Study links spring school closures to decrease in COVID-19 cases, deaths

A study published Wednesday associates widespread school closures in the spring with fewer COVID-19 cases and deaths in the following days and weeks.

School closures may have been associated with 1.37 million fewer cases of COVID-19 over a 26-day period and 40,600 fewer deaths over a 16-day period, according to the study published in the Journal of the American Medical Association (JAMA).

The study comes amid a debate in the U.S. over when and how schools should reopen in the fall. The Trump administration has pressed for schools to fully reopen, arguing that kids are least likely to experience severe COVID-19 illness. The administration is also keen to get the economy moving again and sees school openings as a key factor.

It is not clear, however, what role children play in spreading the virus to adults.

The study was authored by pediatric researchers, led by Dr. Katherine Auger, an associate professor of pediatrics at Cincinnati Children’s Hospital. 

The study found that states that closed schools earlier in the pandemic when the confirmed number of COVID-19 cases and deaths was lower saw fewer total cases and deaths after closures, compared to states that closed schools later when confirmed cases and deaths were higher.

The authors warned that the study results should not necessarily be applied to making decisions about reopening in the fall, noting that infection control practices recommended by the Centers for Disease Control and Prevention (CDC) like spacing desks 6 feet apart and requiring mask-wearing were not in place in the spring.

“It is unclear how COVID-19 spread would be affected if schools remained open while states enacted other policies to restrict movement,” the authors wrote.

“It is possible school-related spread may be mitigated with infection-control interventions recommended by the CDC and the American Academy of Pediatrics.”

The authors note that school closures in the spring were occurring at the same time as stay-at-home orders, closures of nonessential businesses and bans on large gatherings that also likely had an effect on the drop in COVID-19 cases and deaths.

It’s not possible to completely separate the effects of those measures on decreased COVID-19 cases and deaths, the authors wrote.

It’s also not clear whether school closures resulted in decreases in cases because kids weren’t spreading the virus to each other and to adults, or because parents were staying home more to take care of children.

Both the CDC and other health experts have strongly emphasized reopening schools in the fall with safety precautions because closures have had a negative impact on student learning and health.

“Although the findings from the study … suggest a role for school closures in virus mitigation, school and health officials must balance this with academic, health, and economic consequences,” reads an editorial on the study published in JAMA and written by two experts who were not involved with it. 

“A key challenge is that these other outcomes are likely more diffuse, accrue over a longer time horizon, may have consequences that last decades, and are more difficult to count than COVID-19 outcomes, including cases, hospitalizations, and deaths, which are measured in real-time and are widely reported,” write Julie Donohue and Dr. Elizabeth Miller, both of the University of Pittsburgh.

They added that school districts should consider the level of prevalence of COVID-19 in their communities, policies and practices regarding mask-wearing and the risk of transmission among children of different ages.

Anthony Fauci, the nation’s top infectious disease doctor, said whether a school can safely reopen in the fall depends on the level of COVID-19 transmission in the community.

“In the hot zones, you have to take that on a case by case basis, and make a decision based on the welfare of the kids, as well as the feasibility of being able to open up,” Fauci said Wednesday on MSNBC.