Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

Geertruida Bekkering; Nicolas Delvaux; Patrik Vankrunkelsven; Jaan Toelen; Sigrid Aertgeerts; Sofie Crommen; Pedro De Bruyckere; Ignaas Devisch; Tinne Lernout; Katrien Masschalck; Nore Milissen; Geert Molenberghs; Annelies Pascal; Oscar Plomteux; Marc Raes; Lise Rans; Alexandra Seghers; Lode Sweldens; Jeroen Vandenbussche; Guido Vanham; Elke Wollants; Bert Aertgeerts

doi:10.1136/bmjpo-2020-000971

Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

Geertruida Bekkering, Nicolas Delvaux, Patrik Vankrunkelsven, Jaan Toelen, Sigrid Aertgeerts, Sofie Crommen, Pedro De Bruyckere, Ignaas Devisch, Tinne Lernout, Katrien Masschalck, Nore Milissen, Geert Molenberghs, Annelies Pascal, Oscar Plomteux, Marc Raes, Lise Rans, Alexandra Seghers, Lode Sweldens, Jeroen Vandenbussche, Guido VanhamElke Wollants, Bert Aertgeerts

Virology

Research output: Contribution to journal › A1: Web of Science-article › peer-review

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Abstract

Background: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.

Methods: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.

Results: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.

Conclusion: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

Original language	English
Article number	e000971
Journal	BMJ Paediatrics Open
Volume	5
Issue number	1
Number of pages	8
ISSN	2399-9772
DOIs	https://doi.org/10.1136/bmjpo-2020-000971
Publication status	Published - 2021

Keywords

COVID-19
Child
Communicable Disease Control
Educational Personnel
Humans
SARS-CoV-2
Schools

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Bekkering, G., Delvaux, N., Vankrunkelsven, P., Toelen, J., Aertgeerts, S., Crommen, S., Bruyckere, P. D., Devisch, I., Lernout, T., Masschalck, K., Milissen, N., Molenberghs, G., Pascal, A., Plomteux, O., Raes, M., Rans, L., Seghers, A., Sweldens, L., Vandenbussche, J., ... Aertgeerts, B. (2021). Closing schools for SARS-CoV-2: a pragmatic rapid recommendation. BMJ Paediatrics Open, 5(1), Article e000971. https://doi.org/10.1136/bmjpo-2020-000971

@article{96f869b0ccc043f3b66ca6ad3beab0ab,

title = "Closing schools for SARS-CoV-2: a pragmatic rapid recommendation",

abstract = "Background: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.Methods: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.Results: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.Conclusion: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.",

keywords = "COVID-19, Child, Communicable Disease Control, Educational Personnel, Humans, SARS-CoV-2, Schools",

author = "Geertruida Bekkering and Nicolas Delvaux and Patrik Vankrunkelsven and Jaan Toelen and Sigrid Aertgeerts and Sofie Crommen and Bruyckere, {Pedro De} and Ignaas Devisch and Tinne Lernout and Katrien Masschalck and Nore Milissen and Geert Molenberghs and Annelies Pascal and Oscar Plomteux and Marc Raes and Lise Rans and Alexandra Seghers and Lode Sweldens and Jeroen Vandenbussche and Guido Vanham and Elke Wollants and Bert Aertgeerts",

note = "FTX; DOAJ; (CC BY-NC 4.0); {\textcopyright} Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2021",

doi = "10.1136/bmjpo-2020-000971",

language = "English",

volume = "5",

journal = "BMJ Paediatrics Open",

issn = "2399-9772",

publisher = "BMJ Publishing Group",

number = "1",

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Bekkering, G, Delvaux, N, Vankrunkelsven, P, Toelen, J, Aertgeerts, S, Crommen, S, Bruyckere, PD, Devisch, I, Lernout, T, Masschalck, K, Milissen, N, Molenberghs, G, Pascal, A, Plomteux, O, Raes, M, Rans, L, Seghers, A, Sweldens, L, Vandenbussche, J, Vanham, G, Wollants, E & Aertgeerts, B 2021, 'Closing schools for SARS-CoV-2: a pragmatic rapid recommendation', BMJ Paediatrics Open, vol. 5, no. 1, e000971. https://doi.org/10.1136/bmjpo-2020-000971

TY - JOUR

T1 - Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

AU - Bekkering, Geertruida

AU - Delvaux, Nicolas

AU - Vankrunkelsven, Patrik

AU - Toelen, Jaan

AU - Aertgeerts, Sigrid

AU - Crommen, Sofie

AU - Bruyckere, Pedro De

AU - Devisch, Ignaas

AU - Lernout, Tinne

AU - Masschalck, Katrien

AU - Milissen, Nore

AU - Molenberghs, Geert

AU - Pascal, Annelies

AU - Plomteux, Oscar

AU - Raes, Marc

AU - Rans, Lise

AU - Seghers, Alexandra

AU - Sweldens, Lode

AU - Vandenbussche, Jeroen

AU - Vanham, Guido

AU - Wollants, Elke

AU - Aertgeerts, Bert

PY - 2021

Y1 - 2021

N2 - Background: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.Methods: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.Results: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.Conclusion: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

AB - Background: In Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.Methods: A multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.Results: Closing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.Conclusion: The guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

KW - COVID-19

KW - Child

KW - Communicable Disease Control

KW - Educational Personnel

KW - Humans

KW - SARS-CoV-2

KW - Schools

U2 - 10.1136/bmjpo-2020-000971

DO - 10.1136/bmjpo-2020-000971

M3 - A1: Web of Science-article

C2 - 34192193

SN - 2399-9772

VL - 5

JO - BMJ Paediatrics Open

JF - BMJ Paediatrics Open

IS - 1

M1 - e000971

ER -

Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

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