Simulating respiratory disease transmission within and between classrooms to assess pandemic management strategies at schools

Interventions to control coronavirus disease 2019 (COVID-19) in school settings often assume that simply limiting the number of students attending reduces the potential for disease spread. However, using a mathematical model parameterized with a detailed dataset of seasonal influenza in Japanese primary schools, we find that interventions that focus only on reducing the number of students in class at any moment in time (e.g., reduced class sizes and staggered attendance) may not be effective. We propose two approaches for pandemic management in school settings: a routine “preemptive” approach that attempts to keep the within-school reproduction number low by, for example, regular screening and cohorting and a “responsive” approach where fixed-period class closures are employed upon detection of a symptomatic case.