April 2, 2020

expert reaction to rapid evidence review on the impact of school closures on children’s social contacts

A review, published in Eurosurveillance, reports on the impact of school closures on children’s social contacts.

Dr Angharad Rudkin, Child Clinical Psychologist at The University of Southampton, said:

“Literature reviews pull together findings from existing research so that a picture can emerge about trends and patterns. Given that it is too soon to have any findings from the current comparative Covid19 situation, literature reviews can instead be drawn on for useful guidance. This literature review summarised findings from 19 studies looking at the effects of school closures during previous flu outbreaks, where schools were closed for between 1 day and 2 weeks. In these studies, two main findings emerge. Firstly, that teens and younger children were more likely to still go out during school closures. Teens went out in order to meet with friends and younger children were accompanying their parents on trips to the supermarket, and other household tasks. Secondly, the studies showed that how children behave during school closures are related to how parents view school closures. If parents regard a school closure as being unnecessary and ineffective, then they are more likely to let their children go out. Parents can also have concerns about school closures impacting on their child’s education, creating difficulties with childcare, and damaging the economy. Although these studies were conducted in slightly different situations to the one we find ourselves in today, these themes are all familiar from the current school closures, and they provide useful guidance on how to maximise compliance with rules around social distancing and isolation. Convincing parents of the purpose and necessity of school closures is the most important step, as parents’ attitudes filter down to their children, and parents also serve as gatekeepers for their children. To convince parents, information needs to be clearly communicated, the messages need to be relevant with clear examples of what is required and why, and any expectations of behaviour change needs to be backed up by support around financial, social and emotional difficulties.”

Dr Charlotte Jackson, Senior Research Fellow, MRC Clinical Trials Unit (CTU), said:

“This is a useful review of 19 published studies on how children behave during unplanned school closures, including how much children leave their own home and who provides childcare for them. Most of the studies reviewed concerned the 2009 influenza pandemic or other outbreaks of influenza or influenza-like illness. The studies were carried out in a range of countries (ten from the USA, four from Australia and one each from Argentina, Japan, Russia, Taiwan and the UK). The reviewed studies reported that children made fewer contacts during school closures, but it was common for children to leave their homes while schools were closed and children were sometimes looked after by people who were not members of their household. This sort of data is useful for assessing how closing schools can affect transmission during an epidemic, when used together with information on how commonly children become infected and how infectious they are.

“The situation with COVID-19 is different to previous infectious disease outbreaks. Schools are being closed for longer periods, the disease has a higher case fatality ratio than influenza, and the importance of social distancing is being publicised extensively. As the authors note, all of these may influence the extent to which children stay at home. So these studies provide a useful starting point but similar data from the current pandemic will be very important.

“The reported impacts of school closures on parents and families are likely to vary. For example, parents reported concerns about loss of earnings and impacts on their children’s education, which may disproportionately affect more vulnerable families.”

Prof Sarah Stewart-Brown, Professor of Public Health, Warwick Medical School at the University of Warwick, said:

“This is a reliable rapid review, but the need to complete it quickly in order to be of use in the current circumstances mean some studies may have been missed. Educational databases for example were not searched.  However, it is unlikely that conclusions would be very different as most of the studies report similar results.

“The main caveat is that none of these studies looked at school closures for longer than two weeks because that is the longest closures that have been studied. And clearly the longer school closures we are seeing in this pandemic put greater strain on families. The other caveat is that the data in all but one study were collected in a questionnaire survey where parents are reporting from memory and their responses may be affected by ‘social desirability’. In this case the outside contact data could be an underestimate. 

“The conclusions suggest that school closure reduces but does not stop contact between school children and others – both other children and young people and carers outside the home. It refers to children being left alone at home which may not apply in the current situation where workplaces have been closed as well and so parents are at home too.  It also refers to the need for child care by others outside the home

“The review does not comment on long closures because there were no studies of closures longer than two weeks. The studies were not set in the context of the particular recommendations of the current time, that it is permitted- if not ill -to leave the house for exercise and shopping. So the data are not directly applicable. Children stayed at home for 94% of the days they were asked to quarantine but most children did leave the house when the quarantine recommendations required them not to. Only one study was UK based and this was the only European study, most were from US and 4 were carried out in Australia.

“Hopefully after the Easter holidays and when we get access to antibody testing we will start to see reliable information about the spread of the virus in the UK population in this pandemic. This will offer more precise information about what would be helpful going forward.”

The impact of unplanned school closure on children’s social contact: rapid evidence review by Samantha Brooks et al. will be published in Eurosurveillance at 16:00 UK time Thursday 2 April.

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19

Declared interests

None received.