One of the non-pharmaceutical interventions that jurisdictions around the US and in Arizona will be considering in the coming weeks in response to the COVID-19 virus are coordinated school closures. It’s important for decision-makers to be informed about the costs and benefits of such a policy before making a decision.
The best published resource that I found was from The Community Guide’s Evidence Review on School Dismissals to Reduce Transmission of Pandemic Influenza. The Systematic Review is based on evidence from a systematic review of 67 papers.
The supporting materials, analytical framework and the evidence tables are in the Review. It also includes Actual School Dismissals Historical Studies and Modeling Studies. Their review also includes a detailed Rationale Statement.
Results for “Moderate” Pandemics
The Task Force found insufficient evidence to determine the balance of benefits and harms for coordinated (widespread) school dismissals during moderate or less severe pandemics because few studies provided enough information to assess the potential benefits and costs of school dismissals for pandemics.
They also state that the level of public concern in moderate pandemics would be unlikely to support and sustain the extended school dismissals (weeks to months) and that the “social and economic costs of community-wide dismissals would likely exceed potential benefits, especially for some segments of the population, such as families in which both parents work and no other child care is available”.
Results for “Severe” or 1918-Like Pandemics
The Task Force found sufficient evidence that the benefits of coordinated (widespread) school dismissals outweigh the societal and economic costs during a severe influenza pandemic (a pandemic with high rates of severe illness like in 1918). However, the potential benefits are limited to slowing transmission of infection and reducing peak burden of illness on health care resources.
Those conclusions were based on the effectiveness of reducing or delaying the spread of infection and illness within communities from retrospective assessments of public health actions taken during the 1918 pandemic and modeled simulations.
Research Example from the 2009 H1N1 Pandemic
A simulation of costs and benefits for school closures in Pennsylvania during the 2009 H1N1 outbreak found that closure-related costs were greater than savings resulting from reductions in disease. Researchers found that each day of school closure may have cost an estimated average of $120,000 and that the costs of school closure may have been approximately 5 to 40 times higher than the total costs from influenza without school closure mitigation.
