Evolving infectious disease dynamics shape school-based intervention effectiveness.

Publication date: Jul 17, 2025

School-based interventions during epidemics are often controversial, as experienced during the COVID-19 pandemic, where reducing transmission had to be weighed against the adverse effects on young children. However, it remains unclear how the broader epidemiologic context influences the effectiveness of these interventions and when they should be implemented. Through integrated modeling of epidemiological and genetic data from a longitudinal school-based surveillance study of SARS-CoV-2 in 2021-2022 (N children = 336, N adults = 51) and scenario simulations, we show how transmission dynamics in schools changed markedly due to strong increases in community-acquired infections in successive periods of viral variants, ultimately undermining the potential impact of school-based interventions in reducing infection rates in the school-aged population. With pandemic preparedness in mind, this study advocates for a dynamic perspective on the role and importance of schools in infectious disease control, one that adapts to the evolving epidemiological landscape shaped by pathogen characteristics and evolution, shifting public health policies, and changes in human behavior.

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Concepts Keywords
Epidemics Adolescent
Epidemiological Adult
Genetic Child
Modeling Communicable Disease Control
Communicable Diseases
Community-Acquired Infections
COVID-19
Female
Humans
Longitudinal Studies
Male
Pandemics
SARS-CoV-2
School Health Services
Schools
Young Adult

Semantics

Type Source Name
disease MESH infectious disease
pathway REACTOME Infectious disease
disease IDO intervention
disease MESH COVID-19 pandemic
disease MESH community-acquired infections
disease MESH infection
disease IDO role
disease IDO pathogen
disease MESH pathogen transmission
disease MESH influenza
drug DRUGBANK Isoxaflutole
drug DRUGBANK Etoperidone
drug DRUGBANK Ranitidine
disease IDO contact tracing
disease IDO history
drug DRUGBANK Coenzyme M
drug DRUGBANK Flunarizine
drug DRUGBANK Medical air
drug DRUGBANK Aspartame
disease IDO emerging pathogen
disease IDO infectivity
disease IDO process
drug DRUGBANK Trestolone
disease MESH seroconversion
disease MESH chronic disease
drug DRUGBANK Serine
disease IDO assay
disease IDO quality
drug DRUGBANK Naproxen
drug DRUGBANK Huperzine B
disease MESH uncertainty
drug DRUGBANK L-Leucine
disease IDO blood
disease MESH re infection
drug DRUGBANK Diethylstilbestrol
disease MESH Viral Diseases
pathway REACTOME Reproduction
drug DRUGBANK L-Citrulline
drug DRUGBANK Hydroxyethyl Starch

Original Article

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