The impact of school reopening strategies during COVID-19: A case study of Sao Paulo, Brazil.

During the COVID-19 pandemic, many countries opted for strict public health measures, including closing schools. They have now started relaxing some of those restrictions. To avoid overwhelming health systems, predictions for the number of new COVID-19 cases need to be considered when choosing a school reopening strategy. Using computer simulation, we analyze different strategies to reopen schools in the Sao Paulo Metropolitan Area, including the official reopening plan. Our results indicate that reopening schools with all students at once has a big impact on the number of new COVID-19 cases, which could cause a collapse of the health system. On the other hand, a controlled school reopening avoids the collapse of the health system, with a maximum ICU occupancy between 48.8% and 97.8%, depending on how people attending school follow sanitary measures. Postponing the schools' return date for after a vaccine becomes available can save up to 37,753 lives just in the Sao Paulo Metropolitan Area.