SARS-CoV-2 screening testing in schools for children with intellectual and developmental disabilities

Abstract

Background Transmission of SARS-CoV-2 in schools primarily for typically developing children is rare. However, less is known about transmission in schools for children with intellectual and developmental disabilities (IDD), who are often unable to mask or maintain social distancing. The objectives of this study were to determine SARS-CoV-2 positivity and in-school transmission rates using weekly screening tests for school staff and students and describe the concurrent deployment of mitigation strategies in six schools for children with IDD. Methods From November 23, 2020, to May, 28, 2021, weekly voluntary screening for SARS-CoV-2 with a high sensitivity molecular-based saliva test was offered to school staff and students. Weekly positivity rates were determined and compared to local healthcare system and undergraduate student screening data. School-based transmission was assessed among participants quarantined for in-school exposure. School administrators completed a standardized survey to assess school mitigation strategies. Results A total of 59 students and 416 staff participated. An average of 304 school staff and students were tested per week. Of 7289 tests performed, 21 (0.29%) new SARS-CoV-2 positive cases were identified. The highest weekly positivity rate was 1.2% (n = 4) across all schools, which was less than community positivity rates. Two cases of in-school transmission were identified, each among staff, representing 2% (2/103) of participants quarantined for in-school exposure. Mitigation strategies included higher than expected student mask compliance, reduced room capacity, and phased reopening. Conclusions During 24 weeks that included the peak of the COVID-19 pandemic in winter 2020-21, we found lower rates of SARS-CoV-2 screening test positivity among staff and students of six schools for children with IDD compared to community rates. In-school transmission of SARS-CoV-2 was low among those quarantined for in-school exposure. However, the impact of the emerging SARS-CoV-2 Delta variant on the effectiveness of these proven mitigation strategies remains unknown. Trial registration Prior to enrollment, this study was registered at ClinicalTrials.gov on September 25, 2020, identifier NCT04565509, titled Supporting the Health and Well-being of Children with Intellectual and Developmental Disability During COVID-19 Pandemic.

Comparison of Saliva and Midturbinate Swabs for Detection of SARS-CoV-2

“…With that, we should also note that self-collected saliva samples may have limitations in some settings where MTS or anterior nasal swabs might be preferable. For small children or people with intellectual and developmental disabilities (IDD), the collection of saliva may require supervision or assistance ( 26 ). However, in a study with students and staff from six schools dedicated to children with IDD as the study population, investigators found that with the help of nurses and teachers, saliva samples could be collected from students for weekly testing ( 26 ).…”

“…For small children or people with intellectual and developmental disabilities (IDD), the collection of saliva may require supervision or assistance ( 26 ). However, in a study with students and staff from six schools dedicated to children with IDD as the study population, investigators found that with the help of nurses and teachers, saliva samples could be collected from students for weekly testing ( 26 ). In addition, for some people, especially those who are febrile or dehydrated, the saliva samples could be thick and stringy, hence adding difficulty and additional procedures for the laboratory staff to process the samples ( 27 , 28 ).…”

COVID‐19 Related Facilitators and Barriers to In‐Person Learning for Children With Intellectual and Development Disabilities: A Follow‐Up

“…We conducted a qualitative study to understand how COVID‐19 affected the school experience for staff, families, and students, and the impact of a weekly SARS‐CoV‐2 screening testing program 6,17 . The Washington University Institutional Review Board approved this study.…”

A modern view on the clinical value of the study of oral fluid in the practice of a pediatrician

“…Подчеркивают, что при наблюдении за контактными людьми этот тест может быть самостоятельной альтернативой [22]. Высокочувствительный молекулярный тест со слюной полезен при обследовании детей школьного возраста [23]. Исследование слюны представлено в качестве альтернативы при обследовании детей с инфекцией COVID-19 для поиска диагностических и прогностических маркеров [24].…”