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Limited SARS-CoV-2 Transmission in Australian Schools

37 Pages Posted: 4 Aug 2020

See all articles by Kristine Macartney

Kristine Macartney

Children’s Hospital at Westmead - The National Centre for Immunisation Research and Surveillance (NCIRS)

Helen E Quinn

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Alexis J Pillsbury

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Archana Koirala

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Lucy Deng

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Noni Winkler

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Anthea L Katelaris

Western Sydney Public Health Unit

Matthew V.N. O'Sullivan

The University of Sydney, Faculty of Medicine and Health

Craig Dalton

School of Medicine and Public Health, University of Newcastle

Nicholas Wood

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

NSW COVID-19 Schools Study Team Group

Independent

More...

Abstract

Background: School closures have occurred globally during the COVID-19 pandemic despite limited data on transmission among children and in educational settings. We examined SARS-CoV-2 transmission among children and staff in Australian schools and early childhood education and care settings (ECECs).

Methods: COVID-19 cases among school and ECEC attendees in New South Wales (NSW) from 25 January–10 April 2020 were investigated for onward transmission. All identified school/ECEC close contacts were monitored and offered SARS-CoV-2 nucleic acid testing (NAT) if symptomatic. Enhanced investigations in selected sites included NAT and SARS-CoV-2 antibody testing in symptomatic and asymptomatic contacts. Secondary attack rates (ARs) were calculated and compared with state-wide COVID-19 rates.

Findings: Fifteen schools and 10 ECECs had children (n=12) or adults (n=15) attend while infectious, with 1448 contacts monitored. Of these, 43·7% (n=633/1448) had NAT and/or antibody testing, with 18 secondary cases identified (AR: 1.2%). In schools (n=3), 5 secondary cases (3 children; 2 adults) were identified (AR: 0·5%; 5/914). No secondary transmission occurred in nine of 10 ECECs among 497 contacts. However, one outbreak in an ECEC involved transmission to 6 adults and 7 children. Across all settings, 28·0% of secondary infections were asymptomatic (n=5/18; 3 infants, 1 adolescent and 1 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, children and teachers did not contribute significantly to COVID-19 transmission via attendance in educational settings.

Funding: NSW Health funded the National Centre for Immunisation Research and Surveillance for the COVID-19 schools transmission study entitled “Enhanced investigation and analysis of education setting-related COVID-19 in NSW”.

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: The study was commissioned by the NSW Department of Health under the Public Health Act 2010 (NSW) and implemented in conjunction with approval and support from the NSW Department of Education.

Keywords: COVID-19, Pandemic, SARS-CoV-2 transmission, Children, Schools

Suggested Citation

Macartney, Kristine and Quinn, Helen E and Pillsbury, Alexis J and Koirala, Archana and Deng, Lucy and Winkler, Noni and Katelaris, Anthea L and O'Sullivan, Matthew V.N. and Dalton, Craig and Wood, Nicholas and Group, NSW COVID-19 Schools Study Team, Limited SARS-CoV-2 Transmission in Australian Schools (6/12/2020). Available at SSRN: https://ssrn.com/abstract=3627287 or http://dx.doi.org/10.2139/ssrn.3627287

Kristine Macartney (Contact Author)

Children’s Hospital at Westmead - The National Centre for Immunisation Research and Surveillance (NCIRS) ( email )

Westmead
Australia

Helen E Quinn

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Alexis J Pillsbury

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Archana Koirala

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Lucy Deng

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Noni Winkler

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead

Anthea L Katelaris

Western Sydney Public Health Unit

Matthew V.N. O'Sullivan

The University of Sydney, Faculty of Medicine and Health

Craig Dalton

School of Medicine and Public Health, University of Newcastle ( email )

Newcastle
Australia

Nicholas Wood

The National Centre for Immunisation Research and Surveillance (NCIRS), The Children’s Hospital at Westmead