The Impact of School Closure for COVID-19 on the US Healthcare Workforce and the Net Mortality Effects

Jude Bayham; Eli P Fenichel

Targeted pharmaceutical interventions for COVID-19 are likely months away. However, supportive measures by healthcare providers are important. Social distancing, including school closures, can limit COVID-19 cases. However, the evidence that the potential transmission reduction benefits of mandatory school closures exceed the costs of potentially imposing greater child care obligations on healthcare workers, thereby reducing the healthcare workforce, is not overwhelming. We provide the first explicit analysis of the school closure tradeoff between case reduction and labor force impact on patient survival probability. A 15% decline in the healthcare labor force, combined with reasonable parameters for COVID-19 such as a 15% case reduction from school closings and 2% baseline mortality rate implies that a 15% loss in the healthcare labor force must decrease the survival probability per percent healthcare worker loss by 17.6% for school closures to increase cumulative mortality. This means that the per infection probability of survival cannot increase by more than 2.4%; otherwise, school closures will lead reduce patient survival. Even if the only objective is to save lives, there is still a tradeoff associated with closing schools due to potential losses in healthcare labor force capacity.