School reopening without robust COVID-19 mitigation risks accelerating the pandemic

Gurdasani, Deepti; Alwan, Nisreen A; Greenhalgh, Trisha; Hyde, Zoë; Johnson, Luke R.; McKee, Martin; Michie, Susan; Prather, Kimberly A.; Rasmussen, Sarah Dean; Reicher, Stephen; Roderick, Paul; Ziauddeen, Hisham

doi:10.1016/s0140-6736(21)00622-x

Cited by 69 publications

(76 citation statements)

References 6 publications

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“…A study of lower-secondary schools in Sweden suggested a minor impact on the overall spread [ 28 ]. The contribution of in-school transmission in the community is still subject to much debate [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 transmission in students of public schools of Catalonia (Spain) after a month of reopening

et al. 2021

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Introduction SARS-CoV-2 transmission within schools and its contribution to community transmission are still a matter of debate. Methods A retrospective cohort study in all public schools in Catalonia was conducted using publicly available data assessing the association between the number of reported SARS-CoV-2 cases among students and staff in weeks 1–2 (Sept 14-27th, 2020) of the academic year with school SARS-CoV-2 incidence among students in weeks 4–5. A multilevel Poisson regression model adjusted for the community incidence in the corresponding basic health area (BHA) and the type of school (primary or secondary), with random effects at the sanitary region and BHA levels, was performed. Results A total of 2184 public schools opened on September 14th with 778,715 students. Multivariate analysis showed a significant association between the total number of SARS-CoV-2 cases in a centre in weeks 1–2 and the SARS-CoV-2 school incidence among students in weeks 4–5 (Risk Ratio (RR) 1.074, 95% CI 1.044–1.105, p-value <0.001). The adjusted BHA incidence in the first two weeks was associated with school incidence in weeks 4–5 (RR 1.002, 95% CI 1.002–1.003, p-value <0.001). Secondary schools showed an increased incidence in weeks 4 and 5 (RR primary vs secondary 1.709 95% CI 1.599–1.897, p-value <0.001). Conclusions Safety measures adopted by schools were not enough to stop related-to-school transmission in students and could be improved. The safest way to keep schools open is to reduce community transmission down to a minimum.

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 transmission in students of public schools of Catalonia (Spain) after a month of reopening

et al. 2021

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“…However, because the infection probability was not zero in any predictable circumstance, protective measures such as masks and distancing should always be maintained [34]. Moreover, all municipalities must prioritize the goal of high vaccination coverage [35].…”

Section: Discussionmentioning

confidence: 99%

Integrating epidemiological and clinical predictors of SARS-CoV-2 infection in students and school staff in the state of São Paulo

Díaz-Quijano

Silva

D’Agostini

et al. 2021

Preprint

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BackgroundThere is a great deal of uncertainty concerning which contexts would be safe for returning to school and about individual criteria that would reduce contact between the infected and susceptible people in the school setting. Therefore, the purpose of this study was to estimate the prevalence of infection by SARS-CoV-2 in students and school staff; and to identify predictors of infection, including both municipal epidemiological indicators and individual variables reported by the participants.MethodsThis was a virological survey carried out among students (over 14 years old) and school staff in São Paulo state, between epidemiological weeks 43 to 49 of the year 2020. A self-administrated questionnaire including sociodemographic and clinical information was applied. Moreover, a nasopharynx swab was performed for virological testing (RT-PCR). We evaluate the relationship of COVID-19 epidemiological indicators of the residence municipality with the odds of SARS-CoV-2 infection. For this, a composite index relating recent mortality and previous incidence (RM/PI) was proposed based on the ratio of deaths recorded in the second and third week counted back to the sum of cases during the previous seven weeks (weeks 4 to 10 counted back). We obtained a multiple model using random-effects logit regression integrating epidemiological indicators and individual variables.ResultsIn total, 3436 participants were included, residents of 72 municipalities. The overall prevalence of infection was 1.7% (95%CI: 1.3%-2.2%). SARS-CoV-2 infection was independently associated with loss of smell, a history of pulmonary disease, and a recent trip outside the municipality. Moreover, the RM/PI index consistently predicted the SARS-CoV-2 infection (adjusted OR: 1.45; 95%CI 1.02-2.04). Based on these associations, we proposed a classification in four groups with different SARS-Cov-2 infection prevalence (0.54%, 1.27%, 3.8%, and 4.13%).ConclusionEpidemiological and individual variables allowed classifying groups according to the infection probability in a school population of the state of São Paulo. This classification could help guide the return to classes in situations in which epidemiological control is evident, maintaining basic protection measures and increasing vaccination coverage.

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“…Tanto los modelos matemáticos como los datos del mundo real sugieren que la apertura de todas las escuelas sin medidas de mitigación sólidas probablemente conduzcan a que la Rt se eleve por encima de 1 en casi todos los escenarios (es decir, crecimiento exponencial de los contagios) 29 . Las mitigaciones de varios niveles pueden reducir sustancialmente el riesgo de transmisión dentro de las escuelas y los hogares 30 .…”

Section: Cierre Vs Apertura Escolar ¿Cuándo Cómo Y Durante Cuánto Tiempo?unclassified

La suspensión de la presencialidad escolar: un resumen de la evidencia disponible a nivel internacional respecto de su efectividad para contener la actual pandemia de COVID-19

Ciapponi

2021

Evid actual pract ambul

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Tomando como excusa el análisis crítico del reciente informe suscripto por profesionales del Instituto de Cálculo de la Facultad de Ciencias Exactas y Naturales (UBA–CONICET) respecto del impacto de la suspensión de la presencialidad escolar como medida de control de la pandemia de COVID-19, que generó gran debate en Argentina, el autor de este artículo resume la evidencia a nivel internacional proveniente de revisiones sistemáticas sobre la eficacia y seguridad de este tipo de intervenciones, deteniéndose en cuándo, cómo y durante cuánto tiempo es razonable aplicarla. Por último, reflexiona y esboza propuestas que ayuden a fortalecer la racionalidad en la toma de decisiones.

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School reopening without robust COVID-19 mitigation risks accelerating the pandemic

Cited by 69 publications

References 6 publications

SARS-CoV-2 transmission in students of public schools of Catalonia (Spain) after a month of reopening

SARS-CoV-2 transmission in students of public schools of Catalonia (Spain) after a month of reopening

Integrating epidemiological and clinical predictors of SARS-CoV-2 infection in students and school staff in the state of São Paulo

La suspensión de la presencialidad escolar: un resumen de la evidencia disponible a nivel internacional respecto de su efectividad para contener la actual pandemia de COVID-19

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