Staff–pupil SARS-CoV-2 infection pathways in schools in Wales: a population-level linked data approach

Thompson, Daniel; Abbasizanjani, Hoda; Fry, Richard; Marchant, Emily; Griffiths, Lucy J; Akbari, Ashley; Hollinghurst, Joe; North, Laura; Lyons, Jane; Torabi, Fatemeh; Davies, Gareth; Gravenor, Mike B.; Lyons, Ronan A

doi:10.1136/bmjpo-2021-001049

Cited by 8 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, recent evidence indicates that children below the age of 14 appear to have lower susceptibility to infection and display fewer clinical symptoms [ 2 – 5 ]. Population-level data suggests that whilst transmission risks within school exists, risks are lower compared to within households [ 6 ]. Adults living with young children (0–11 years) during the period after schools reopened encountered no greater risk of COVID-19 infection [ 7 ], and school staff were at no greater risk of COVID-19 infection than other working-age adults [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 mitigation measures in primary schools and association with infection and school staff wellbeing: An observational survey linked with routine data in Wales, UK

et al. 2022

Self Cite

View full text Add to dashboard Cite

Introduction School-based COVID-19 mitigation strategies have greatly impacted the primary school day (children aged 3–11) including: wearing face coverings, two metre distancing, no mixing of children, and no breakfast clubs or extra-curricular activities. This study examines these mitigation measures and association with COVID-19 infection, respiratory infection, and school staff wellbeing between October to December 2020 in Wales, UK. Methods A school staff survey captured self-reported COVID-19 mitigation measures in the school, participant anxiety and depression, and open-text responses regarding experiences of teaching and implementing measures. These survey responses were linked to national-scale COVID-19 test results data to examine association of measures in the school and the likelihood of a positive (staff or pupil) COVID-19 case in the school (clustered by school, adjusted for school size and free school meals using logistic regression). Linkage was conducted through the SAIL (Secure Anonymised Information Linkage) Databank. Results Responses were obtained from 353 participants from 59 primary schools within 15 of 22 local authorities. Having more direct non-household contacts was associated with a higher likelihood of COVID-19 positive case in the school (1–5 contacts compared to none, OR 2.89 (1.01, 8.31)) and a trend to more self-reported cold symptoms. Staff face covering was not associated with a lower odds of school COVID-19 cases (mask vs. no covering OR 2.82 (1.11, 7.14)) and was associated with higher self-reported cold symptoms. School staff reported the impacts of wearing face coverings on teaching, including having to stand closer to pupils and raise their voices to be heard. 67.1% were not able to implement two metre social distancing from pupils. We did not find evidence that maintaining a two metre distance was associated with lower rates of COVID-19 in the school. Conclusions Implementing, adhering to and evaluating COVID-19 mitigation guidelines is challenging in primary school settings. Our findings suggest that reducing non-household direct contacts lowers infection rates. There was no evidence that face coverings, two metre social distancing or stopping children mixing was associated with lower odds of COVID-19 or cold infection rates in the school. Primary school staff found teaching challenging during COVID-19 restrictions, especially for younger learners and those with additional learning needs.

show abstract

Section: Introductionmentioning

confidence: 99%

COVID-19 mitigation measures in primary schools and association with infection and school staff wellbeing: An observational survey linked with routine data in Wales, UK

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Previous research examining transmission in school-aged children found SARS-CoV-2 infections within the household to be the strongest predictor for a subsequent positive SARS-CoV-2 test[34]. Findings in this study that girls are more likely to test positive for SARS-CoV-2 may suggest sex differences between household contact patterns including more repeated, extended contact with household members by girls.…”

Section: Discussionmentioning

confidence: 53%

Pre-COVID-19 pandemic health-related behaviours in children (2018-2020) and association with being tested for SARS-CoV-2 and testing positive for SARS-CoV-2 (2020-2021): a retrospective cohort study using survey data linked with routine health data in Wales, UK

Marchant

Lowthian

Crick

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Objectives Examine if prior health-related behaviours during primary school are associated with being tested for SARS-CoV-2 and testing positive during adolescence. Design Retrospective cohort study using an online cohort survey (1 April 2014 to 28 February 2020) linked to routine PCR SARS-CoV-2 test results (1 March 2020 to 31 August 2021) Setting Children attending primary schools in Wales (2014-2020), UK who were part of the HAPPEN schools network. Participants Complete linked records of eligible participants were obtained for n=6,891 individuals. 43.2% (n=3,021) were tested (baseline age 12.3 ± 2.0, 48% boys) and 11.2% (n=774) tested positive for SARS-CoV-2 (baseline age 12.8 ± 2.1, 43.9% boys). Main outcome measures Logistic regression of health-related behaviours and sex, age, deprivation, clustered by school was used to determine Odds Ratios (OR) of factors associated with being tested for or testing positive for SARS-CoV-2. Results Sleeping 9+ hours (OR=1.15, 95% CI 1.01 to 1.29), participating in 3+ out of school clubs (OR=1.15, 95% CI 1.02 to 1.31), able to swim (OR=1.29, 95% CI 1.10 to 1.52) and ride a bike (OR=1.16, 95% CI 0.98 to 1.37, p<0.1) were associated with being tested for SARS-CoV-2. Participating in 3+ out of school clubs (OR=1.12, 95% CI 1.02 to 1.56), able to ride a bike (OR=1.36, 95% CI 0.97 to 1.92, p<0.1), sex (girl; OR=1.25, 95% CI 1.06 to 1.47) and baseline age (OR=1.16, 95% CI 1.10 to 1.22) were associated with an increased likelihood of testing 1.06 to 1.47 Conclusions Actions associated with a child being PCR-tested and identified as positive may be related to parental health literacy e.g. parents recognising symptoms, knowledge of testing services. Identification of adolescent positive cases may be highly skewed towards children whose parents have higher health literacy. As those not accessing testing services remain undetected true rates of COVID-19 are not known in adolescence.

show abstract

“…Whether the school environment provided increased opportunities for transmission cannot be confirmed here, but we do observe that the increase in infections for students began in July 2021 -after students finished school for the summer. Other studies that use data in pre-Delta and Omicron periods suggest that school is unlikely to be associated with high rates of transmission 9,11 ; however, there appears to be limited research after this period. Statistics from Euro surveillance show a sharp increase in COVID-19 for school-aged children and their household members from August to October 2021, and theorise this was partially attributed to the Delta variant.…”

Section: Discussionmentioning

confidence: 99%

“…We created a national e-cohort of school students, staff and linked household members (details outlined in Thompson et al. 11 ) for both students and staff in Wales (Figure 1). We used anonymised linked population-scale, individual-level data held within the Secure Anonymised Information Linkage (SAIL) Databank at Swansea University to create the e-cohort at an individual and household level.…”

Section: Methodsmentioning

confidence: 99%

“…8 In terms of the education workforce, research is inconsistent as to whether SARS-CoV-2 is more common in school staff than in the community 9 or students. 10 The school’s role in transmission points to community rates being the main predictor of infections, 7,10 with schools being unlikely to play a critical role in transmission 9,11 ; however, most studies focus on the initial and Alpha variant periods, but newer research suggests greater infections due to the Delta variant. 12 Alongside the primary effects of COVID-19, the secondary harms include the negative impact on the mental health and wellbeing of children 13 and the educational workforce.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends in SARS-CoV-2 infection and vaccination in school staff, students and their household members from 2020 to 2022 in Wales, UK: an electronic cohort study

et al. 2023

Self Cite

View full text Add to dashboard Cite

Objectives We investigated SARS-CoV-2 infection trends, risk of SARS-CoV-2 infection and COVID-19 vaccination uptake among school staff, students and their household members in Wales, UK. Design Seven-day average of SARS-CoV-2 infections and polymerase chain reaction tests per 1000 people daily, cumulative incidence of COVID-19 vaccination uptake and multi-level Poisson models with time-varying covariates. Setting National electronic cohort between September 2020 and May 2022 when several variants were predominant in the UK (Alpha, Delta and Omicron). Participants School students aged 4 to 10/11 years (primary school and younger middle school, n = 238,163), and 11 to 15/16 years (secondary school and older middle school, n = 182,775), school staff in Wales ( n = 47,963) and the household members of students and staff ( n = 697,659). Main outcome measures SARS-CoV-2 infection and COVID-19 vaccination uptake. Results School students had a sustained period of high infection rates compared with household members after August 2021. Primary schedule vaccination uptake was highest among staff (96.3%) but lower for household members (72.2%), secondary and older middle school students (59.8%), and primary and younger middle school students (3.3%). Multi-level Poisson models showed that vaccination was associated with a lower risk of SARS-CoV-2 infection. The Delta variant posed a greater infection risk for students than the Alpha variant. However, Omicron was a larger risk for staff and household members. Conclusions Public health bodies should be informed of the protection COVID-19 vaccines afford, with more research being required for younger populations. Furthermore, schools require additional support in managing new, highly transmissible variants. Further research should examine the mechanisms between child deprivation and SARS-CoV-2 infection.

show abstract

Staff–pupil SARS-CoV-2 infection pathways in schools in Wales: a population-level linked data approach

Cited by 8 publications

References 18 publications

COVID-19 mitigation measures in primary schools and association with infection and school staff wellbeing: An observational survey linked with routine data in Wales, UK

COVID-19 mitigation measures in primary schools and association with infection and school staff wellbeing: An observational survey linked with routine data in Wales, UK

Pre-COVID-19 pandemic health-related behaviours in children (2018-2020) and association with being tested for SARS-CoV-2 and testing positive for SARS-CoV-2 (2020-2021): a retrospective cohort study using survey data linked with routine health data in Wales, UK

Trends in SARS-CoV-2 infection and vaccination in school staff, students and their household members from 2020 to 2022 in Wales, UK: an electronic cohort study

Contact Info

Product

Resources

About