Preventing spread of COVID-19 in schools

Overall, results suggested that a range of school measures may have beneficial effects on the spread of disease, healthcare utilisation and school attendance.

Remote teaching (eg, via computer) compared with in-person teaching probably reduced the spread of COVID-19 and hospitalisations, but probably had no effect on deaths in the general population. However, online teaching was associated with negative unintended consequences and the widening of inequalities. Thus, if fully in-person teaching is not possible, hybrid teaching (a combination of in-person and remote teaching) could be the most favourable option to ensure students maintain some in-person teaching and school contact, while reducing transmission. In this review, the effects of hybrid teaching on COVID-19 transmission were mixed.

There may have been a beneficial effect of mask mandates on transmission-related outcomes. Full mandates were probably more beneficial than partial or no mandates. Evidence of an effect of physical distancing on risk of infection was mixed – there was probably a decrease in risk for students, but an increase for staff. Improved ventilation probably reduced cases among staff and students.

Daily testing strategies to replace or reduce quarantine probably helped to reduce missed school days and reduce transmission.