SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

Abstract

Background: In fall 2020 when schools in the Netherlands operated under a limited set of COVID-19 measures, we conducted outbreaks studies in four secondary schools to gain insight in the level of school transmission and the role of SARS-CoV-2 transmission via air and surfaces. Methods: Outbreak studies were performed between 11 November and 15 December 2020 when the wild-type variant of SARS-CoV-2 was dominant. Clusters of SARS-CoV-2 infections within schools were identified through a prospective school surveillance study. All school contacts of cluster cases, irrespective of symptoms, were invited for PCR testing twice within 48 hrs and 4-7 days later. Combined NTS and saliva samples were collected at each time point along with data on recent exposure and symptoms. Surface and active air samples were collected in the school environment. All samples were PCR-tested and sequenced when possible. Results: Out of 263 sampled school contacts, 24 tested SARS-CoV-2 positive (secondary attack rate 9.1%), of which 62% remained asymptomatic and 42% had a weakly positive test result. Phylogenetic analysis on 12 subjects from 2 schools indicated a cluster of 8 and 2 secondary cases, respectively, but also other distinct strains within outbreaks. Of 51 collected air and 53 surface samples, none were SARS-CoV-2 positive. Conclusion: Our study confirmed within school SARS-CoV-2 transmission and substantial silent circulation, but also multiple introductions in some cases. Absence of air or surface contamination suggests environmental contamination is not widespread during school outbreaks.

Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents

“…Several other studies were not able to detect SARS-CoV-2 in air in the surrounding of patients more than eight days after post-onset of symptoms ( Chia et al , 2020 ; Dumont-Leblond et al , 2021 ; Semelka et al , 2021 ). Moreover, in other studies in human and animal settings, SARS-CoV-2 was only detected in environmental samples if the human and animal source organisms were actively shedding SARS-CoV-2 during sampling ( de Rooij et al , 2021 ; Jonker et al , 2022 ). These observations emphasize that timing of sampling in the direct environment of patients and other populations is of importance for detecting SARS-CoV-2 and that surroundings from SARS-CoV-2 patients in early stage are contaminated with SARS-CoV-2.…”