ObjectivesThe regional government of Piedmont approved an experimental screening testing program entitled “Scuola Sicura” with the aim to: rapidly contain thes spread of COVID-19 in the school population together with general mitigation strategies such as contact tracing, and case isolation, and to monitor the transmission rate in this population. In this paper we report the initial process and outcome evaluation results and the criticalities encountered during program rollout.DesignDescriptive study of the trend in the period Janaury-March 2021.The evaluation of the preventive capacity of the program is limited to the period of in-class learning. The data sources used are the COVID-19 platform Piedmont, the archives of the local health Departments and the CedAP-SDO archive. Setting and participantsThe screening program targeted second and third grade students in first level secondary schools throughout Piedmont. Each class was subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresThe following indices were calculated with a 95% confidence interval: 1. number of positive cases detected vs. total number of students tested in the “Scuola Sicura” program;2. number of positive cases detected outside the “Scuola Sicura” program vs total number of students enrolled in the 2nd and 3rd grades of first-level secondary schools in Piedmont.To evaluate the preventive capacity, quarantines were detected. In order to investigate the spread of COVID-19 in households, the mother-child pair was tracked and cases of positivity among mothers were identified. Results69% of schools in Piedmont participated in the program; the actual participation was 19.5% of the total number of students enrolled in second and third grades of first-level secondary schools. SS detected 114 positives cases for SARS-CoV-2, yielding a prevalence of 0.52% (95%CI 0.42-0.61) when calculated for the total number of students tested by the program. Starting from 08.03.2021, the target classes have started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. For 61 of the 69 cases (88%) identified by SS before 8 March, the mother-child couple was reconstruncted through record linkage between the CedAP and SDO archives. Forty-six mothers perfomed a swab test after that of the child with a positive result in 24% of cases (n=11). Asymptomatic cases identified at screening accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for COVID-19 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs. When well organized and implemented jointly with other transmission prevention measures and contact tracing, school screening may be a viable strategy to keep schools open when high levels of the virus are circulating in the community.
People with multiple sclerosis (PWMS) are at high risk of being affected by the disruption of health services that occurred during the COVID-19 pandemic months. The aim of this study was to evaluate the effect of the pandemic on the health outcomes of PWMS. PWMS and MS-free residing in Piedmont (north-west of Italy) were identified from electronic health records and linked with the regional COVID-19 database, the hospital-discharge database, and the population registry. Both cohorts (9333 PWMS and 4,145,856 MS-free persons) were followed-up for access to swab testing, hospitalisation, access to the Intensive Care Unit (ICU), and death from 22 February 2020 to 30 April 2021. The relationship between the outcomes and MS was evaluated using a logistic model, which was adjusted for potential confounders. The rate of swab testing was higher in PWMS, but the positivity to infection was similar to that of MS-free subjects. PWMS had a higher risk of hospitalisation (OR = 1.74; 95% IC, 1.41–2.14), admission to ICU (OR = 1.79; 95% IC, 1.17–2.72), and a slight, albeit not statistically significant, increase in mortality (OR = 1.28; 95% IC, 0.79–2.06). Compared to the general population PWMS with COVID-19 had an increased risk of hospitalization and admission to the ICU; the mortality rate did not differ.
ObjectivesAims of “Scuola Sicura” (SS) were to monitor the rate of COVID-19 and to contain its spread within the school population through early case isolation. We report the initial process and outcome evaluation results.DesignDescriptive study of an experimental screening testing program in children in Piedmont in the period January-March 2021. We used data from the COVID-19 platform and the Local Health Units, the archives of birth certificates (CedAP) and hospital discharge files (SDO).Setting and participantsThe screening program targeted second and third grade students in first level secondary schools. Participants were subdivided into four groups; one group each week underwent screening, yielding one test per student per month.Main outcome measuresWe calculated:1. number of positive cases detected vs. total number of students tested in the SS program;2. number of positive cases detected outside the SS program vs. total number of students in the target population.We detected the number of quarantines due to SS and no-SS case identification. To investigate the spread of COVID-19 in households, the mother-child pairs were identified through record linkage between the CedAP and SDO archives, and positive mothers were identified.ResultsSixty-nine percent of schools and 19.5% of the students participated in the program. SS detected 114 positives cases for SARS-CoV-2. On 08.03.2021, the target classes started distance learning: 69 of the 114 positive students were identified before that date, leading to the activation of 67 quarantine measures. We were able to identify the mothers of 61 out of 69 of those students (88%); 46 mothers had performed a swab test after the positivity of their child with a positive result in 11 cases. Asymptomatic cases identified at screening during in-class learning period accounted for 26.5% of the total number of cases occurred in the participating classes.ConclusionsThis is one of the few studies (and the first in Italy) to describe the functioning and predictive capacity of school screening testing for SARS-CoV-2 in a real-world situation. Our findings provide data-driven suggestions for government agencies when planning large-scale school screening testing programs.
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