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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
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+

doi.org/10.1101/2020.0…

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.

eurosurveillance.org/content/10.280…

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.

academic.oup.com/cid/advance-ar…

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

doi.org/10.1101/2020.0…

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

eurosurveillance.org/content/10.280…

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

academic.oup.com/cid/article/do…

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

doi.org/10.1016/S2352-…

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)

cdc.gov/mmwr/volumes/6…

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

medrxiv.org/content/10.110…

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
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Keep Current with Alasdair Munro

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