COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020

Abstract

Background The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England. Methods Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire. Interpretation There were 969 school outbreaks reported to PHE, comprising 2% ( n = 450) of primary schools and 10% ( n = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48%) than secondary (25/79, 32%) school outbreaks ( P = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95%CI, 4.75–5.41) than students, especially primary school teaching staff (378/3852; 9.81%; 95%CI, 8.90–10.82%) compared to secondary school teaching staff (284/7146; 3.97%; 95%CI, 3.79–5.69%). Secondary school students (1105/91,919; 1.20%; 95%CI, 1.13–1.28%) had higher attack rates than primary school students (328/39,027; 0.84%; 95%CI, 0.75–0.94%). Conclusions A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed. Funding PHE

SARS-CoV-2 infection, antibody positivity and seroconversion rates in staff and students following full reopening of secondary schools in England: A prospective cohort study, September–December 2020

“…The UK experience following full reopening of all school years in the autumn term was different to the partial reopening of some primary and secondary school years in the previous summer mini-term [7]. Nationally, SARS-CoV-2 infection rates were higher across all age-groups including children, and there were more infections and outbreaks reported in educational settings during the autumn term [9,19]. Using the same methodology in primary schools, the SARS-CoV-2 antibody seroconversion rate was 5% among staff and students [20], and a lower proportion of primary schools than secondary schools experienced a COVID-19 outbreak during the first half of the autumn term.…”

“…), which in-turn will have a small but measurable impact on the reproduction number for SARS-CoV-2 [21]. There is, however, increasing evidence that the risk of SARS-CoV-2 transmission within school premises is very low, [22À24] especially among students [19]. In North Carolina, for example, surveillance of 11 school districts with more than 90,000 students and staff attending school in-person for 9 weeks, found 773 community-acquired SARS-CoV-2 infections, while contact tracing found only 32 additional infections that were acquired within school [24].…”

COVID-19 in children and the importance of COVID-19 vaccination

“…Li et al found that reopening schools was associated with increases in transmission [ 43 ]. Moreover, cases of children testing positive for SARS-CoV-2 have risen following the reopening of schools [ 44 , 45 ]. In the 1 month ending 18 June, 2021, 181 SARS-CoV-2 outbreaks were confirmed in the UK related to primary and secondary schools [ 13 ].…”

Surge in SARS-CoV-2 transmission in school-aged children and household contacts, England, August to October 2021

“…Weekly test positivity data reported by ONS and UKHSA showed a marked rise in positivity rate among secondary school-aged children over this period [8,9]. A similar rise was seen at the start of the previous (2020/21) academic year in England [10], however, the magnitude of the rise has been more pronounced this year. The differences could in part be attributable to increased transmissibility of the SARS-CoV-2 Delta (Phylogenetic Assignment of Named Global Outbreak (Pango) lineage designation B.1.617.2 and AY.…”