Minimal transmission of SARS-CoV-2 from paediatric COVID-19 cases in primary schools, Norway, August to November 2020

Brandal, Lin Thorstensen; Ofitserova, Trine Skogset; Meijerink, Hinta; Rykkvin, Rikard; Lund, Hilde Marie; Hungnes, Olav; Greve-Isdahl, Margrethe; Bragstad, Karoline; Nygård, Karin; Winje, Brita Askeland

doi:10.2807/1560-7917.es.2020.26.1.2002011

Cited by 110 publications

(115 citation statements)

References 10 publications

(19 reference statements)

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“…Over 18 weeks, this screening program detected 37 of the 126 total positive tests among students and staff engaged in in-person learning, and in-school transmission was rare. These findings are consistent with data from Australia, the UK, Norway, Germany, and Italy, 7–9,18,19 as well as emerging data from K-12 schools across the US. 10,16,17,20–22 However, rare in-school transmissions did occur associated with breaks in mitigation protocols, consistent with data from Israel, Utah, and Mississippi.…”

Section: Discussionsupporting

confidence: 89%

Weekly SARS-CoV-2 screening of asymptomatic students and staff to guide and evaluate strategies for safer in-person learning

Doron

Ingalls

Beauchamp³

et al. 2021

Preprint

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Background: Data suggest that COVID-19 transmission in K-12 schools is uncommon, but few studies have confirmed this using widespread screening of asymptomatic individuals. Objective: To evaluate the incidence of asymptomatic COVID-19, document the frequency of in-school transmission, and confirm feasibility of widespread asymptomatic screening in schools. Design: Prospective observational study Setting: Single mid-sized suburban school district including 10 schools and a central office. Participants: District staff and students Interventions: Asymptomatic screening PCR for SARS-CoV-2 Measurements: Concurrent with a hybrid model and layered mitigation, weekly pooled testing of staff and secondary students was offered using saliva samples collected at home. Identification of >1 case in a school prompted investigation for possible in-school transmission. Staff and families were surveyed about satisfaction with the screening program. Results: From weeks 1-18, rates of incident COVID-19 in the surrounding community rose steadily. Weekly staff and student screening identified 0-7 asymptomatic cases/week. In week 7, 5 cases were identified among staff who shared an office setting. Enhancements to mitigation strategies were undertaken. The proportion of survey respondents self-reporting comfort with in-person learning before versus after implementation of screening increased. Limitations: Because screening testing was not mandatory, the results from the participating population might not represent the entire school community. Conclusions: In this school district with layered mitigation measures, in-school transmission was rare. The program identified a cluster with in-school staff-to-staff transmission and spurred enhancement of safety strategies. A weekly COVID-19 screening program can provide critical data to inform mitigation efforts, and provides school-specific, current data to inform decisions about in-person learning models. Screening provided reassurance and identified asymptomatic cases. Funding: The Wellesley Education Foundation provided funding for the testing.

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Section: Discussionsupporting

confidence: 89%

Weekly SARS-CoV-2 screening of asymptomatic students and staff to guide and evaluate strategies for safer in-person learning

Doron

Ingalls

Beauchamp³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…Recent infection surveys using PCR tests,1718 show that around 0.5-1% of children have a positive result, and school closures mean it has not been possible to obtain evidence regarding the spread of the new variant in schools. However, earlier studies, including from Australia, Norway, Switzerland, Italy, and Germany,1920212223 in which all individuals were tested regardless of symptoms found transmission rates to be low, particularly among primary schoolchildren 1920212223. Ecological studies and descriptive studies of viral prevalence within schools show that it reflects community prevalence but is not higher 24…”

Section: Transmissionmentioning

confidence: 91%

Closing schools is not evidence based and harms children

Lewis

Munro

Smith

et al. 2021

BMJ

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“…Even during periods of moderate to high community transmission, in many countries few outbreaks have been observed among children in schools where infection control measures have been implemented. [11][12][13] Although some outbreaks have been reported in educational settings during early 2020 (eg, in Israel 14 and the United States 15 ), full or partial opening of schools in many countries in autumn 2020 has not resulted in increased outbreaks. 11 16-18 Most studies in schools have focused on people with identified SARS-CoV-2 infection and subsequent contact tracing within schools.…”

Section: Introductionmentioning

confidence: 99%

Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: prospective cohort study of 55 schools

Ulytė

Radtke

Abela

et al. 2021

BMJ

100

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Objectives To examine longitudinal changes in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and to determine the clustering of children who were seropositive within school classes in the canton of Zurich, Switzerland from June to November 2020. Design Prospective cohort study. Setting Switzerland had one of the highest second waves of the SARS-CoV-2 pandemic in Europe in autumn 2020. Keeping schools open provided a moderate to high exposure environment to study SARS-CoV-2 infections. Children from randomly selected schools and classes, stratified by district, were invited for serological testing of SARS-CoV-2. Parents completed questionnaires on sociodemographic and health related questions. Participants 275 classes in 55 schools; 2603 children participated in June-July 2020 and 2552 in October-November 2020 (age range 6-16 years). Main outcome measures Serology of SARS-CoV-2 in June-July and October-November 2020, clustering of children who were seropositive within classes, and symptoms in children. Results In June-July, 74 of 2496 children with serological results were seropositive; in October-November, the number had increased to 173 of 2503. Overall SARS-CoV-2 seroprevalence was 2.4% (95% credible interval 1.4% to 3.6%) in the summer and 4.5% (3.2% to 6.0%) in late autumn in children who were not previously seropositive, leading to an estimated 7.8% (6.2% to 9.5%) of children who were ever seropositive. Seroprevalence varied across districts (in the autumn, 1.7-15.0%). No significant differences were found among lower, middle, and upper school levels (children aged 6-9 years, 9-13 years, and 12-16 years, respectively). Among the 2223 children who had serology tests at both testing rounds, 28/70 (40%) who were previously seropositive became seronegative, and 109/2153 (5%) who were previously seronegative became seropositive. Symptoms were reported for 22% of children who were seronegative and 29% of children who were newly seropositive since the summer. Between July and November 2020, the ratio of children diagnosed with SARS-CoV-2 infection to those who were seropositive was 1 to 8. At least one child who was newly seropositive was detected in 47 of 55 schools and in 90 of 275 classes. Among 130 classes with a high participation rate, no children who were seropositive were found in 73 (56%) classes, one or two children were seropositive in 50 (38%) classes, and at least three children were seropositive in 7 (5%) classes. Class level explained 24% and school level 8% of variance in seropositivity in the multilevel logistic regression models. Conclusions With schools open since August 2020 and some preventive measures in place, clustering of children who were seropositive occurred in only a few classes despite an increase in overall seroprevalence during a period of moderate to high transmission of SARS-CoV-2 in the community. Uncertainty remains as to whether these findings will change with the new variants of SARS-CoV-2 and dynamic levels of community transmission. Trial registration NCT04448717

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Minimal transmission of SARS-CoV-2 from paediatric COVID-19 cases in primary schools, Norway, August to November 2020

Cited by 110 publications

References 10 publications

Weekly SARS-CoV-2 screening of asymptomatic students and staff to guide and evaluate strategies for safer in-person learning

Weekly SARS-CoV-2 screening of asymptomatic students and staff to guide and evaluate strategies for safer in-person learning

Closing schools is not evidence based and harms children

Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: prospective cohort study of 55 schools

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