Secondary Attack Rates in Primary and Secondary School Bubbles Following a Confirmed Case: Active, Prospective National Surveillance, November to December 2020, England

24 Pages Posted: 3 Sep 2021

See all articles by Annabel Powell

Annabel Powell

Public Health England - Immunisation and Countermeasures Division

Georgina Ireland

Public Health England

Frances Baawuah

Government of the United Kingdom - Public Health England Colindale

Joanne Beckmann

East London NHS Foundation Trust

Ifeanichukwu Okike

Derbyshire Healthcare NHS Foundation Trust

Shazaad Ahmad

The University of Manchester - Manchester University NHS Foundation Trust

Joanna Garstang

Birmingham Community Healthcare NHS Trust

Andrew J. Brent

Oxford University Hospitals NHS Foundation Trust

Bernadette Brent

Oxford University Hospitals NHS Foundation Trust

Felicity Aiano

Government of the United Kingdom - Public Health England Colindale; UK Health Security Agency

James Hargreaves

London School of Hygiene & Tropical Medicine - Faculty of Public Health and Policy

Sinéad Langan

London School of Hygiene & Tropical Medicine

Punam Mangtani

London School of Hygiene and Tropical Medicine

Patrick Nguipdop-Djomo

London School of Hygiene and Tropical Medicine

Joanna Sturgess

London School of Hygiene and Tropical Medicine

William E. Oswald

London School of Hygiene & Tropical Medicine - Department of Disease Control

Katherine Halliday

London School of Hygiene & Tropical Medicine - Faculty of Infectious and Tropical Diseases

Emma Rourke

Office for National Statistics

Fiona Dawe

Office for National Statistics

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division

Meaghan Kall

Public Health England Colindale; UK Health Security Agency - COVID-19 National Epidemiology Cell; UK Health Security Agency - COVID-19 Vaccines and Epidemiology Division

Maria Zambon

Public Health England - Virus Reference Department

John Poh

Public Health England

Samreen Ijaz

Blood Borne Virus Unit, National Infection Service, Colindale Public Health England

Angie Lackenby

Virus Reference Department, Public Health England

Joanna Ellis

Government of the United Kingdom - Public Health England

Kevin Brown

Public Health England

Ian Diamond

Office for National Statistics

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

Date Written: July 29, 2021

Abstract

Background: Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members.

Methods: Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies.

Results: During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6/60) in primary and 3.9% (4/102) in secondary school students, compared to 6.3% (1/16) and 0% (0/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12/183) and 3.7% (1/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11/317) and 0% (0/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts.

Interpretation: Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.

Note: Funding: This surveillance was funded by the Department of Health and Social Care (DHSC) and Public Health England (PHE).

Declaration of Interests: None.

Ethics Approval Statement: This investigation was undertaken as part of PHE’s duty, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002 to (a) diagnose communicable diseases and other risks to public health; (b) recognise trends in such diseases and risks; (c) control and prevent the spread of such diseases and risks; and (d) monitor and manage outbreaks of communicable disease and incidents of exposure to communicable disease. Participants were considered recruited once they provided online consent and completed the online questionnaire. Participants were also asked obtain consent from other household members. Parents gave consent for their children all students (aged <16 years) Other household members also provided consent. All consent was undertake online using the snapsurvey questionnaire platform. Participants could not be recruited unless they provided online consent (adults for themselves, parents for children) and completed an online recruitment questionnaire

Keywords: COVID-19; SARS-CoV-2; Schools; Transmission; Contacts; Testing; Secondary Attack Rate

Suggested Citation

Powell, Annabel and Ireland, Georgina and Baawuah, Frances and Beckmann, Joanne and Okike, Ifeanichukwu and Ahmad, Shazaad and Garstang, Joanna and Brent, Andrew J. and Brent, Bernadette and Aiano, Felicity and Hargreaves, James and Langan, Sinéad and Mangtani, Punam and Nguipdop-Djomo, Patrick and Sturgess, Joanna and Oswald, William E. and Halliday, Katherine and Rourke, Emma and Dawe, Fiona and Amin-Chowdhury, Zahin and Kall, Meaghan and Zambon, Maria and Poh, John and Ijaz, Samreen and Lackenby, Angie and Ellis, Joanna and Brown, Kevin and Diamond, Ian and Ramsay, Mary E. and Ladhani, Shamez, Secondary Attack Rates in Primary and Secondary School Bubbles Following a Confirmed Case: Active, Prospective National Surveillance, November to December 2020, England (July 29, 2021). Available at SSRN: https://ssrn.com/abstract=3895741 or http://dx.doi.org/10.2139/ssrn.3895741

Annabel Powell

Public Health England - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Georgina Ireland

Public Health England ( email )

Frances Baawuah

Government of the United Kingdom - Public Health England Colindale

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Joanne Beckmann

East London NHS Foundation Trust ( email )

Ifeanichukwu Okike

Derbyshire Healthcare NHS Foundation Trust ( email )

Shazaad Ahmad

The University of Manchester - Manchester University NHS Foundation Trust

Oxford Road
Manchester, M13 9PL
United Kingdom

Joanna Garstang

Birmingham Community Healthcare NHS Trust ( email )

Andrew J. Brent

Oxford University Hospitals NHS Foundation Trust ( email )

Bernadette Brent

Oxford University Hospitals NHS Foundation Trust ( email )

Felicity Aiano

Government of the United Kingdom - Public Health England Colindale ( email )

UK Health Security Agency ( email )

James Hargreaves

London School of Hygiene & Tropical Medicine - Faculty of Public Health and Policy ( email )

15-17 Tavistock Place
London, WC1H 9SH
United Kingdom

Sinéad Langan

London School of Hygiene & Tropical Medicine ( email )

Punam Mangtani

London School of Hygiene and Tropical Medicine

Keppel Street
London, WC1E 7HT
United Kingdom

Patrick Nguipdop-Djomo

London School of Hygiene and Tropical Medicine ( email )

Keppel Street
London, WC1E 7HT
United Kingdom

Joanna Sturgess

London School of Hygiene and Tropical Medicine ( email )

Keppel Street
London, WC1E 7HT
United Kingdom

William E. Oswald

London School of Hygiene & Tropical Medicine - Department of Disease Control ( email )

London, WC1E 7HT
United Kingdom

Katherine Halliday

London School of Hygiene & Tropical Medicine - Faculty of Infectious and Tropical Diseases ( email )

Keppel St.
Bloomsbury, London, WC1E 7HT
United Kingdom

Emma Rourke

Office for National Statistics ( email )

London, SW1A 2AA
United Kingdom

Fiona Dawe

Office for National Statistics ( email )

London, SW1A 2AA
United Kingdom

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Meaghan Kall

Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

UK Health Security Agency - COVID-19 National Epidemiology Cell ( email )

London
United Kingdom

UK Health Security Agency - COVID-19 Vaccines and Epidemiology Division ( email )

Maria Zambon

Public Health England - Virus Reference Department ( email )

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

John Poh

Public Health England ( email )

Samreen Ijaz

Blood Borne Virus Unit, National Infection Service, Colindale Public Health England ( email )

Angie Lackenby

Virus Reference Department, Public Health England

Joanna Ellis

Government of the United Kingdom - Public Health England ( email )

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

Kevin Brown

Public Health England ( email )

Wellington House,
133-155 Waterloo Rd,
London, SE1 8UG

Ian Diamond

Office for National Statistics ( email )

London, SW1A 2AA
United Kingdom

Mary E. Ramsay

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

United Kingdom

Shamez Ladhani (Contact Author)

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

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
106
Abstract Views
1,068
Rank
485,509
PlumX Metrics