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. 2023 Nov 7;2023:10.31478/202311a. doi: 10.31478/202311a

FIGURE 4. Causal Loop Diagram to Inform Systems Thinking in Public Education Response to COVID-19.

FIGURE 4

SOURCE: Bradley, D. T., M. A. Mansouri, F. Kee, and L. M. T. Garcia. 2020. A systems approach to preventing and responding to COVID-19. eClinicalMedicine 21:100325. https://doi.org/10.1016/j.eclinm.2020.100325; Walsh, S., A. Chowdhury, V. Braithwaite, S. Russell, J. M. Birch, J. L. Ward, C. Waddington, C. Brayne, C. Bonell, R. M. Viner, and O. T. Mytton. 2021. Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies. BMJ Open 11(8):e053371. https://doi.org/10.1136/bmjopen-2021-053371; Centers for Disease Control and Prevention (CDC). 2022. Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning. Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-childcare-guidance.html (accessed October 17, 2023); Alonso, S., M. Català, D. López, E. Álvarez-Lacalle, I. Jordan, J. J. García-García, V. Fumadó, C. Muñoz-Almagro, E. Gratacós, N. Balanza, R. Varo, P. Millat, B. Baro, S. Ajanovic, S. Arias, J. Claverol, M. F. de Sevilla, E. Bonet-Carne, A. Garcia-Miquel, E. Coma, M. Medina-Peralta, F. Fina, C. Prats, and Q. Bassat. 2022. Individual prevention and containment measures in schools in Catalonia, Spain, and community transmission of SARS-CoV-2 after school re-opening.PLOS ONE 17(2):e0263741. https://doi.org/10.1371/journal.pone.0263741; and Head, J. R., K. L. Andrejko, Q. Cheng, P. A. Collender, S. Phillips, A. Boser, A. K. Heaney, C. M. Hoover, S. L. Wu, G. R. Northrup, K. Click, N. S. Bardach, J. A. Lewnard, and J. V. Remais. 2021. School closures reduced social mixing of children during COVID-19 with implications for transmission risk and school reopening policies. Journal of the Royal Society Interface 18(177):20200970. https://doi.org/10.1098/rsif.2020.0970.

NOTE: Generated by authors using Miro online whiteboard. The green box indicates a hypothetical decision maker’s position in the system. Yellow boxes highlight central aspects of the system that a decision maker might attempt to affect directly. Plus and minus signs indicate positive or negative causal relationships. Green symbols indicate a desirable causal relationship, red symbols indicate an undesirable causal relationship, and question marks indicate relationships of unknown nature as a result of knowledge gaps (in the case of school closures impacting transmission) or key decisions that have yet to be made (e.g., whether learning continuity plans choose to encourage or discourage school closures). Colored arrows highlight examples of positive feedback loops in the system: green arrows denote a loop of desirable causal relationships that decision makers may want to reinforce, and red arrows denote one that may be targeted for disruption.