The impact of the lockdown and the re-opening of schools and day cares on the epidemiology of SARS-CoV-2 and other respiratory infections in children : a nationwide register study in Finland
Haapanen, Marjut; Renko, Marjo; Artama, Miia; Kuitunen, Ilari (2021-03-29)
Marjut Haapanen, Marjo Renko, Miia Artama, Ilari Kuitunen, The impact of the lockdown and the re-opening of schools and day cares on the epidemiology of SARS-CoV-2 and other respiratory infections in children – A nationwide register study in Finland, EClinicalMedicine, Volume 34, 2021, 100807, ISSN 2589-5370, https://doi.org/10.1016/j.eclinm.2021.100807
© 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
https://creativecommons.org/licenses/by-nc-nd/4.0/
https://urn.fi/URN:NBN:fi-fe2021052030753
Tiivistelmä
Abstract
Background: Nationwide restrictions started in Finland in March to prevent the spread of COVID-19, leading to school and day care closures. The aim of this study is to describe the effect of closures and re-openings on the respiratory pathogen epidemiology.
Methods: Laboratory-confirmed cases of SARS-CoV-2; respiratory syncytial virus (RSV); influenza (A & B); parainfluenza-, adeno-, and rhinoviruses; Mycoplasma pneumoniae; and Streptococcus pneumoniae in children were collected from the National Infectious Disease Register over the period of 2017–2020. Weekly incidences (weeks 1 to 35) with 95% confidence intervals (CIs) were calculated per 100 000 children in 2020 and compared by incidence rate ratios (IRRs) to corresponding periods in 2017−2019.
Findings: The lockdown had immediate impact on the incidences of respiratory pathogens except SARS-CoV-2. Week after the lockdown began IRR was 0•3 (CI 0•3–0•4) and next week the IRR was 0•1 (0•1–0•2). The incidence of SARS-CoV-2 started to decline eight weeks after the lockdown began. The highest recorded weekly incidence of SARS-CoV-2 was 7•2/100 000 children. The effect of the lockdown lasted until late summer. Rhinovirus and SARS-CoV-2 began to increase before the schools or day cares opened in August. The re-opening of schools seemed to have no impact on the incidence of any pathogen.
Interpretation: Our results suggest that general social distancing, including school and day care closures, played a crucial role in reducing infections, and the effect lasted for several weeks. The re-opening of schools and day care centres seems to have had no immediate impact on the incidences of any respiratory pathogens.
Funding: This study had no funding source.
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