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

28 Pages Posted: 25 Aug 2020

See all articles by Sharif A. Ismail

Sharif A. Ismail

Government of the United Kingdom - Immunisation and Countermeasures Division

Vanessa Saliba

Public Health England - Immunisation and Countermeasures Division

Jamie Lopez Bernal

Public Health England Colindale; UK Health Security Agency - COVID-19 Surveillance Cell

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department

Shamez Ladhani

Public Health England - Immunisation and Countermeasures Division; University of London, St. George's, Paediatric Infectious Diseases Research Group

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Abstract

Background: There are limited data on SARS-CoV-2 infection and transmission in educational settings. This information is critical for policy makers and practitioners to ensure the safety of staff, students and the wider community during the COVID-19 pandemic.

Methods: Public Health England initiated enhanced national surveillance following the reopening of educational settings during the summer mini-term on 01 June 2020. COVID-19 related situations in educational settings across England were reviewed daily and followed-up until 31 July 2020. SARS-CoV-2 infection and outbreak rates were calculated for staff and students attending early year settings, primary and secondary schools during June 2020.

Findings: There were 67 single confirmed cases, 4 co-primary cases and 30 COVID-19 outbreaks during June 2020, with a strong correlation between number of outbreaks and regional COVID-19 incidence (0.51 outbreaks for each SARS-CoV-2 infection per 100,000 in the community; p=0.001). Overall, SARS-CoV-2 infections and outbreaks were uncommon across all educational settings. Staff members had an increased risk of SARS-CoV-2 infections compared to students in any educational setting, and the majority of cases linked to outbreaks were in staff. The probable transmission direction for the 30 confirmed outbreaks was: staff-to-staff (n=15), staff-to-student (n=7), student-to-staff (n=6) and student-to-student (n=2).

Interpretation: SARS-CoV2 infections and outbreaks were uncommon in educational settings during the first month after the easing of national lockdown in England. The strong correlation with regional SARS-CoV-2 incidence emphasises the importance of controlling community transmission to protect educational settings. Additional interventions should focus on reducing transmission in and among staff members.

Funding: None

Declaration of Interests: The authors declare no conflicts of interest.

Ethics Approval Statement: PHE has legal permission, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002, to process patient confidential information for national surveillance of communicable diseases and as such, individual patient consent is not required.

Keywords: SARS-CoV-2, COVID-19, schools, children, transmission, outbreak

Suggested Citation

Ismail, Sharif A. and Saliba, Vanessa and Bernal, Jamie Lopez and Ramsay, Mary E. and Ladhani, Shamez, SARS-CoV-2 Infection and Transmission in Educational Settings: Cross-Sectional Analysis of Clusters and Outbreaks in England. Available at SSRN: https://ssrn.com/abstract=3675431 or http://dx.doi.org/10.2139/ssrn.3675431

Sharif A. Ismail (Contact Author)

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Vanessa Saliba

Public Health England - Immunisation and Countermeasures Division

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Jamie Lopez Bernal

Public Health England Colindale ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

UK Health Security Agency - COVID-19 Surveillance Cell ( email )

United Kingdom

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department ( email )

United Kingdom

Shamez Ladhani

Public Health England - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

University of London, St. George's, Paediatric Infectious Diseases Research Group

United Kingdom