ArticlePLoS computational biology2021
COVID-19 in schools: Mitigating classroom clusters in the context of variable transmission.
Article in PLoS computational biology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Measures implemented in the school setting to contain the COVID-19 pandemicThe Cochrane database of systematic reviews · 2022Pooled it
- Combining and comparing regional SARS-CoV-2 epidemic dynamics in Italy: Bayesian meta-analysis of compartmental models and global sensitivity analysis.Frontiers in public health · 2022Pooled it
- On campus dormitories as viral transmission sinks: Phylodynamic insights into student housing networks during the COVID-19 pandemic.PLoS pathogens · 2025Article
- Factors shaping Covid-19 vaccine acceptability among young people in South Africa and Nigeria: An exploratory qualitative study.PLOS global public health · 2025Article
- Insights from respiratory virus co-infections.World journal of virology · 2024Review
- Limited impact of lifting universal masks on SARS-CoV-2 transmission in schools: The crucial role of outcome measurements.PNAS nexus · 2024Article
- Airborne disease transmission during indoor gatherings over multiple time scales: Modeling framework and policy implications.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Predicting COVID-19 transmission in a student population in Seoul, South Korea, 2020-2021.Clinical and experimental pediatrics · 2023Article
- Community-based COVID-19 outbreak of the B.1.1.7 (Alpha) variant of concern in Newfoundland, February to March 2021.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2023Article
- Insights on COVID-19 Vaccination in Portugal: A Qualitative Study among Health Professionals and Teachers.Vaccines · 2022Article
- Impact of ventilation and avoidance measures on SARS-CoV-2 risk of infection in public indoor environments.The Science of the total environment · 2022Article
- Unravelling the drivers behind COVID-19 vaccination hesitancy and refusal among teachers: A nationwide study.Vaccine · 2022Article
- In-person learning low risk for COVID-19 acquisition: Findings from a population-based analysis of the 2020-2021 school year in Saskatchewan, Canada.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2022Article
- Using simulation modelling and systems science to help contain COVID-19: A systematic review.Systems research and behavioral science · 2022Article
- Examination of SARS-CoV-2 In-Class Transmission at a Large Urban University With Public Health Mandates Using Epidemiological and Genomic Methodology.JAMA network open · 2022Article
- Resources Required for Implementation of SARS-CoV-2 Screening in Massachusetts K-12 Public Schools in Winter/Spring 2021.The Journal of school health · 2022Article
- Minimal SARS-CoV-2 classroom transmission at a large urban university experiencing repeated into campus introduction.medRxiv : the preprint server for health sciences · 2022Article
- Quantifying pupil-to-pupil SARS-CoV-2 transmission and the impact of lateral flow testing in English secondary schools.Nature communications · 2022Article
- Educators' Psychosocial Burdens Due to the COVID-19 Pandemic and Predictive Factors: A Cross-Sectional Survey of the Relationship with Sense of Coherence and Social Capital.International journal of environmental research and public health · 2022Article
- Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Widespread school closures occurred during the COVID-19 pandemic. Because closures are costly and damaging, many jurisdictions have since reopened schools with control measures in place. Early evidence indicated that schools were low risk and children were unlikely to be very infectious, but it is becoming clear that children and youth can acquire and transmit COVID-19 in school settings and that transmission clusters and outbreaks can be large. We describe the contrasting literature on school transmission, and argue that the apparent discrepancy can be reconciled by heterogeneity, or "overdispersion" in transmission, with many exposures yielding little to no risk of onward transmission, but some unfortunate exposures causing sizeable onward transmission. In addition, respiratory viral loads are as high in children and youth as in adults, pre- and asymptomatic transmission occur, and the possibility of aerosol transmission has been established. We use a stochastic individual-based model to find the implications of these combined observations for cluster sizes and control measures. We consider both individual and environment/activity contributions to the transmission rate, as both are known to contribute to variability in transmission. We find that even small heterogeneities in these contributions result in highly variable transmission cluster sizes in the classroom setting, with clusters ranging from 1 to 20 individuals in a class of 25. None of the mitigation protocols we modeled, initiated by a positive test in a symptomatic individual, are able to prevent large transmission clusters unless the transmission rate is low (in which case large clusters do not occur in any case). Among the measures we modeled, only rapid universal monitoring (for example by regular, onsite, pooled testing) accomplished this prevention. We suggest approaches and the rationale for mitigating these larger clusters, even if they are expected to be rare.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.