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People can't stop talking about schools and #COVID19
Here's a thread on school transmission studies!
Summary:
- If prevalence high in the community, it will be high in schools and some will transmit
- Isolated cases result in low transmission
- Infection prevention works
1/11
Here's a thread on school transmission studies!
Summary:
- If prevalence high in the community, it will be high in schools and some will transmit
- Isolated cases result in low transmission
- Infection prevention works
1/11
First, when it's gone not so well
A high prevalence area in France pre-lockdown had a secondary school with 40% seropositivity in staff and pupils; higher than in pupils households, suggesting school transmission
Almost all pupils 15y+
https://doi.org/10.1101/2020.04.18.20071134
2/11
A high prevalence area in France pre-lockdown had a secondary school with 40% seropositivity in staff and pupils; higher than in pupils households, suggesting school transmission
Almost all pupils 15y+
https://doi.org/10.1101/2020.04.18.20071134
2/11
Famously, Israel had trouble after opening schools alongside everything else and experiencing a big surge in cases
This secondary school had 2 symptomatic cases, so everyone was tested. 13% of pupils and 16% of staff were positive.
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.29.2001352
3/11
This secondary school had 2 symptomatic cases, so everyone was tested. 13% of pupils and 16% of staff were positive.
https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.29.2001352
3/11
Finally, a private school in Chile.
9% of pupils and 16% of staff were seropositive in an area of high community prevalence. Unclear how much transmission within the school and how much acquired outside. Index case likely a preschool teacher.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa955/5869860
4/11
9% of pupils and 16% of staff were seropositive in an area of high community prevalence. Unclear how much transmission within the school and how much acquired outside. Index case likely a preschool teacher.
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa955/5869860
4/11
Where did things go well?
In the same French region as above but in a primary school, only 8.8% of pupils tested positive (lower than parents, suggesting mostly household transmission)
3 kids attended school with no evidence of onward transmission
https://doi.org/10.1101/2020.06.25.20140178
5/11
In the same French region as above but in a primary school, only 8.8% of pupils tested positive (lower than parents, suggesting mostly household transmission)
3 kids attended school with no evidence of onward transmission
https://doi.org/10.1101/2020.06.25.20140178
5/11
Next, Ireland
6 cases (3 kids, 3 teachers) with school contact tracing
Only 2 transmissions from >1000 contacts, both from a teacher to other adults outside of school
Asymptomatic contacts not tested, so possible undercounting
https://eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.21.2000903#figuresntables
6/11
6 cases (3 kids, 3 teachers) with school contact tracing
Only 2 transmissions from >1000 contacts, both from a teacher to other adults outside of school
Asymptomatic contacts not tested, so possible undercounting
https://eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.21.2000903#figuresntables
6/11
Now Singapore
3 +ve cases:
-12yo in secondary school. 8 classmates symptomatic, all tested negative
-5yo (sibling of
) in primary school. 34 classmates tested, all negative
-16 staff in pre-school cluster. 70% of kids tested, all negative
https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa794/5862649
7/11
3 +ve cases:
-12yo in secondary school. 8 classmates symptomatic, all tested negative
-5yo (sibling of
) in primary school. 34 classmates tested, all negative-16 staff in pre-school cluster. 70% of kids tested, all negative
https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa794/5862649
7/11
Australia!
27 index cases (15 children, 12 adults)
All symptomatic contacts traced, + 44% of all close contacts screened w/ serology
18 secondary cases (highest SAR adult to adult, 4.4%)
Reduced class attendance and good contact tracing in place
https://doi.org/10.1016/S2352-4642(20)30251-0
8/11
27 index cases (15 children, 12 adults)
All symptomatic contacts traced, + 44% of all close contacts screened w/ serology
18 secondary cases (highest SAR adult to adult, 4.4%)
Reduced class attendance and good contact tracing in place
https://doi.org/10.1016/S2352-4642(20)30251-0
8/11
Rhode Island, US
Childcare centres w/ capacity 19,000 children
Confirmed/probable cases; 30 children, 22 adults
20/29 programmes with a +ve case had no secondary transmission
Good infection prevention (small groups, masks, cleaning, symptom check)
https://www.cdc.gov/mmwr/volumes/69/wr/mm6934e2.htm#F1_down
9/11
Childcare centres w/ capacity 19,000 children
Confirmed/probable cases; 30 children, 22 adults
20/29 programmes with a +ve case had no secondary transmission
Good infection prevention (small groups, masks, cleaning, symptom check)
https://www.cdc.gov/mmwr/volumes/69/wr/mm6934e2.htm#F1_down
9/11
England school reopening; >20,000 schools with >1mil children
67 single cases
30 outbreaks:
-22/30 staff/staff or staff/student transmission
-6/30 only 2 cases
Outbreaks correlated w/ community prevalence
Small classes in "bubbles", hand hygiene
https://www.medrxiv.org/content/10.1101/2020.08.21.20178574v1
10/11
67 single cases
30 outbreaks:
-22/30 staff/staff or staff/student transmission
-6/30 only 2 cases
Outbreaks correlated w/ community prevalence
Small classes in "bubbles", hand hygiene
https://www.medrxiv.org/content/10.1101/2020.08.21.20178574v1
10/11
What does this mean?
Careful reopening of schools in areas of low community prevalence with good, basic infection prevention measures can work
Israel had problems, but Denmark, Finland, Norway, Netherlands, Switzerland, Iceland, Singapore etc managed it well
11/11
Careful reopening of schools in areas of low community prevalence with good, basic infection prevention measures can work
Israel had problems, but Denmark, Finland, Norway, Netherlands, Switzerland, Iceland, Singapore etc managed it well
11/11
