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Transmission of SARS-CoV-2 in Australian educational settings: a prospective cohort study
- Source :
- The Lancet Child & Adolescent Health, The Lancet. Child & Adolescent Health
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Summary Background School closures have occurred globally during the COVID-19 pandemic. However, empiric data on transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children and in educational settings are scarce. In Australia, most schools have remained open during the first epidemic wave, albeit with reduced student physical attendance at the epidemic peak. We examined SARS-CoV-2 transmission among children and staff in schools and early childhood education and care (ECEC) settings in the Australian state of New South Wales (NSW). Methods Laboratory-confirmed paediatric (aged ≤18 years) and adult COVID-19 cases who attended a school or ECEC setting while considered infectious (defined as 24 h before symptom onset based on national guidelines during the study period) in NSW from Jan 25 to April 10, 2020, were investigated for onward transmission. All identified school and ECEC settings close contacts were required to home quarantine for 14 days, and were monitored and offered SARS-CoV-2 nucleic acid testing if symptomatic. Enhanced investigations in selected educational settings included nucleic acid testing and SARS-CoV-2 antibody testing in symptomatic and asymptomatic contacts. Secondary attack rates were calculated and compared with state-wide COVID-19 rates. Findings 15 schools and ten ECEC settings had children (n=12) or adults (n=15) attend while infectious, with 1448 contacts monitored. Of these, 633 (43·7%) of 1448 had nucleic acid testing, or antibody testing, or both, with 18 secondary cases identified (attack rate 1·2%). Five secondary cases (three children; two adults) were identified (attack rate 0·5%; 5/914) in three schools. No secondary transmission occurred in nine of ten ECEC settings among 497 contacts. However, one outbreak in an ECEC setting involved transmission to six adults and seven children (attack rate 35·1%; 13/37). Across all settings, five (28·0%) of 18 secondary infections were asymptomatic (three infants [all aged 1 year], one adolescent [age 15 years], and one adult). Interpretation SARS-CoV-2 transmission rates were low in NSW educational settings during the first COVID-19 epidemic wave, consistent with mild infrequent disease in the 1·8 million child population. With effective case-contact testing and epidemic management strategies and associated small numbers of attendances while infected, children and teachers did not contribute significantly to COVID-19 transmission via attendance in educational settings. These findings could be used to inform modelling and public health policy regarding school closures during the COVID-19 pandemic. Funding NSW Government Department of Health.
- Subjects :
- Male
Early childhood education
medicine.medical_specialty
Adolescent
Secondary infection
education
Pneumonia, Viral
Population
Attack rate
Article
Education, Distance
Betacoronavirus
03 medical and health sciences
COVID-19 Testing
0302 clinical medicine
030225 pediatrics
Pandemic
Disease Transmission, Infectious
Developmental and Educational Psychology
Humans
Medicine
Pediatrics, Perinatology, and Child Health
030212 general & internal medicine
Child
Prospective cohort study
Pandemics
School Health Services
education.field_of_study
Clinical Laboratory Techniques
SARS-CoV-2
business.industry
Australia
Attendance
COVID-19
Outbreak
Coronavirus
Family medicine
Communicable Disease Control
Quarantine
Pediatrics, Perinatology and Child Health
Female
Coronavirus Infections
business
Subjects
Details
- ISSN :
- 23524642
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- The Lancet Child & Adolescent Health
- Accession number :
- edsair.doi.dedup.....17aaa703ded4b53b2ea141fe914fedee