US COVID-19 school closures were not cost-effective, but other non-pharmaceutical interventions were, new study finds

School closures during the COVID-19 pandemic imposed enormous long-term costs while other measures delivered better health outcomes for far less money, according to new research led by Oxford University's Department of Statistics and the Leverhulme Centre for Demographic Science analysing non-pharmaceutical interventions in the United States.

The study, published in BMC Global and Public Health, examined policies implemented across US states during 2020, before vaccines became available. Researchers from Oxford and the University of Washington analysed eleven different non-pharmaceutical interventions, combining disease modelling with economic analysis to calculate both health benefits and costs to society.

During this pre-vaccine period, policymakers relied entirely on non-pharmaceutical measures such as mask mandates, social distancing, testing, contact tracing, and facility closures to control the virus.

School closures prevented roughly 77,200 COVID-19 deaths and reduced transmission rates by 8.2% but created £1.6 trillion ($2 trillion) in future economic losses through damaged education. Students lost upwards of 0.35 schoolyears of learning, with some states keeping schools closed for nearly the entire 2020-2021 academic year.

In comparison, mask mandates cut transmission by 19%, making them more effective at preventing disease spread, while imposing minimal costs. Testing and contact tracing programmes also proved efficient compared to implementation costs.

Lead author Nicholas Irons said: ‘The pandemic posed unprecedented challenges to decision-makers at all levels. While our policy response was not optimal – and we could not have expected it to be – our study shows that many of the measures implemented mitigated economic damage in addition to suppressing transmission of the virus. School closures were a notable exception.’

An optimal combination of interventions could have cut the pandemic's total US impact from £3.7 trillion ($4.6 trillion) to £1.5 trillion ($1.9 trillion) while saving over 100,000 additional lives.

‘Our study shows how using statistical methods to analyse all the sources of data could improve health outcomes and vastly reduce costs to society,’ said co-author Adrian Raftery from the University of Washington. ‘Going forward, better national surveillance data needs to be collected regularly in the US, as was done in the UK during the pandemic.’

The findings provide a blueprint for future pandemic planning, offering concrete data on which interventions deliver the best health outcomes while minimising economic and social disruption. The research suggests rapid deployment of testing, contact tracing, mask mandates and social distancing, combined with targeted facility closures, could control similar future outbreaks without massive educational costs.

The full paper, ‘Optimal pandemic control strategies and cost‑effectiveness of COVID‑19 non‑pharmaceutical interventions in the United States,’ is available in the journal BMC Global and Public Health.

[ends]

Media contacts

For further information or to arrange an interview, please contact the University of Oxford press office at news.office@admin.ox.ac.uk or on +44 (0)1865 280528.

Notes to Editors

• School closures created £1.6 trillion ($2 trillion) in future economic losses while more effective interventions like masks cost pennies per person
• An optimal policy combination could have saved 100,000 more lives while cutting total pandemic costs in half, from £3.7 trillion to £1.5 trillion ($4.6 trillion to $1.9 trillion)
• First comprehensive cost benefit analysis using statistical decision theory finds mask mandates were twice as effective as school closures at reducing transmission (19% vs 8.2%)
• Study provides framework for future pandemic responses, showing rapid deployment of testing, tracing, masks and social distancing could control outbreaks without massive educational disruption

The paper ‘Optimal pandemic control strategies and cost‑effectiveness of COVID‑19 non‑pharmaceutical interventions in the United States published in BMC Global and Public Health is available here: https://doi.org/10.1186/s44263-025-00189-z and https://bmcglobalpublichealth.biomedcentral.com/articles/10.1186/s44263-025-00189-z

About the University of Oxford

Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the ninth year running, and number 3 in the QS World Rankings 2024. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.