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Table 4 Impact of School Practices on Influenza Transmission, 2000–2016

From: School practices to promote social distancing in K-12 schools: review of influenza pandemic policies and practices

Article Type of practice Impact Summary
Sugisaki [38] Class closure Two-day class closure carried out day after 10% absenteeism rate (compared to no class closure or two-day or three-day closures carried out ≥2 days after a 10% absentee rate) is effective for mitigating influenza outbreaks in elementary school; school actions should be conducted at the class level as a basic strategy.
Lofgren [34] Suspending use of common areas Closing the playground and other common areas when 5% of students were symptomatic (compared to requiring symptomatic students to leave school) significantly reduced the total number of infected students.
Gemetto [33] Class and grade closure While the closure of one class yields a smaller mitigation effect than the closure of the whole elementary school, the closure of the corresponding grade (two classes) leads to a reduction of large outbreak probability and a reduction of epidemic size that are similar to those obtained by closing the entire elementary school.
Fumanelli [32] Class and grade closure Reactive gradual (e.g., starting from class-by-class), reactive school-by-school, and county-wide school closure gave comparable outcomes in terms of infection attack rate reduction, peak incidence reduction or peak delay, while national closure of all schools of the country at the same time was not able to reach the same levels of mitigation.
Cooley [35] Reduced schedule: 3 day weekend Using a 3-day weekend as an intervention strategy (compared to a 2-day weekend) could be effective at reducing the peak attack rate for mild epidemics similar in severity to the 2009 H1N1 pandemic.
Ridenhour [20] Classroom restriction, hall restriction, schoolyard restriction, lunchroom restriction, different classroom schedules Classroom restrictions were the best single intervention at lower infection probabilities. At higher transmission rates, employing staggered classroom schedules is the best single intervention.