Potentially successful alternative strategies and proactive measures avoiding school closure are available both at general population level and within schools.
Although high-quality evidence is still lacking to confirm no benefit in pandemic control in countries that relied the most on school closure and reciprocally no negative impact from minimizing school closures, reports found in the grey literature, in particular by the ECDC, do imply such a trend. The modelled protective potential of school closures [45] appears to be comparable to that of other non-pharmaceutical interventions (NPI), such as bans on mass gatherings or closure of non-essential businesses, implying that widespread school closures could be circumvented through ready employment of alternative strategies, while still achieving minimized Sars-CoV-2 spread. This was exemplified in real-life by the minimal and only temporary closures of Taiwanese schools throughout 2020 [46]. Furthermore, as synthesized in a large systematic review [47], multiple organizational, environmental and surveillance measures have been implemented heterogeneously worldwide to minimize the risk of in-class infection, including highly effective test-and-trace strategies, decreased class size, opening for specific cohorts in a staggered timetable, lessons held outdoors, physical distancing as well as hygiene measures in the classroom, the creation of social bubbles limiting contacts between those who rarely meet, and the instruction to stay at home when sick [48-50]. Although successfully curtailed school-related outbreaks are less likely to be reported in the literature than outbreaks that have occurred, we have sufficient real-world evidence indicating that different types of infection control measures may effectively either avert or minimalize COVID-19 clusters among students [51-54]. While the efficacy of each measure has been extensively modelled, very few experimental and quasi-experimental studies have been published assessing the effectiveness of specific measures, including one finding that lower physical distancing policies may safely be adopted in school settings [55]. A larger pool for evidence extrapolation is now needed to better tailor guidelines for safe school re-opening. Acquiring this data would provide critical knowledge for all future cost-effective policymaking minimizing educational losses even at times of high-intensity coronavirus spread in the community.