Prevalence and Transmission of Severe Acute Respiratory Syndrome Coronavirus Type 2 in Childcare Facilities: A Longitudinal Study

Abstract

Objective: To evaluate the role of childcare facilities in the transmission of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in a longitudinal study to gain further knowledge of SARS-CoV-2 prevalence, transmission, and spread among preschool children, their parents, and their caregivers.

Study design: Children aged 1-6 years, their parents, and their caregivers in 14 childcare facilities in Dresden, Saxony/Germany were invited to participate in the KiTaCoviDD19-study between July 2020 and January 2021. Seroprevalence of SARS-CoV-2 antibodies was assessed up to 4 times during the study period in all participating adults, and demographic characteristics, as well as epidemiologic information on personal SARS-CoV-2 history were obtained. Samples for stool virus shedding of SARS-CoV-2 were analyzed by polymerase chain reaction every 2-4 weeks in all participating children.

Results: In total, 318 children, 299 parents and 233 childcare workers were enrolled. By January 2021, 11% of the participating adults were found to be seropositive, whereas the percentage of children shedding SARS-CoV-2 was 6.8%. Overall, we detected 17 children with SARS-CoV-2 virus shedding in 8 different childcare facilities. In 4 facilities, there were a maximum of 3 connected cases in children. Approximately 50% of SARS-CoV-2 infections in the children could not be connected to a secondary case in our study population.

Conclusions: This study does not provide evidence of relevant asymptomatic ("silent") spread of SARS-CoV-2 in childcare facilities in both low- and high-prevalence settings. Our findings add to the evidence that childcare and educational settings do not have a crucial role in driving the SARS-CoV-2 pandemic.

Keywords: children; coronavirus; covid-19; infection; preschool.

Figure 1

Timeline of serologic testing (1, baseline; 2, second serologic testing; 3, third serologic testing; 4, additional serologic testing in December 2020) and reported numbers of SARS-CoV-2 infections in Dresden, Saxony/Germany.

Figure 2

Positive SARS-CoV-2–infected children and the occurrence of epidemiologically linked transmissions within the single participating childcare facilities. Childcare facility 1, no epidemiologic link detected; childcare facilities 2-8, single cases without an epidemiologic link detected; childcare facilities 9-11, 2 epidemiologically linked cases detected; childcare facilities 12-14, outbreaks with >2 epidemiologically linked cases detected; stopwatch, officially mandated quarantine by local health department during the study period.