The effectiveness of infection prevention and control measures applied in education and childcare settings for children: a summary and critical appraisal

This summary was conducted as part of the Evidence Service’s collaboration with Heath and Care Research Wales

Next update: Update not planned

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Introduction

A range of measures to reduce the spread of COVID-19 has been introduced in schools and education settings worldwide.

The aim of this review was to find and examine the evidence to assess how effective these control measures have been.  This would help the Welsh Government to decide which measures should be kept in place in schools and childcare as the pandemic progressed.

Main points

How up to date is this evidence?

The most recent reliable evidence was taken from a national review of research studies in July 2021, mostly in the USA.

What we found?

The results showed that:

• When infection control measures were used in primary school and daycare settings, the risk of spread of the virus child to child, or child to adult was low.
• In secondary schools, the risk of spread of the virus varied more, depending on activities of pupils outside school and on whether pupils stuck to the rules.
• A wide range of measures were used to control spread.  Different combinations of methods used made it difficult to judge how effective individual methods were.
• Spread was reduced when several methods of control were used together. 
• Face coverings reduced spread in secondary schools, though this was not always true in primary schools.

Reduced spread was also linked to:

• Keeping one metre apart (especially amongst staff)
• Restricting visitor access to the school
• Cancelling after school clubs
• Daily symptom screening
• Holding lessons outdoors

The findings on effects of class size and increased ventilation on spread of the virus were not consistent.  Part-time face-to-face learning was actually found to increase the spread compared to full-time face-to-face learning.

There were not enough data to judge whether staff or pupil vaccinations were effective at reducing the spread of the virus in these schools and childcare settings.

What this means?

Future Actions:

• Several methods of control of spread should be used together in schools.
• Future research results should be studied to provide new information on control methods suitable for use with hard-to-reach groups and specialist education settings. Changes may also be needed if new variants of COVID arise.

Technical information

This review was conducted in a short time frame to inform the upcoming Welsh Government ‘Local COVID-19 Infection Control Decision Framework’ which is due to be published at the start of the Autumn 2021 term. The aim of this review was to identify, appraise and synthesise the evidence from secondary research evaluating the effectiveness of infection prevention and control measures applied in education and childcare settings.

Glossary

Critical appraisal: The process of carefully and systematically examining research to judge its validity, the trustworthiness of results, and its value and relevance in a particular context.