Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;148(4):e2021052686.
doi: 10.1542/peds.2021-052686. Epub 2021 Jul 28.

Community SARS-CoV-2 Surge and Within-School Transmission

Kanecia O Zimmerman  1   2   3 , M Alan Brookhart  4 , Ibukunoluwa C Kalu  3 , Angelique E Boutzoukas  3 , Kathleen A McGann  3 , Michael J Smith  3 , Gabriela M Maradiaga Panayotti  3 , Sarah C Armstrong  2 , David J Weber  5 , Ganga S Moorthy  3 , Daniel K Benjamin Jr; ABC Science Collaborative
Affiliations

Community SARS-CoV-2 Surge and Within-School Transmission

Kanecia O Zimmerman et al. Pediatrics. 2021 Oct.

Abstract

Objectives: When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in the setting of high levels of community transmission. We describe secondary transmission of SARS-CoV-2 within North Carolina kindergarten through 12th-grade school districts during a winter surge to determine if mitigation strategies can hinder within-school transmission.

Methods: From October 26, 2020, to February 28, 2021, 13 North Carolina school districts participating in The ABC Science Collaborative were open for in-person instruction, adhered to basic mitigation strategies, and tracked community- and school-acquired SARS-CoV-2 cases. Public health officials adjudicated each case. We combined these data with that from August 2020 to evaluate the effect of the SARS-CoV-2 winter surge on infection rates as well as weekly community- and school-acquired cases. We evaluated the number of secondary cases generated by each primary case as well as the role of athletic activities in school-acquired cases.

Results: More than 100 000 students and staff from 13 school districts attended school in person; of these, 4969 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, North Carolina local health department staff identified an additional 209 infections among >26 000 school close contacts (secondary attack rate <1%). Most within-school transmissions in high schools (75%) were linked to school-sponsored sports. School-acquired cases slightly increased during the surge; however, within-school transmission rates remained constant, from presurge to surge, with ∼1 school-acquired case for every 20 primary cases.

Conclusions: With adherence to basic mitigation strategies, within-school transmission of SARS-CoV-2 can be interrupted, even during a surge of community infections.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. Community Rates vs. Community- and School-acquired Infections
Community rates of infection vs. community-acquired (primary) and school-acquired (secondary) infections in school buildings.
See this image and copyright information in PMC

References

    1. European Centre for Disease Prevention and Control (ECDC). COVID-19 in children and the role of school settings in COVID-19 transmission. Available at: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-school.... Published August 6, 2020. Accessed May 27, 2021.
    1. Zimmerman KO, Akinboyo IC, Brookhart MA, et al. Incidence and secondary transmission of SARs-CoV-2 infections in schools. Pediatrics. 2021;14(4):e2020048090. - PMC - PubMed
    1. Falk A, Benda A, Falk P, Steffen S, Wallace Z, Høeg TB. COVID-19 cases and transmission in 17 K-12 schools - Wood County, Wisconsin, August 31-November 29, 2020. MMWR Morb Mortal Wkly Rep. 2021;70(4):136–140. - PMC - PubMed
    1. Centers for Disease Control and Prevention (CDC). Operational strategy for K-12 schools through phased prevention. Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/op.... Updated May 15, 2021. Accessed May 27, 2021.
    1. Patrick SW, Henkhaus LE, Zickafoose JS, et al. Well-being of parents and children during the COVID-19 pandemic: a national survey. Pediatrics. 2020;146(4):e2020016824. - PubMed