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Measures implemented in the school setting to contain the COVID-19 pandemic
Cochrane Database of Systematic Reviews ; 1(159), 2022.
Article in English | GIM | ID: covidwho-1838128
ABSTRACT

Background:

In response to the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the impact of coronavirus disease 2019 (COVID-19), governments have implemented a variety of measures to control the spread of the virus and the associated disease. Among these, have been measures to control the pandemic in primary and secondary school settings.

Objectives:

To assess the effectiveness of measures implemented in the school setting to safely reopen schools, or keep schools open, or both, during the COVID-19 pandemic, with particular focus on the different types of measures implemented in school settings and the outcomes used to measure their impacts on transmission-related outcomes, healthcare utilisation outcomes, other health outcomes as well as societal, economic, and ecological outcomes. Search

methods:

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and the Educational Resources Information Center, as well as COVID-19-specific databases, including the Cochrane COVID-19 Study Register and the WHO COVID-19 Global literature on coronavirus disease (indexing preprints) on 9 December 2020. We conducted backward-citation searches with existing reviews. Selection criteria We considered experimental (i.e. randomised controlled trials;RCTs), quasi-experimental, observational and modelling studies assessing the effects of measures implemented in the school setting to safely reopen schools, or keep schools open, or both, during the COVID-19 pandemic. Outcome categories were (i) transmission-related outcomes (e.g. number or proportion of cases);(ii) healthcare utilisation outcomes (e.g. number or proportion of hospitalisations);(iii) other health outcomes (e.g. physical, social and mental health);and (iv) societal, economic and ecological outcomes (e.g. costs, human resources and education). We considered studies that included any population at risk of becoming infected with SARS-CoV-2 and/or developing COVID-19 disease including students, teachers, other school staff, or members of the wider community. Data collection and

analysis:

Two review authors independently screened titles, s and full texts. One review author extracted data and critically appraised each study. One additional review author validated the extracted data. To critically appraise included studies, we used the ROBINS-I tool for quasi-experimental and observational studies, the QUADAS-2 tool for observational screening studies, and a bespoke tool for modelling studies. We synthesised findings narratively. Three review authors made an initial assessment of the certainty of evidence with GRADE, and several review authors discussed and agreed on the ratings. Main

results:

We included 38 unique studies in the analysis, comprising 33 modelling studies, three observational studies, one quasi-experimental and one experimental study with modelling components. Measures fell into four broad categories (i) measures reducing the opportunity for contacts;(ii) measures making contacts safer;(iii) surveillance and response measures;and (iv) multicomponent measures. As comparators, we encountered the operation of schools with no measures in place, less intense measures in place, single versus multicomponent measures in place, or closure of schools. Across all intervention categories and all study designs, very low- to low-certainty evidence ratings limit our confidence in the findings. Concerns with the quality of modelling studies related to potentially inappropriate assumptions about the model structure and input parameters, and an inadequate assessment of model uncertainty. Concerns with risk of bias in observational studies related to deviations from intended interventions or missing data. Across all categories, few studies reported on implementation or described how measures were implemented. Where we describe effects as 'positive', the direction of the point estimate of the effect favours the intervention(s);'negative' effects do not favour the intervention. We found 23 modelling studie
Keywords

Full text: Available Collection: Databases of international organizations Database: GIM Type of study: Controlled clinical trial / Prognostic study / Randomized controlled trials / Reviews Language: English Journal: Cochrane Database of Systematic Reviews Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: GIM Type of study: Controlled clinical trial / Prognostic study / Randomized controlled trials / Reviews Language: English Journal: Cochrane Database of Systematic Reviews Year: 2022 Document Type: Article