Title | 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. | ||
Author | Haapanen, Marjut; Renko, Marjo; Artama, Miia; Kuitunen, Ilari | ||
Journal | EClinicalMedicine | Publication Year/Month | 2021-Apr |
PMID | 33817612 | PMCID | PMC8007090 |
Affiliation + expend | 1.School of Medicine, University of Eastern Finland, Yliopistonranta 1, PL 1627, 70211 Kuopio, Finland. |
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.