Alliance for Pandemic Preparedness

December 9, 2020

SARS-CoV-2 Infection and Transmission in Educational Settings: A Prospective, Cross-Sectional Analysis of Infection Clusters and Outbreaks in England

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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