<scp>COVID</scp>
            ‐19, children and schools: overlooked and at risk

Hyde, Zoë

doi:10.5694/mja2.50823

Cited by 85 publications

(83 citation statements)

References 34 publications

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“…To which extent children are inflicted by SARS-CoV-2 and to which extent opening or closing of schools impacts the dynamics of the SARS-CoV-2 pandemic is much debated. 1,4 One aspect of this debate concerns the occurrence of SARS-CoV-2 infection in children compared to adults. In our study, we detected SARS-CoV-2 infection in 1.42% (95% CI 1.06-1.90%) of study participants at the second round of examinations (10)(11)(12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

“…1 Thus, there is extensive debate about the role of schools and children in the SARS-CoV-2 pandemic. 1,4 Several prior studies have examined representative samples of the general population to assess how frequently SARS-CoV-2 infections occur in children compared to adults. For instance, seroepidemiological studies [5][6][7] showed a somewhat lower prevalence of SARS-CoV-2 antibodies in children than in adults, but it remains unclear whether this difference arises from reduced exposure related to schools closures, a distinct immune response, orindeedreduced susceptibility.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of RT-qPCR-detected SARS-CoV-2 infection at schools: First results from the Austrian School-SARS-CoV-2 prospective cohort study

Willeit

Krause

Lamprecht

et al. 2021

Preprint

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BackgroundThee is much debate about the role of schools and children in the SARS-CoV-2 pandemic. We aimed to quantify reliably the prevalence of SARS-CoV-2 infections at schools detected with reverse-transcription polymerase-chain-reaction (RT-PCR).MethodsThis nationwide prospective cohort study monitors a representative sample of pupils (grade 1-8) and teachers at Austrian schools throughout the school year 2020/2021. We repeatedly test participants for SARS-CoV-2 infection using a gargling solution and RT-PCR. We herein report on the first two rounds of examinations. We used mixed-effect logistic regression to estimate odds ratios and robust 95% confidence intervals (95% CI).FindingsWe analysed data on 10734 participants from 245 schools (9465 pupils, 1269 teachers). Prevalence of RT-PCR-detected SARS-CoV-2 infection increased from 0.39% at round 1 (95% CI 0.28-0.55%, 29 September-22 October 2020) to 1.42% at round 2 (95% CI 1.06-1.90%, 10-16 November). Odds ratios for SARS-CoV-2 infection were 2.29 (95% CI 1.26-4.17, P=0.007) in regions with >500 vs. ≤500 inhabitants/km2, 1.69 (95% CI 1.42-2.00, P<0.001) for a two-fold higher regional 7-day incidence, and 2.71 (95% CI 1.68-4.39, P<0.001) in pupils at schools with a high/very high vs. low/moderate social deprivation index. Associations of community incidence and social deprivation persisted in multivariable models. There were no differences between age groups, sexes, pupils vs. teachers, or primary (grade 1-4) vs. secondary schools (grade 5-8).InterpretationThis monitoring study in Austrian schools revealed SARS-CoV-2 infection in 0.39%-1.42% of participants and identified associations of regional community incidence and social deprivation with higher prevalence.FundingBMBWF Austria.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of RT-qPCR-detected SARS-CoV-2 infection at schools: First results from the Austrian School-SARS-CoV-2 prospective cohort study

Willeit

Krause

Lamprecht

et al. 2021

Preprint

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“…The MJA has engaged in the debate about how to protect health care workers from infection, 10 a devastating outcome of the pandemic that was largely preventable. MJA authors have jumped into the often heated debates about schools and virus transmission, 11 the value of face masks, 12 the positive and negative effects of various public health measures, 10,13 lessons learned in an early nursing home outbreak, 14 the urgency of ensuring sufficient numbers of intensive care beds, 15 professional guidelines, 16,17 and protecting Indigenous Australians, 18 to name a few of the areas touched upon in our Journal. As, despite evidence and expert agreement, aberrant beliefs continued to circulate widely on social media, often causing alarm, the MJA has provided a source of reputable peer‐reviewed evidence, with expert syntheses of what is known and what has changed, published as rapidly as is responsible 19…”

Section: Our Response To the Covid‐19 Pandemicmentioning

confidence: 99%

Health and medicine in a pandemic year: moving from the “winter of despair” to the “spring of hope”

Talley¹

2020

Medical Journal of Australia

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“…Given that children are more likely to develop asymptomatic infection compared to other age groups, [17][18][19][20] they can be important drivers of silent transmission. 21 We developed an agestratified SARS-CoV-2 transmission model to investigate the impact of a targeted strategy for identifying silent infections among this age group when only adults are vaccinated. We then calculated the proportion and the speed of identification required to suppress future attack rates below 5% and, alternatively, the vaccination coverage among children which could achieve the same goal.…”

Section: Introductionmentioning

confidence: 99%

Simulated identification of silent COVID-19 infections among children and estimated future infection rates with vaccination

Moghadas

Fitzpatrick

Shoukat

et al. 2021

Preprint

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ImportanceA significant proportion of COVID-19 transmission occurs silently during the pre-symptomatic and asymptomatic stages of infection. Children, while being important drivers of silent transmission, are not included in COVID-19 vaccination campaigns given their exclusion from clinical trials thus far.ObjectiveTo investigate the impact of a targeted approach to identifying silent infections among children as a proxy for their vaccination.DesignThis study used an age-structured disease transmission model to simulate the synergistic impact of interventions in reducing attack rates over the course of one year.SettingA synthetic population representative of the demographics of the United States (US).ParticipantsSix age groups of 0-4, 5-10, 11-18, 19-49, 50-64, 65+ years old, stratified for their population size based on US census data.ExposuresVaccination of adults, self-isolation of all symptomatic cases within 24 hours of symptom onset, and detection of silent infections.Main Outcomes and MeasuresVaccination of adults was implemented to reach a 40% coverage over the course of one year with a vaccine efficacy of 95% against symptomatic and severe COVID-19. Without vaccination of children, we determined the proportion and speed that would be required for identifying silent infections among this age group to suppress future attack rates below 5%.ResultsA targeted approach that identifies 20.6% and 28.6% of silent infections among children within 2 or 3 days post-infection, respectively, would be required to bring attack rates under 5% with vaccination of adults. If silent infections among children remained undetected, achieving the same attack rates would require an unrealistically high vaccination coverage (at least 82%) of this age group, in addition to the base-case 40% vaccination coverage of adults. The results were robust in sensitivity analyses with respect to vaccine efficacy against infection and reduced susceptibility of children to infection.Conclusions and RelevanceIn the absence of vaccine availability for children, a targeted approach to rapid identification of silent COVID-19 infections in this age group can significantly mitigate disease burden. Without measures to interrupt transmission chains from silent infections, vaccination of adults is unlikely to contain the outbreaks in the near term.Key PointsQuestionWhat is the impact of a targeted strategy for identification of silent COVID-19 infections among children in the absence of their vaccination?FindingsIn this modelling study, we found that identifying 20-30% of silent infections among children within three days post-infection would bring attack rates below 5% if only adults were vaccinated. If silent infections among children remained undetected, achieving the same attack rate would require an unrealistically high vaccination coverage (at least 82%) of this age group, in addition to vaccination of adults.MeaningRapid identification of silent infections among children can replicate effects of their vaccination.

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COVID ‐19, children and schools: overlooked and at risk

Cited by 85 publications

References 34 publications

Prevalence of RT-qPCR-detected SARS-CoV-2 infection at schools: First results from the Austrian School-SARS-CoV-2 prospective cohort study

Prevalence of RT-qPCR-detected SARS-CoV-2 infection at schools: First results from the Austrian School-SARS-CoV-2 prospective cohort study

Health and medicine in a pandemic year: moving from the “winter of despair” to the “spring of hope”

Simulated identification of silent COVID-19 infections among children and estimated future infection rates with vaccination

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