Transmission of SARS-CoV-2 from Children and Adolescents

Chu, Victoria; Yousaf, Anna R; Chang, Karen; Schwartz, Noah G.; McDaniel, Clinton J.; Szablewski, Christine M.; Brown, Mark F.; Winglee, Kathryn; Lee, Scott H.; Cui, Zhaohui; Adebayo, Adebola; Aholou, Tiffiany; Amin, Minal M.; Aryee, Peter A.; Castaneda, Cindy; Chambers, Trudy V.; Fleshman, Amy C.; Goodman, Christin H.; Holmes, T.V.; Ivey-Stephenson, Asha Z.; Kamitani, Emiko; Katz, Susan; Knapp, Jennifer K.; Kolasa, Maureen; Lumsden, Maranda; Mayweather, Erin; Mohammed, Asfia; Moorman, Anne C.; Patel-Larson, Alpa; Perinet, Lara C.; Pilgard, Mark A.; Pratt, Deirdre D.; Railey, Shanica; Shah, Jaina A.; Tuckey, Dawn; Dirlikov, Emilio; Rose, Dale A.; Villanueva, Julie; Fry, Alicia M.; Hall, Aron J.; Kirking, Hannah L.; Tate, Jacqueline E.; Drenzek, Cherie; Lanzieri, Tatiana M.; Stewart, Rebekah J

doi:10.1101/2020.10.10.20210492

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…We consider variation in (daily) baseline probabilities of infection upon contact between 5 and 25%. This corresponds to secondary attack rates of 4%-14% and thus captures most of the variation reported in the literature, [ 1 , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] ] including estimates for more transmissible variants such as B.1.1.7 [21] , [22] , [23] . To obtain the total probability of infection upon interaction, this baseline probability is multiplied by the riskiness of the specific interaction and by the infected student's infectiousness.…”

Section: Methodsmentioning

confidence: 99%

Social network-based cohorting to reduce the spread of SARS-CoV-2 in secondary schools: A simulation study in classrooms of four European countries

Kaiser

Kretschmer

Leszczensky

2021

The Lancet Regional Health - Europe

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Background Operating schools safely under pandemic conditions is a widespread policy goal. We analyse the effectiveness of classroom cohorting, i.e., the decomposition of classrooms into smaller isolated units, in inhibiting the spread of SARS-CoV-2 in European secondary schools and compare different cohorting strategies. Methods Using real-world network data on 12,291 adolescents collected in classrooms in England, Germany, the Netherlands, and Sweden in 2010/2011, we apply agent-based simulations to compare the effect of forming cohorts randomly to network-based cohorting. Network-based cohorting attempts to allocate out-of-school contacts to the same cohort to prevent cross-cohort infection more effectively. We consider explicitly minimizing out-of-school cross-cohort contacts, approximating this information-heavy optimization strategy by chained nominations of contacts, and dividing classrooms by gender. We also compare the effect of instructing cohorts in-person every second week to daily but separate in-person instruction of both cohorts. Findings We find that cohorting reduces the spread of SARS-CoV-2 in classrooms. Relative to random cohorting, network-based strategies further reduce infections and quarantines when transmission dynamics are strong. In particular, network-based cohorting inhibits superspreading in classrooms. Cohorting that explicitly minimizes cross-cohort contacts is most effective, but approximation based on chained nominations and classroom division by gender also outperform random cohorting. Every-second-week instruction in-person contains outbreaks more effectively than daily in-person instruction of both cohorts. Interpretation Cohorting of school classes can curb SARS-CoV-2 outbreaks in the school context. Factoring in out-of-school contacts can achieve a more effective separation of cohorts. Network-based cohorting reduces the risk of outbreaks in schools and can prevent superspreading events. Funding None.

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Section: Methodsmentioning

confidence: 99%

Social network-based cohorting to reduce the spread of SARS-CoV-2 in secondary schools: A simulation study in classrooms of four European countries

Kaiser

Kretschmer

Leszczensky

2021

The Lancet Regional Health - Europe

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“…Of course, the secondary attack rate is lower when instruction is organized in a weekly rota-system and parts of the infectious period do not attack rate among adolescents from previous studies, with Liu et al (2020) reporting a secondary attack rate of 4% in 10 to 19-year-olds in a contact study with all contacts, and Dattner et al (in Viner, Mytton, et al 2020:11)reporting a household secondary attack rate of 34% among 7 to 19-year-olds. Other estimates are in between (Chu et al 2020;Goldstein, Marc Lipsitch, and Cevik 2020;Laxminarayan et al 2020;Sachdev et al 2020;).…”

Section: Baseline Probability Of Infection Upon Contactmentioning

confidence: 99%

Social network-based strategies for classroom size reduction can help limit outbreaks of SARS-CoV-2 in high schools. A simulation study in classrooms of four European countries

Kaiser

Kretschmer

Leszczensky

2020

Preprint

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Background Until pharmaceutical measures are widely available to slow the spread of SARS-CoV-2, social distancing strategies are key to avert overwhelmed health systems. Since schools host large numbers of students in enclosed spaces, they are feared to produce infection clusters. With school closures coming at high social and economic costs, social distancing measures within schools are needed to make them as safe as possible. One widely discussed distancing measure in the school context is to use cohorting strategies, i.e., to split larger clusters such as classrooms into smaller groups that are instructed separately. In addition to facilitating social distancing within these cohorts, cohorting strategies also aim to prevent transmission across cohorts. However, little is known about which cohorting strategies are particularly effective to prevent disease transmission between cohorts in schools. Methods Using nationally representative data on adolescents in classrooms in four European countries, we simulate how four different cohorting strategies can mitigate the spread of SARS-CoV-2 in high schools. We model the effect of forming two cohorts randomly, splitting cohorts by gender, optimizing cohorts by minimizing students' out-of-school cross-cohort contacts, and approximating this optimization strategy by network chains. The rationale of all non-random cohorting strategies is to prevent the spread of SARS-CoV-2 from one cohort to the other by reducing cross-cohort out-of-school contact. We also compare the overall effect of cohorting to no cohorting and differentiate between a rota-system in which cohorts receive in-person instruction in alternating weeks and a system with separate but same-day in-person instruction for both cohorts. Data were collected between 2010 and 2011 as part of the CILS4EU project, a network panel study of 14-15-year-olds in England, Germany, the Netherlands, and Sweden. Across all four countries, we model the transmission of SARS-CoV-2 in 507 classrooms, capturing a total of 12,291 students. Findings Our simulations suggest that all four cohorting strategies reduce the spread of SARS-CoV-2 in classrooms, but vary in their effectiveness. Relative to random cohorting, all strategies that factor in out-of-school cross-cohort ties have particularly strong effects on the frequency of cross-cohort transmission but also substantively reduce the total number of infections and the share of students in quarantine when transmission dynamics are strong. Cohorting that explicitly minimizes out-of-school contact between students in different cohorts is most effective, but network-based approximation also breaks many cross-cohort ties and thus performs well. Because adolescents' out-of-school contacts tend to be strongly segregated by gender, dividing classrooms by gender also outperforms random cohorting but is less effective than directly using network information. For all cohorting strategies, rota-systems with instruction in alternating weeks contain outbreaks more effectively than same-day in-person instruction. Interpretation Cohorting of school classes as a social distancing measure can help to effectively curb SARS-CoV-2 outbreaks in the school context. If schools consider splitting up classes into two smaller cohorts, factoring in out-of-school contacts can help achieve a more effective separation of cohorts. The paper proposes effective cohorting strategies that outperform naive random cohorting in preventing the spread of SARS-CoV-2. These strategies may limit outbreaks to one cohort, keep the size of infection clusters low, and reduce the number of students in quarantine if an index case occurs in the student body. Our findings thus suggest that if schools consider cohorting, they should assign students who meet after school to the same cohort. In particular, cohorting on the basis of gender or network chains is effective and may be successfully implemented within the constraints posed by the classroom context.

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“…According to the current evidence, the COVID-19 virus is transmitted through respiratory droplets or contact. [12].…”

Section: Introductionmentioning

confidence: 99%

Effect of an e-Educational Poster on Improving Knowledge, Attitude, and Practice on Proper Use of Hand Hygiene among School Students

Weerasinghe¹

2022

Preprint

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Hand hygiene is important to prevent the spread of the COVID-19 virus by contact. It also interrupts the transmission of other viruses and bacteria causing common colds, flu, and pneumonia, thus useful in reducing the general burden of infectious disease. Literature shows that there is inadequate knowledge, attitude, and practice on the proper use of hand hygiene among school students. Therefore knowledge, attitude, and practice on hand hygiene of school students should be improved. Currently, different approaches are used to improve knowledge, attitude, and practice on the proper use of hand hygiene among school students. But e-educational posters are rare and the effect of e- educational posters to improve the knowledge, attitude, and practice of school students on the proper use of hand hygiene has not been studied. Therefore, the main purpose of this study was to determine the effect of an e-educational poster on improving the knowledge, attitude, and practice of the proper use of hand hygiene among school students. An interventional and prospective study was conducted on advanced-level students in Dehiovita educational zone, Sri Lanka. Pre group consisted of 405 students prior to the e-educational poster intervention. The Post group consisted of 364 subjects after being educated through e-educational poster intervention on the proper use of hand hygiene. Data analysis was conducted by using SPSS Software version 25. Students of the pre and post-groups were identical in terms of demographic variables; gender (P=0.905), subject stream (P=0.972), and grade (P=0.774). After the educational intervention, a significant improvement was established in the mean score of knowledge (P < 0.05), attitude (P < 0.05), and practice (P < 0.05) of students in the post-group compared with the pre-group. Within each group, there was no difference in knowledge, attitudes and practice attributes due to gender (p>0.05) or grade (p>0.05). However, there was an influence of the educational stream on attitude (P<0.05) and practice (p< 0.05) in pre-group as well as post-group. The influence of the educational stream on knowledge was significant (P<0.05) in the pre-group but not significant (P=0.051) in post group.

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Transmission of SARS-CoV-2 from Children and Adolescents

Cited by 5 publications

References 21 publications

Social network-based cohorting to reduce the spread of SARS-CoV-2 in secondary schools: A simulation study in classrooms of four European countries

Social network-based cohorting to reduce the spread of SARS-CoV-2 in secondary schools: A simulation study in classrooms of four European countries

Social network-based strategies for classroom size reduction can help limit outbreaks of SARS-CoV-2 in high schools. A simulation study in classrooms of four European countries

Effect of an e-Educational Poster on Improving Knowledge, Attitude, and Practice on Proper Use of Hand Hygiene among School Students

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