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. 2022 Jan 29;74(2):319-326.
doi: 10.1093/cid/ciab332.

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in a Georgia School District-United States, December 2020-January 2021

Jenna R Gettings  1   2   3 , Jeremy A W Gold  2   3 , Anne Kimball  2   3 , Kaitlin Forsberg  2 , Colleen Scott  2 , Anna Uehara  2 , Suxiang Tong  2 , Marisa Hast  2 , Megan R Swanson  2 , Elana Morris  2 , Emeka Oraka  2   4 , Olivia Almendares  2 , Ebony S Thomas  1 , Lemlem Mehari  5 , Jazmyn McCloud  5 , Gurleen Roberts  5 , Deanna Crosby  5 , Abirami Balajee  2   6 , Eleanor Burnett  2 , Rebecca J Chancey  2 , Peter Cook  2 , Morgane Donadel  2 , Catherine Espinosa  2 , Mary E Evans  2 , Katherine E Fleming-Dutra  2 , Catalina Forero  2 , Esther A Kukielka  2   3 , Yan Li  2 , Paula L Marcet  2 , Kiren Mitruka  2 , Jasmine Y Nakayama  2   3 , Yoshinori Nakazawa  2 , Michelle O'Hegarty  2 , Caroline Pratt  2   3 , Marion E Rice  2 , Roxana M Rodriguez Stewart  2 , Raquel Sabogal  2 , Emanny Sanchez  2 , Andres Velasco-Villa  2 , Mark K Weng  2 , Jing Zhang  2 , Grant Rivera  7 , Tonia Parrott  8 , Rachel Franklin  5 , Janet Memark  5 , Cherie Drenzek  1 , Aron J Hall  2 , Hannah L Kirking  2 , Jacqueline E Tate  2 , Snigdha Vallabhaneni  2
Affiliations

Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in a Georgia School District-United States, December 2020-January 2021

Jenna R Gettings et al. Clin Infect Dis. .

Abstract

Background: To inform prevention strategies, we assessed the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and settings in which transmission occurred in a Georgia public school district.

Methods: During 1 December 2020-22 January 2021, SARS-CoV-2-infected index cases and their close contacts in schools were identified by school and public health officials. For in-school contacts, we assessed symptoms and offered SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) testing; performed epidemiologic investigations and whole-genome sequencing to identify in-school transmission; and calculated secondary attack rate (SAR) by school setting (eg, sports, elementary school classroom), index case role (ie, staff, student), and index case symptomatic status.

Results: We identified 86 index cases and 1119 contacts, 688 (61.5%) of whom received testing. Fifty-nine of 679 (8.7%) contacts tested positive; 15 of 86 (17.4%) index cases resulted in ≥2 positive contacts. Among 55 persons testing positive with available symptom data, 31 (56.4%) were asymptomatic. Highest SARs were in indoor, high-contact sports settings (23.8% [95% confidence interval {CI}, 12.7%-33.3%]), staff meetings/lunches (18.2% [95% CI, 4.5%-31.8%]), and elementary school classrooms (9.5% [95% CI, 6.5%-12.5%]). The SAR was higher for staff (13.1% [95% CI, 9.0%-17.2%]) vs student index cases (5.8% [95% CI, 3.6%-8.0%]) and for symptomatic (10.9% [95% CI, 8.1%-13.9%]) vs asymptomatic index cases (3.0% [95% CI, 1.0%-5.5%]).

Conclusions: Indoor sports may pose a risk to the safe operation of in-person learning. Preventing infection in staff members, through measures that include coronavirus disease 2019 vaccination, is critical to reducing in-school transmission. Because many positive contacts were asymptomatic, contact tracing should be paired with testing, regardless of symptoms.

Keywords: COVID-19; SARS-CoV-2; infection control; physical distancing; schools.

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