COVID-19 Outbreaks Following Full Reopening of Primary and Secondary Schools in England: Retrospective, Cross-Sectional National Surveillance

31 Pages Posted: 5 Feb 2021

See all articles by Felicity Aiano

Felicity Aiano

Public Health England - Immunisation and Countermeasures Division

Anna Mensah

Government of the United Kingdom - Immunisation and Countermeasures Division

Kelsey McOwat

Public Health England - Immunisation and Countermeasures Division

Chinelo Obi

Public Health England - Immunisation and Countermeasures Division

Amoolya Vusirikala

Public Health England Colindale

Annabel A. Powell

Public Health England - Immunisation and Countermeasures Division

Jessica Flood

Public Health England - Immunisation and Countermeasures Division

Johanna Bosowski

Public Health England - Immunisation and Countermeasures Division

Louise Letley

Public Health England - Immunisation and Countermeasures Division

Samuel Jones

Public Health England - Immunisation and Countermeasures Division

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division

Joanne Lacy

Immunisation and Countermeasures Division, Public Health England

Iain Hayden

Immunisation and Countermeasures Division, Public Health England

Sharif A. Ismail

Government of the United Kingdom - Immunisation and Countermeasures Division

Mary E. Ramsay

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

Shamez N. Ladhani

Government of the United Kingdom - Immunisation and Countermeasures Division; St. George’s University of London - Paediatric Infectious Diseases Research Group

Vanessa Saliba

Government of the United Kingdom - Immunisation and Countermeasures Division

Multiple version iconThere are 2 versions of this paper

Date Written: January 14, 2021

Abstract

Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England.

Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted to complete an online questionnaire.

Interpretation: There were 969 primary (n=450) and secondary school outbreaks (n=519) reported to PHE, representing 3% of primary schools and 15% of secondary schools in England. Of the 369 schools contacted, 190 geographically-representative schools completed the questionnaire; 2,425 cases were reported. Secondary school students (1.20%; 95%CI, 1.13-1.28%) had higher attack rates than primary school students (0.84%; 95%CI, 0.75-0.94%). Outbreaks were larger and across more year groups in secondary schools than in primary schools. When an outbreak occurred, attack rates were higher in staff (926/19,083; 4.85%; 95%CI, 4.55-5.17%) than students, especially among primary school teaching staff (9.81%; 95%CI, 8.90-10.82%) compared to secondary school teaching staff (3.97%; 95%CI, 3.79-5.69%). Staff represented 59% (471/799) of cases in primary school outbreaks and 27% (410/1515) in secondary schools (P<0.001). Teaching staff were more likely to be the index case in primary (48/100, 48%) than in secondary (25/79, 32%) schools (P=0.027).

Conclusions: Secondary schools were more likely to be affected by a COVID-19 outbreak than primary schools and to experience larger outbreaks across multiple school years. The higher attack rate among teaching staff during an outbreak suggests that additional protective measures may be needed.

Funding: PHE

Note: Funding: This surveillance was internally funded by PHE and did not receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors.

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

JEL Classification: G

Suggested Citation

Aiano, Felicity and Mensah, Anna and McOwat, Kelsey and Obi, Chinelo and Vusirikala, Amoolya and Powell, Annabel A. and Flood, Jessica and Bosowski, Johanna and Letley, Louise and Jones, Samuel and Amin-Chowdhury, Zahin and Lacy, Joanne and Hayden, Iain and Ismail, Sharif A. and Ramsay, Mary E. and Ladhani, Shamez N. and Saliba, Vanessa, COVID-19 Outbreaks Following Full Reopening of Primary and Secondary Schools in England: Retrospective, Cross-Sectional National Surveillance (January 14, 2021). Available at SSRN: https://ssrn.com/abstract=3766014 or http://dx.doi.org/10.2139/ssrn.3766014

Felicity Aiano

Public Health England - Immunisation and Countermeasures Division

London
United Kingdom

Anna Mensah

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

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Kelsey McOwat

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Chinelo Obi

Public Health England - Immunisation and Countermeasures Division

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

Amoolya Vusirikala

Public Health England Colindale

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Annabel A. Powell

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Jessica Flood

Public Health England - Immunisation and Countermeasures Division

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Johanna Bosowski

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Louise Letley

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Samuel Jones

Public Health England - Immunisation and Countermeasures Division

London
United Kingdom

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Joanne Lacy

Immunisation and Countermeasures Division, Public Health England

Iain Hayden

Immunisation and Countermeasures Division, Public Health England

Sharif A. Ismail

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

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Mary E. Ramsay

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

United Kingdom

Shamez N. Ladhani (Contact Author)

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

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

St. George’s University of London - Paediatric Infectious Diseases Research Group

London
United Kingdom

Vanessa Saliba

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

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

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