Controlling SARS-CoV-2 in schools using repetitive testing strategies

Torneri, Andrea; Willem, Lander; Colizza, Vittoria; Kremer, Cécile; Meuris, Christelle; Darcis, Gilles; Hens, Niel; Libin, Pieter

doi:10.7554/elife.75593

Cited by 8 publications

(16 citation statements)

References 32 publications

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“…In practice, this can be used to evaluate and if necessary adapt mitigation measures in school. Symptomatic isolation has already been shown not to be very effective in reducing SARS-CoV-2 infections in schools [8, 9], and we found that data obtained from such a strategy results in consistent underestimation of positivity rates. Further research is needed to investigate how the accuracy of outbreak reconstruction depends on which proportion of a school population is sampled and how many of these samples are sequenced.…”

Section: Discussionmentioning

confidence: 63%

“…A previously developed individual-based model representing a population of primary school children and their teachers was used to investigate how the accuracy of estimated weekly positivity rates depends on the proportion of a school that is sampled in a repetitive screening strategy (see Methods for a description of the model) [9, 21]. The probability of symptomatic infection was set to 65% for children and 85% for adults, as observed in the surveillance study.…”

Section: Resultsmentioning

confidence: 99%

“…The copyright holder for this preprint this version posted October 17, 2022. ; https://doi.org/10.1101/2022.10.17.22281175 doi: medRxiv preprint although the reduction in final size increased with higher levels of compliance [9]. When social mixing between classes is high, as in primary schools, other classes may have already been affected before the first case is detected, making a reactive screening strategy less efficient [29].…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…In addition, the number of school days lost would be reduced up to 80% compared to reactive screening policies [8]. In line with this, another modeling study found that repetitive screening greatly reduced the attack rate in school, while reactive screening performed only slightly better than symptomatic isolation [9]. Furthermore, using a repetitive screening strategy allowed for increasing the class closure threshold without much impact on the attack rate.…”

Section: Introductionmentioning

confidence: 99%

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Reconstruction of SARS-CoV-2 outbreaks in a primary school using epidemiological and genomic data

Kremer

Torneri

Libin

et al. 2022

Preprint

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Mathematical modeling studies have shown that repetitive screening can be used to mitigate SARS-CoV-2 transmission in primary schools while keeping schools open. However, not much is known about how transmission progresses within schools and whether there is a risk of importation to households. In this study, we reconstructed outbreaks observed during a prospective study in a primary school and associated households in Liège (Belgium) during the academic year 2020-2021. In addition we performed a simulation study to investigate how the accuracy of estimated weekly positivity rates in a school depends on the proportion of a school that is sampled in a repetitive screening strategy. We found that transmission occurred mainly within the school environment and that observed positivity rates are a good approximation to the true positivity rate, especially in children. This study shows that it is worthwile to implement repetitive testing in school settings, which in addition to reducing infections can lead to a better understanding of the extent of transmission in schools during a pandemic and importation risk at the community level.

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Section: Discussionmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 99%

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reconstruction of SARS-CoV-2 outbreaks in a primary school using epidemiological and genomic data

Kremer

Torneri

Libin

et al. 2022

Preprint

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“…The contribution of students to SARS‐CoV‐2 transmission and the high prevalence in the student population we have found through an extensive screening hint at the difficulties in tracking asymptomatic infections and the challenges implementing reactive class/school closures to interrupt SARS‐CoV‐2 transmission. 12 , 16 , 23 , 24 The persistent circulation of SARS‐CoV‐2 and the shift of the age of cases towards younger ages observed throughout Europe in 2022 highlight the need of closely monitoring the epidemiological situation in schools.…”

Section: Discussionmentioning

confidence: 99%

Estimating SARS‐CoV‐2 transmission in educational settings: A retrospective cohort study

Manica

Poletti

Deandrea

et al. 2022

Influenza Resp Viruses

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Background School closures and distance learning have been extensively adopted to counter the COVID‐19 pandemic. However, the contribution of school transmission to the spread of SARS‐CoV‐2 remains poorly quantified. Methods We analyzed transmission patterns associated with 976 SARS‐CoV‐2 exposure events, involving 460 positive individuals, as identified in early 2021 through routine surveillance and an extensive screening conducted on students, school personnel, and their household members in a small Italian municipality. In addition to population screenings and contact‐tracing operations, reactive closures of class and schools were implemented. Results From the analysis of 152 clear infection episodes and 584 exposure events identified by epidemiological investigations, we estimated that approximately 50%, 21%, and 29% of SARS‐CoV‐2 transmission was associated with household, school, and community contacts, respectively. We found substantial transmission heterogeneities, with 20% positive individuals causing 75% to 80% of ascertained infection episodes. A higher proportion of infected individuals causing onward transmission was found among students (46.2% vs. 25%, on average), who also caused a markedly higher number of secondary cases (mean: 1.03 vs. 0.35). By reconstructing likely transmission chains from the entire set of exposures identified during contact‐tracing operations, we found that clusters originated from students or school personnel were associated with a larger average cluster size (3.32 vs. 1.15) and a larger average number of generations in the transmission chain (1.56 vs. 1.17). Conclusions Uncontrolled SARS‐CoV‐2 transmission at school could disrupt the regular conduct of teaching activities, likely seeding the transmission into other settings, and increasing the burden on contact‐tracing operations.

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Effectiveness of SARS‐CoV‐2 testing strategies: A scoping review

Saif‐Ur‐Rahman,

Movsisyan,

Kothari

et al. 2023

Cochrane Evidence Synthesis and Methods

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IntroductionRapid identification of severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) infections by testing potentially reduced coronavirus disease‐19 (COVID‐19) cases. Testing strategies varied across countries and during different stages of the pandemic. This scoping review aims to map the available evidence on the effectiveness of SARS‐CoV‐2 testing strategies for suspected cases and asymptomatic populations to inform the development of World Health Organization recommendations for SARS‐CoV‐2 testing strategies.MethodsWe followed the standard methods for scoping reviews. We searched Medline (OVID), EMBASE (Elsevier), and Europe PMC using a comprehensive search strategy. The search was conducted in January 2023 and covered the period from January 2020 to January 2023. Two review authors independently screened the titles and abstracts, and full texts. Data were extracted onto a pilot‐tested form by a review author and cross‐checked by another review author. We provided a descriptive report summarizing the extracted data around the outcomes and created an interactive map of the available evidence using the evidence for policy and practice mapper.ResultsWe identified 34,550 citations from the databases. After the screening, we included 17 studies from 11 countries for data extraction. The study designs were randomized controlled trials (n = 3), nonrandomized experimental studies (n = 3), cohort studies (n = 3), cross‐sectional studies (n = 4), self‐controlled case series (n = 1), and economic evaluations (n = 3). Among the included studies, 14 used reverse transcription‐polymerase chain reaction and 10 studies used antigen‐detecting rapid diagnostic test. The settings of the studies were healthcare facilities (n = 8), communities (n = 4), schools, and workplaces (n = 3). Included studies considered symptomatic and asymptomatic individuals, or both, or asymptomatic contacts. Most of the studies (n = 14) reported the COVID‐19 positivity rate as the primary outcome. Other reported outcomes are the number of COVID‐19 cases (n = 11), number of hospitalizations and deaths (n = 3), and cost (n = 3).ConclusionWe identified evidence gaps in the effectiveness of SARS‐CoV‐2 testing strategies, particularly in specific settings such as schools and long‐term care facilities. This scoping review provides a foundation for further research, allowing researchers and stakeholders to focus on addressing the identified gaps.

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Controlling SARS-CoV-2 in schools using repetitive testing strategies

Cited by 8 publications

References 32 publications

Reconstruction of SARS-CoV-2 outbreaks in a primary school using epidemiological and genomic data

Reconstruction of SARS-CoV-2 outbreaks in a primary school using epidemiological and genomic data

Estimating SARS‐CoV‐2 transmission in educational settings: A retrospective cohort study

Effectiveness of SARS‐CoV‐2 testing strategies: A scoping review

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