The Science behind Safe School Re-opening: Leveraging the Pillars of Infection Control to Support Safe Elementary and Secondary Education during the COVID-19 Pandemic

• Main Authors: Branch-Elliman, W. (Author), Schechter-Perkins, E.M (Author), Van Den Berg, P. (Author)
• Format: Article
• Language: English
• Published: Oxford University Press 2022
• Subjects: child; coinfection; coronavirus disease 2019; COVID-19; disease transmission; education; environmental surveillance; health care cost; health care policy; household; human; implementation science; infection control; infection prevention; infection risk; influenza A (H1N1); influenza vaccination; obesity; pandemic; prevalence; public health; quarantine; redundancy analysis; Review; risk factor; school reopening; secondary education; social distancing; sport
• Online Access: View Fulltext in Publisher

 There are limited tools for adapting coronavirus disease 2019 (COVID-19) infection control plans to school settings. We present an infection prevention model for optimizing safe re-opening for elementary and secondary schools during the global COVID-19 pandemic and review the current evidence behind various infection prevention interventions in school settings. The model is adapted from the Centers for Disease Control and Prevention fundamental pillars for infection prevention and includes 4 categories of intervention: epidemiologic controls (town prevalence metrics, diagnostic testing, quarantine strategies), administrative controls (state vaccination policies, alternative school models, symptom screens, quarantine breaks), engineering/environmental controls (distancing, outdoor space, ventilation), and personal protective equipment (PPE)/hand hygiene (face coverings, hand sanitizing). The adapted infection control pillars model utilizes implementation science-informed considerations to maximize pragmatism and adherence by leveraging evidence-based strategies. It highlights the necessity of redundant infection prevention interventions, acknowledges the importance of community buy-in to achieve real-world effectiveness, and addresses tactics to overcome implementation barriers. Recommendations are grounded in the Dynamic Sustainability Framework and include suggestions to maintain infection prevention effectiveness over time to ensure ongoing safety. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.