School Reopening during COVID-19 Pandemic: Is It Safe? A Systematic Review

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Michelle Gunawan
Aurielle Annalicia Setiawan
Ivena Leonita


Introduction: School closures around the world during the COVID-19 pandemic has brought adverse impacts to students’ learning processes. School reopening has been implemented in some regions, accompanied with health protocols. Strict implementation of health measures and policies are keys in preventing outbreaks in school settings. It is also necessary to identify precipitating factors in outbreaks to design the most effective health policies. Objective: To review the most effective health policies to prevent outbreaks and to identify precipitating factors in outbreaks during school reopening. Methods: Studies were collected from PubMed, ScienceDirect, Cochrane and ResearchGate from 2020-2021 and were selected based on the inclusion criteria. This systematic review was reported according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta Analyses) flow diagram. Quality of studies were assessed using the JBI (Joanna-Briggs Institute) checklist. Results: From 209 studies, 7 studies were eligible for qualitative analysis.  Current health measures implemented during the school reopening are sufficient to maintain low attack rates. Student attack rates are lower compared to staff (0.03% vs 4.4%) and students in higher levels of education are more likely to have higher attack rates (kindergarten vs high school: 17.5% vs 33.5%). Some effective health measures are physical distancing, hand hygiene, use of masks, bubbles and a mandatory 14-day quarantine before entering schools. Young adults and staffs tend to have lower compliance to health measures, which results in higher attack rates. Precipitating factors identified are frequency of school attendance, parents’ occupation as healthcare workers, older age, certain ethnic groups, and positive COVID-19 cases in households. Conclusion: It is safe to reopen schools, if proper health protocols are actualized, such as wearing masks, maintaining hand hygiene, physical distancing, and early restriction to attend school for suspects, while main precipitating factors are frequency of attendance, age, and parents’ occupation.

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Gunawan, M., Setiawan, A. A., Leonita, I. and Neville (2022) “School Reopening during COVID-19 Pandemic: Is It Safe? A Systematic Review”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia. Available at: (Accessed: 25May2022).
Scientific Papers (AMSA Intl Academic Competition)


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