Health Care

The impact of school opening model on SARS-CoV-2 community incidence and mortality

Peer-reviewed Publication

Westyn Branch-Elliman, Nathorn Chaiyakunapruk, Isabella Epshtein, Zeynep Ertem, Richard E. Nelson, Emily Oster, Eli Perencevich, Warren B. P. Pettey, Elissa M. Schechter-Perkins, Polly van den Berg, and Fernando A. Wilson

October 2021

The role that traditional and hybrid in-person schooling modes contribute to the community incidence of SARS-CoV-2 infections relative to fully remote schooling is unknown. The researchers conducted an event study using a retrospective nationwide cohort evaluating the effect of school mode on SARS-CoV-2 cases during the 12 weeks after school opening (July–September 2020, before the Delta variant was predominant), stratified by US Census region. After controlling for case rate trends before school start, state-level mitigation measures and community activity level, SARS-CoV-2 incidence rates were not statistically different in counties with in-person learning versus remote school modes in most regions of the United States. In the South, there was a significant and sustained increase in cases per week among counties that opened in a hybrid or traditional mode versus remote, with weekly effects ranging from 9.8 (95% confidence interval (CI) = 2.7–16.1) to 21.3 (95% CI = 9.9–32.7) additional cases per 100,000 persons, driven by increasing cases among 0–9 year olds and adults. Schools can reopen for in-person learning without substantially increasing community case rates of SARS-CoV-2; however, the impacts are variable. Additional studies are needed to elucidate the underlying reasons for the observed regional differences more fully.