COVID-19 LITERATURE SITUATION REPORT DEC. 9, 2020

The risk of SARS-CoV-2 infections and outbreaks were low in educational settings since reopening in the summer half-term in England, with the likelihood of a school outbreak strongly associated with the regional level of COVID-19 incidence. A prospective cohort study among 57,600 educational settings in England reported that there were 113 educational settings in which a single infected individual was identified, nine settings in which two or more cases were detected within 48 hours (no evidence of a chain of transmission), and 55 outbreaks (at least two epidemiologically linked cases, with sequential cases diagnosed within 14 days in the same educational setting). The outbreaks involved 210 epidemiologically linked cases. This analysis corresponds to a reopening period from June 1-July 17, 2020, with enhanced surveillance after the first national lockdown. 

The risk of outbreaks increased by 72% for every five cases per 100,000 population increase in community incidence (p<0.0001). Most cases linked to outbreaks (73% of 210) were in staff members and the median number of secondary cases in outbreaks was 1 (IQR 1–2) for student index cases and 1 (IQR 1–5) for staff index cases. Staff-to-staff transmission was most common, while  student-to-student transmission was rare.

Ismail et al. (Dec 9, 2020). SARS-CoV-2 Infection and Transmission in Educational Settings: A Prospective, Cross-Sectional Analysis of Infection Clusters and Outbreaks in England. The Lancet Infectious Diseases. https://doi.org/10.1016/S1473-3099(20)30882-3 

Data pertaining to symptoms of anxiety and depression collected from adults during the first 20 weeks of lockdown in England suggest that poor mental health was most prevalent during the early days of lockdown. Researchers observed a sharp decline in both depressive symptoms and anxiety as early as the second week of lockdown, suggesting rapid adaptation to circumstances. Although inequalities in mental health experiences persisted for the entire 20-week period, some groups, including women, younger adults, and individuals with lower educational attainment, had faster improvements in symptoms.

Fancourt et al. (2020). Trajectories of Anxiety and Depressive Symptoms during Enforced Isolation Due to COVID-19: Longitudinal Analyses of 36,520 Adults in England. The Lancet Psychiatry. https://doi.org/10.1101/2020.06.03.20120923

To address inconsistencies in how policies related to closing and reopening elements of society are described and analyzed, researchers developed a framework to categorize the various policies in place in 12 US states. A comparative content analysis using a 16-element framework, including domains such as bars, restaurants, childcare, and religious gatherings,  revealed high granularity and nuance between state-level policy taxonomies, with some domains (e.g. restaurants and movie theaters) showing bimodal policy intensity distributions compatible with binary (yes/no) coding, and some domains (e.g. childcare and religious gatherings) showing broader variability that would be missed without more granular coding. The framework may be useful for describing specific stages of closing and reopening, as well as for comparing the effects of different policies in various areas.

Lane et al. (Dec 8, 2020). Strengthening Policy Coding Methodologies to Improve COVID-19 Disease Modeling and Policy Responses: A Proposed Coding Framework and Recommendations. BMC Medical Research Methodology. https://doi.org/10.1186/s12874-020-01174-w

[Preprint, not peer-reviewed] Using publicly available neighborhood-level data on COVID-19 cases from 58 US urban counties and the two largest cities in Canada, Saha et al. reported a consistent finding that the most racially and/or economically privileged neighborhoods had the lowest rates of COVID-19 cases and deaths. No consistent trends were found for the relationship between SARS-CoV-2 testing rates and neighborhood deprivation.

Saha et al. (Dec 9, 2020). Neighbourhood-Level Racial/Ethnic and Economic Inequities in COVID-19 Burden Within Urban Areas in the US and Canada. Pre-print downloaded Dec 9 from https://www.medrxiv.org/content/10.1101/2020.12.07.20241018v1