Updated: August 29, 2020 9:37:12 am
A new study carried out by Public Health England (PHE) detected 67 single Covid-19 cases and 30 outbreaks in schools across England in June. Concluding that coronavirus outbreaks and infections in schools are “rare” and that “children were more likely to acquire SARS-CoV-2 infection at home than in school”, the report has implications for policymakers as they take decisions involving re-opening schools.
What does the study say?
Starting June 1, the PHE initiated a national surveillance through which Covid-19 related situations in educational institutions across England were reviewed and followed up until July 31. Infection and outbreak rates were calculated for staff and students attending early year settings, primary and secondary schools.
The study concludes that there was a strong correlation between the number of outbreaks and regional Covid-19 incidence and that staff members had an increased risk of infection than students.
The study identified 198 confirmed cases (70 in children and 128 in staff members) of the coronavirus after schools reopened in June. This means that out of an estimated 1 million children who attended pre-school and primary school in June, only 70 were infected.
Among the 30 outbreaks noted in the study, over 15 were staff to staff transmission, seven involved staff to student transmission, six involved transmission from student to staff and two were student to student transmissions.
Where did the children acquire the infection from?
The study notes that the students who were infected mostly acquired it at home, usually from a key worker or a healthcare worker parent. Most children were asymptomatic and were identified as part of contact tracing after their parents developed Covid-19 symptoms. The study also found “very little” transmission between the students, “which is consistent with emerging literature for preschool and primary school students”.
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What we know about children and coronavirus
In the initial phases of the pandemic, it was believed that children are not strong spreaders of the disease, but studies conducted recently suggest that children may be able to spread the disease as much as adults. One Italian study published last month suggested that although child contacts of positive cases were less likely to become cases themselves, children were more likely to infect household members.
Another study published in JAMA Pediatrics assessed levels of virus genetic material in the nose, among 145 cases of mild to moderate Covid-19 within the first week of symptom onset. The viral load was compared in three age groups – children under 5, children aged 5-17, and adults. The study found that virus levels were much higher in children under 5 compared with the other two groups. The findings point to the possibility that the youngest children transmit the virus as much as other age groups, the Ann & Robert H Lurie Children’s Hospital of Chicago said in a statement.
On the contrary, a study from Switzerland published in the American Academy of Pediatrics’ journal Pediatrics suggested that children most frequently acquire Covid-19 from adults, rather than transmitting it to them.
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What are the limitations of the study?
Before the results of this study are applied generally, the authors note, it is important to consider that educational settings opened in England only in regions with low community transmission. Further, the institutions that did open had stringent social distancing and infection control measures in place and there were also strict protocols for class and bubble sizes, “which may not be achievable when schools open fully in the next academic year”.
Significantly, of the 8.9 million students in England, only 1.6 million attended school during the period in consideration.
What does this mean?
Overall, the study concludes that coronavirus infections were uncommon in educational settings in England and infections in schools mostly involved staff members, which means further interventions are required to protect this group.
The study also acknowledges the importance of controlling the disease in a community, since there is a “strong correlation” between Covid-19 outbreaks in schools and the regional incidence of the infection.
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