns like how infectious children are and because of the difficulty in separating out the effect of school closures from other measures that states took to control the virus. In addition, early in the pandemic, testing was especially limited and spotty, raising questions about how well the number of confirmed cases reflected actual infections.
The paper, published Wednesday in JAMA, is likely to remind school districts and policymakers how consequential their decisions could be for the shape of the pandemic this fall. The study focuses on a six-week period in the spring; the authors acknowledged their findings are not broadly applicable today because before closings in the spring, there were no precautions, such as smaller classes and the wearing of masks, that are being recommended for reopening.
“At the time, there wasn’t any masking in schools, there wasn’t physical distancing, there wasn’t an increase in hygiene and that sort of thing,” said Dr. Katherine Auger, an associate professor of pediatrics at Cincinnati Children’s Hospital and the lead author of the study. “The findings of our studies took place before any of those measures were in.”
Still, Auger said, she believed that the conclu
sions of the study supported the idea that decisions on reopening schools should strongly consider the prevalence of virus cases in the community.
“Are there a lot of cases right now? Is it a hot spot? Is it an outbreak? Is it a surge?” Auger said. She added that the American Academy of Pediatrics guidelines “emphasize making sure that the community numbers are reasonable before trying to open schools, and I think this manuscript sort of bolsters that a bit.”
But other experts noted the impact of preventive measures taken by states — including stay-at-home orders, closures of restaurants and nonessential businesses and limits on large social gatherings — simultaneously or shortly after school closings made it hard to determine the specific role of schools in such analyses.
“I think we have to be incredibly cautious when interpreting estimates from a study like this,” said Julie Donohue, a professor of public health at the University of Pittsburgh who co-wrote an editorial about the study. “In particular, I think it’s important to emphasize that we really can’t isolate the impact of school closures from other interventions.”
Given that the study is being published just as districts around the country are struggling with whether and how to reopen schools, some experts expressed concern that its estimates about the impact of closing schools early in the pandemic would be seized upon as an argument that schools should remain closed. Experts on public health and education have recommended that communities and schools should work toward reopening with strong health precautions in place, because in-person schooling has such tremendous value for children’s academic, social and emotional development.
“I do worry that these large estimates of the effect of school closures will lead people to give up because it is going to be challenging to open schools,” Donohue said.