Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Nov 25, 2022
Open Peer Review Period: Nov 25, 2022 - Dec 9, 2022
Date Accepted: Nov 30, 2023
(closed for review but you can still tweet)
Evaluating the effectiveness of school closures in COVID-19-related syndromes from community-based syndromic surveillance: Longitudinal observational study
ABSTRACT
Background:
Background:
During the coronavirus disease 2019 (COVID-19) pandemic, a school closure policy was adopted to prevent cluster transmission in schools and subsequent household transmission. However, the effectiveness of school closures is not consistent with studies conducted in different countries.
Objective:
Objective:
This study aimed to explore the association between school closure and the daily standardized incidence of COVID-19-related syndromes in an outpatient syndromic surveillance system.
Methods:
Methods:
We calculated the incidence of COVID-19-related syndromes derived from a community-based syndromic surveillance system between the first week of January and second or fourth weeks after school closure in 2021 and 2022 in Taipei City, Taiwan. The effect of school closure on the standardized incidence of COVID-19-related syndromes was evaluated by interrupted time-series analysis using an autoregressive integrated moving average with a distributed lag function. The exogenous variables were changes in human mobility measured by Google COVID-19 community mobility reports. Furthermore, the models quantified the influence of different age groups and the hierarchy of medical facilities, such as clinics or community hospitals.
Results:
Results:
School closure was only negatively and significantly associated with the overall standardized incidence of COVID-19-related syndromes in 2021 for two weeks after the intervention (coefficient, -1.24; 95% confidence interval [CI], -2.40 to -0.08). However, in different age groups, school closure had a significantly negative association with standardized incidence among people aged 1318 and >65 years for two weeks after intervention in clinics in 2021. In community hospitals, school closure was significantly positively associated with standardized incidence for people aged 1924 years in 2021. In 2022, two weeks after intervention, school closure had a significantly negative association with the standardized incidence among people aged 06, 712, and 1924 years in community hospitals and aged >45 years in clinics. Furthermore, the standardized incidence was positively associated with movement change toward grocery and pharmacy in all age groups in 2022. In addition, movement changes toward residence were significantly positively associated with standardized incidence among all age groups.
Conclusions:
Conclusions:
Overall, school closure effectively suppresses COVID-19-related syndromes in students due to the reduction of physical contact. In addition, school closures have a spillover effect on the elderly who stay at home.
Citation
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Copyright
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