Expected impact of school closure and telework to mitigate COVID-19 epidemic in France
With COVID-19 now a global pandemic, several countries face sustained and extensive epidemic spread in their territories. Forty-nine countries have announced or implemented school closures to mitigate the epidemic, 30 of which are nationwide (including China, Republic of Korea, Japan, Italy, France). French authorities announced on March 12, 2020 that school closure will be implemented nationwide starting March 16. These measures have been evaluated for seasonal or pandemic influenza, but their effectiveness for COVID-19 remains unclear. Focusing on the 3 regions in France reporting more than 300 confirmed cases (as of March 13, 2020) and showing an increase in the influenza-like-illness incidence from sentinel surveillance (Île-de-France, Hauts-de-France, Grand Est), we evaluate the impact of school closure and telework through a stochastic age-structured data-driven epidemic model. The model is based on demographic and social contact data between children and adults for each region, and is parameterized to COVID-19 epidemic, accounting for current uncertainties in the relative susceptibility and transmissibility of children. Numerical results show that school closure alone would have limited benefit in reducing the peak incidence (less than 10% reduction with 8-week school closure for regions in the early phase of the epidemic). When coupled with 25% adults teleworking, 8-week school closure would be enough to delay the peak by almost 2 months with an approximately 40% reduction of the case incidence at the peak. This is critical to reduce the burden on the healthcare system in the weeks of highest demand. Moderate overall reduction of the final attack rate (15%) would also be achieved. Results across regions are qualitatively similar, with differences in predictions due to different age profiles, the current epidemic situation, and epidemic growth. Different hypotheses on children susceptibility and infectivity relative to adults show similar epidemic and intervention outcomes. Explicit guidance on telework and interventions to facilitate its application to all professional categories who can adopt it should be urgently provided. These findings help informing countries to prepare for effective COVID-19 epidemic mitigation.