An evidence-based theory of change for reducing SARS-CoV-2 transmission in reopened schools

• Published in: Health & place Vol. 64; pp. 102398 - 6
• Main Authors: Bonell, Chris, Melendez-Torres, G.J., Viner, Russell M., Rogers, M. Brooke, Whitworth, Michael, Rutter, Harry, Rubin, G. James, Patton, George
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.07.2020; Elsevier Science Ltd
• Subjects: Aerosols; Betacoronavirus - isolation & purification; Coronavirus Infections - prevention & control; COVID-19; Disease control; Elimination; Environment; Evidence-Based Practice; Fomites; Humans; Infection Control - standards; Occupational health; Oral administration; Pandemics - prevention & control; Pneumonia, Viral - prevention & control; Prevention; Protective equipment; SARS-CoV-2; SARSCoV2; Schools; Schools - organization & administration; Schools - standards; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; COVID-19; Prevention; Environment; SARSCoV2; Schools; Disease control
• ISSN: 1353-8292; 1873-2054
• DOI: 10.1016/j.healthplace.2020.102398

Schools have closed worldwide as part of measures to prevent SARS-CoV-2 transmission but are beginning to reopen in some countries. Various measures are being pursued to minimise transmission but existing guidance has not developed a comprehensive framework or theory of change. We present a framework informed by the occupational health hierarchy of control and a theory of change informed by realist approaches. We present measures focused on elimination, substitution, engineering, administration, education and personal protective equipment. We theorise that such measures offer a means of disrupting SARS-CoV-2 transmission via routes involving fomites, faeco-oral routes, droplets and aerosols. •Schools have been closed worldwide to prevent SARS-CoV-2 transmission but are beginning to reopen in a number of countries.•Existing guidance on measures to prevention transmission has not developed a comprehensive framework or theory of change.•We present a framework for measures informed by the occupational health hierarchy of control and a theory of change.•We theorise that, together, such measures offer a means of disrupting SARS-CoV-2 transmission.