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Observational Study
. 2021 Apr;82(4):67-74.
doi: 10.1016/j.jinf.2021.02.022. Epub 2021 Feb 25.

SARS-CoV-2 infections in children following the full re-opening of schools and the impact of national lockdown: Prospective, national observational cohort surveillance, July-December 2020, England

Anna A Mensah  1 , Mary Sinnathamby  1 , Asad Zaidi  2 , Laura Coughlan  1 , Ruth Simmons  1 , Sharif A Ismail  3 , Mary E Ramsay  1 , Vanessa Saliba  1 , Shamez N Ladhani  4
Affiliations
Observational Study

SARS-CoV-2 infections in children following the full re-opening of schools and the impact of national lockdown: Prospective, national observational cohort surveillance, July-December 2020, England

Anna A Mensah et al. J Infect. 2021 Apr.

Abstract

Introduction: The reopening of schools during the COVID-19 pandemic has raised concern for the safety of staff and students, their families and the wider community. We monitored SARS-CoV-2 infection rates in school-aged children and compared them with adult infection rates before and after schools reopened in England.

Methods: Public Health England receives daily electronic reports of all SARS-CoV-2 tests nationally. SARS-CoV-2 infection rates by school year from July to December 2020 were analysed, including the effect of a national month-long lockdown whilst keeping schools open in November 2020 RESULTS: SARS-CoV-2 infections rates were low during early summer but started increasing in mid-August, initially in young adults followed by secondary and then primary school-aged children prior to schools reopening in September 2020. Cases in school-aged children lagged behind and followed adult trends after schools reopened, with a strong age gradient in weekly infection rates. There was a strong (P<0.001) correlation in regional infection rates between adults and secondary (R2=0.96-0.98), primary (R2=0.93-0.94) and preschool-aged (R2=0.62-0.85) children. The November lockdown was associated with declines in adult infection rates, followed a week later, by declines in student cases. From 23 November 2020, cases in adults and children increased rapidly following the emergence of a more transmissible novel variant of concern (VOC-202,012/01; B.1.1.7).

Conclusions: In school-aged children, SARS-CoV-2 infections followed the same trajectory as adult cases and only declined after national lockdown was implemented whilst keeping schools open. Maintaining low community infection rates is critical for keeping schools open during the pandemic.

Keywords: COVID-19; Children; SARS-CoV-2; Schools; Transmission.

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Conflict of interest statement

Declaration of Competing Interest We declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Weekly infection rates of confirmed COVID-19 cases per 100,000 population per age cohort, England.
Fig. 2
Fig. 2
Weekly infection rates of confirmed COVID-19 cases per 100,000 population for each school cohort and adult age groups, England.
Fig. 3
Fig. 3
Weekly COVID-19 test rates per 100,000 population and weekly COVID-19 positivity rates for preschool, primary and secondary school birth cohorts, England.
Fig. 4
Fig. 4
Regional weekly infection rates of confirmed COVID-19 cases per 100,000 population for school cohorts and adult age groups, England.
Fig. 5
Fig. 5
Correlation between weekly SARS-CoV-2 infection rates in adults (18–64 years old) and school cohorts across the nine different regions in England, along with linear regression, correlation coefficient and coefficient of determination R² for the week starting (A) 27 July 2020 (low community infection rates) and (B) 19 October 2020 (low community infection rates).
See this image and copyright information in PMC

References

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