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. 2021 Aug;26(34):2100184.
doi: 10.2807/1560-7917.ES.2021.26.34.2100184.

SARS-CoV-2 infection and transmission in school settings during the second COVID-19 wave: a cross-sectional study, Berlin, Germany, November 2020

Stefanie Theuring  1 , Marlene Thielecke  1 , Welmoed van Loon  1 , Franziska Hommes  1 , Claudia Hülso  1 , Annkathrin von der Haar  1 , Jennifer Körner  1 , Michael Schmidt  2 , Falko Böhringer  3 , Marcus A Mall  4 , Alexander Rosen  4 , Christof von Kalle  5 , Valerie Kirchberger  6 , Tobias Kurth  7 , Joachim Seybold  6 , Frank P Mockenhaupt  1 ; BECOSS Study Group  8
Collaborators, Affiliations

SARS-CoV-2 infection and transmission in school settings during the second COVID-19 wave: a cross-sectional study, Berlin, Germany, November 2020

Stefanie Theuring et al. Euro Surveill. 2021 Aug.

Abstract

BackgroundSchool attendance during the COVID-19 pandemic is intensely debated.AimIn November 2020, we assessed SARS-CoV-2 infections and seroreactivity in 24 randomly selected school classes and connected households in Berlin, Germany.MethodsWe collected oro-nasopharyngeal swabs and blood samples, examining SARS-CoV-2 infection and IgG antibodies by RT-PCR and ELISA. Household members self-swabbed. We assessed individual and institutional prevention measures. Classes with SARS-CoV-2 infection and connected households were retested after 1 week.ResultsWe examined 1,119 participants, including 177 primary and 175 secondary school students, 142 staff and 625 household members. SARS-CoV-2 infection occurred in eight classes, affecting each 1-2 individuals. Infection prevalence was 2.7% (95% confidence interval (CI): 1.2-5.0; 9/338), 1.4% (95% CI: 0.2-5.1; 2/140), and 2.3% (95% CI: 1.3-3.8; 14/611) among students, staff and household members. Six of nine infected students were asymptomatic at testing. We detected IgG antibodies in 2.0% (95%CI: 0.8-4.1; 7/347), 1.4% (95% CI: 0.2-5.0; 2/141) and 1.4% (95% CI: 0.6-2.7; 8/576). Prevalence increased with inconsistent facemask-use in school, walking to school, and case-contacts outside school. For three of nine households with infection(s), origin in school seemed possible. After 1 week, no school-related secondary infections appeared in affected classes; the attack rate in connected households was 1.1%.ConclusionSchool attendance under rigorously implemented preventive measures seems reasonable. Balancing risks and benefits of school closures need to consider possible spill-over infection into households. Deeper insight is required into the infection risks due to being a schoolchild vs attending school.

Keywords: COVID-19; Germany; SARS-CoV-2; adolescents; children; schools.

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Conflict of interest statement

Conflict of interest: TK states to have received outside of the submitted work personal fees from Eli Lily & Company, Teva, TotalEnergies and the BMJ. All other authors declare that they have no conflict of interests.

Figures

Figure
Figure
7-day incidence of recorded SARS-CoV-2 infections according to age groups in Berlin, Germany, November 2020 (n = 98,461)
See this image and copyright information in PMC

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