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. 2021 Dec;37(6):503-512.
doi: 10.1177/10598405211050393. Epub 2021 Oct 4.

Is Symptom Screening Useful for Identifying COVID-19 Infection in School Settings? Georgia, USA

Megan Swanson  1 , Marisa Hast  1 , Eleanor Burnett  1 , Emeka Oraka  1   2 , Anne Kimball  1   3 , Elana Morris  1 , Paula L Marcet  1 , Olivia Almendares  1 , Rachel Franklin  4 , Lemlem Mehari  4 , Jazmyn McCloud  4 , Hannah L Kirking  1 , Jacqueline E Tate  1 , Colleen Scott  1
Affiliations

Is Symptom Screening Useful for Identifying COVID-19 Infection in School Settings? Georgia, USA

Megan Swanson et al. J Sch Nurs. 2021 Dec.

Abstract

This study's goal was to characterize the utility of symptom screening in staff and students for COVID-19 identification and control of transmission in a school setting. We conducted a secondary analysis of cross-sectional data for staff, students and associated household members in a Georgia school district exposed to COVID-19 cases who received RT-PCR testing and symptom monitoring. Among positive contacts, 30/49 (61%) of students and 1/6 (17%) of staff reported no symptoms consistent with COVID-19. Symptom sensitivity was 30% in elementary students and 42% in middle/high students. Fifty-three percent (10/19) of symptomatic positive contacts had at least one household member test positive for SARS-CoV-2 compared with 50% (10/20) of asymptomatic positive contacts. The absence of symptoms in children is not indicative of a lack of SARS-CoV-2 infection or reduced risk of infection for associated household members. Testing all close contacts of people with COVID-19 in schools is needed to interrupt transmission networks.

Keywords: COVID-19; elementary school students; epidemiology; high school students; school nurses; screening testing; symptoms; transmission.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Staff and student contacts for SARS-CoV-2 transmission investigation in a school district— Georgia, United States, December 1, 2020–January 22, 2021, † All household members of positive contacts were offered SARS-CoV-2 testing, in some instances more than one household member was tested per positive person (range 0–8).
Figure 2.
Figure 2.
Time from exposure to symptom onset for students and staff testing positive and negative for SARS-CoV-2—Georgia, United States, December 1, 2020–January 22, 2021.
Figure 3.
Figure 3.
Sensitivity, specificity, positive predictive value, and negative predictive value for SARS-CoV-2 infection by staff and student school level for any symptoms and CSTE case definition symptoms—Georgia, United States, December 1, 2020–January 22, 2021.
See this image and copyright information in PMC

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