Experts raise doubts that Japan school closures will curb coronavirus

Will nationwide school closures help curb the spread of the novel coronavirus? Likely not as much as Prime Minister Shinzo Abe anticipated when he abruptly called on schools to shut starting this week due to a rising number of infections.

Abe admitted in the Diet earlier this week that he had made the decision without consulting infectious disease experts “because we did not have the luxury of taking our time in coming up with a decision.”

Public health experts have raised concerns the move may turn out to be counterproductive.

What options are there for single parents and dual-income households?

In response to Abe’s request last week, nearly all prefectures decided to shut elementary, junior and senior high schools nationwide.

However, many elementary schools have left facilities open for children unable to stay home alone while their parents work.

Among the services working parents can use are gakudō (after-school clubs) that typically look after first, second and third graders until their parents come home from work.

Access to such services is guaranteed in the 1997 Child Welfare Act. However, children need to be officially enrolled in gakudō and pay a monthly fee of several thousand yen to participate in such programs. Traditional gakudō, which generally close at around 6 p.m., are publicly funded and run by local municipalities. According to the health ministry, which supervises these programs, there were 25,881 such places nationwide attended by around 1.3 million children ages 6 to 10 as of May 1 last year.

The ministry has asked those facilities to stay open and to use open classrooms.

But not all schools are offering parents that option, either due to staffing issues, due to their belief that closing their doors completely could help protect children from the virus, or for other reasons.

Taketoshi Tamashiro, principal of Haneji Elementary School and Kindergarten in Nago, Okinawa Prefecture, said the school was not running a gakudō during the school closures, adding that, because of a mutual understanding of the situation, he had not received any complaints from parents about this.

“I can’t say if it’s a good thing or a bad thing from our perspective, but thinking about the worst-case scenarios, I completely understand the request (to close schools nationwide),” Tamashiro said in a telephone interview Wednesday.

The government has offered subsidies for employers to cover wages of their workers, up to ¥8,330 per day from Feb. 27 through March 31, regardless of the type of their contract.

The government also has increased financial support for parents unable to go to work during the school break. The Cabinet usually offers monthly subsidies of up to ¥52,800 for parents who use baby-sitting services arranged by their companies, but the subsidies have been increased to up to ¥264,000 for March after the government received many complaints from parents.

Additionally, various non-governmental groups, including those offering private after-school care, have been expanding their operations to meet the needs of working parents.

For instance, Tokyo-based nonprofit organization Florence, which offers day care for children with special needs, has been accepting children without special needs to ease the burden on working parents. Day care centers were excluded from the prime minister’s closure request.

Are school closures an effective strategy to slow down the spread of the virus?

Not necessarily. Public health experts are concerned the measure may be missing the mark.

“As the largest groups of people the disease affects are in their 50s or 60s, closing elementary, middle and high schools doesn’t make much sense from a public health perspective,” Reiko Saito, a professor at Niigata University’s Graduate School of Medical and Dental Sciences, said in an email. Saito, who specializes in community disease control, also warned that the situation in gakudō facilities that accept large numbers of children won’t differ from the standard situation in schools.

The government has been trying to address this problem.

In a notice sent to municipalities nationwide, the health ministry asked gakudō operators to make sure that children maintain a distance of least 1 meter when seated and to avoid having them come in close contact with each other.

Experts point out that although children are less likely to develop severe illnesses from the coronavirus, they still can become carriers and can infect others outside school.

During a news conference in Tokyo in February, Hitoshi Oshitani, a virology professor at the Tohoku University Graduate School of Medicine, warned that many people who contract the virus are asymptomatic or develop only mild symptoms, just like in the case of other viral infections.

What has been the approach in other parts of Asia?

Hong Kong, which has also seen a rise in coronavirus cases since late January, ordered school closures beginning with the end of the Lunar New Year holiday on Feb. 3. After several extensions, the school closures were extended again last week until at least April 20.

Karen Grepin, associate professor at the University of Hong Kong’s School of Public Health, pointed out that school closures were just one aspect of a public health response that included travel restrictions, recommendations to work from home and contact tracing.

Grepin added, however, that school closures “have been shown to be effective at curbing the spread of other infectious diseases, notably influenza, and thus in my opinion, should be considered as part of a comprehensive response if the goal is to curb the spread of the virus.”

In Singapore, the education ministry said on its website that it had considered closing all schools as Hong Kong has done, but that this was deemed unnecessary due to a lack of sustained community transmission.

While not ruling out school closures, the ministry also noted that this would not necessarily prevent all infections, especially in cases of older students who are more likely to go out. Instead of school closures, the ministry on Jan. 27 ordered all students and staff returning from mainland China to take a mandatory two-week leave of absence, during which time students would follow a home-based learning plan set by their school.

Daily temperature checks were also introduced for staff and students when school resumed on Jan. 29. Further guidance issued by the education ministry on Feb. 7 ordered the cancellation of school trips and inter-school activities.

Professor Hannah Clapham of the National University of Singapore’s School of Public Health praised Singapore’s testing of all pneumonia cases — not just those with a travel history to affected areas — and the city-state’s intensive contact tracing as two factors that contributed to its effective response.

Clapham added that if children are transmitting the disease, school closures could be effective at slowing transmission. But she said the overall impact on case numbers is not as clear.

“There are questions around whether transmission will rebound when schools open again even if closures have reduced transmission for a period of time,” she said.

Have school closures to combat an epidemic been effective in the past?

Both Singapore and Hong Kong decided to close schools for at least 10 days during the SARS epidemic in 2003. Severe acute respiratory syndrome killed 774 people worldwide, including 299 in Hong Kong and 33 in Singapore. The outbreak didn’t make it to Japan.

In Japan, school closures were ordered amid the H1N1 influenza outbreak in 2009. In March that year, the Osaka Prefectural Government decided to close all 526 junior high schools and 270 high schools in the prefecture for a week after receiving a report that around 100 students had been infected with the virus. Most nurseries, primary schools, colleges and universities in nine cities followed suit. At that time, students were ordered to stay at home.

Saito said the move “was effective because elementary and middle school students were the most vulnerable groups at that time.”