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School reopening and COVID-19 in the community: evidence from a natural experiment in Ontario, Canada

Fitzpatrick T, Wilton A, Cohen E, Rosella L, Guttmann A. Health Aff. 2022; 41(6):864-72. Epub 2022 Jun 6. DOI:

In December 2020, Ontario, Canada, entered a provincewide shutdown to mitigate COVID-19 transmission. A regionalized approach was taken to reopen schools throughout early 2021 without any other opening of the economy, offering a unique natural experiment to estimate the impact of school reopening on community transmission. Estimated increases of 0.07, 0.08, 0.07, and 0.13 percentage points in community COVID-19 case growth rates occurred 11–15, 16–20, 21–25, and 26–30 days, respectively, after schools reopened. Although small, these changes were particularly evident among children younger than age fourteen, increased over time, and were greater when lag periods were considered, which points to a likely causal effect between in-person classes and a small increase in transmission. These findings suggest that although additional COVID-19 cases are to be expected after the reopening of schools, these risks may be manageable with sufficient, layered mitigation policies.