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Abstract
Background Better understanding of the role that children and school staff play in the transmission of SARS-CoV-2 is essential to guide policy development on controlling infection while minimising disruption to children’s education and well-being.
Methods Our national e-cohort (n=464531) study used anonymised linked data for pupils, staff and associated households linked via educational settings in Wales. We estimated the odds of testing positive for SARS-CoV-2 infection for staff and pupils over the period August– December 2020, dependent on measures of recent exposure to known cases linked to their educational settings.
Results The total number of cases in a school was not associated with a subsequent increase in the odds of testing positive (staff OR per case: 0.92, 95% CI 0.85 to 1.00; pupil OR per case: 0.98, 95% CI 0.93 to 1.02). Among pupils, the number of recent cases within the same year group was significantly associated with subsequent increased odds of testing positive (OR per case: 1.12, 95% CI 1.08 to 1.15). These effects were adjusted for a range of demographic covariates, and in particular any known cases within the same household, which had the strongest association with testing positive (staff OR: 39.86, 95% CI 35.01 to 45.38; pupil OR: 9.39, 95% CI 8.94 to 9.88).
Conclusions In a national school cohort, the odds of staff testing positive for SARS-CoV-2 infection were not significantly increased in the 14-day period after case detection in the school. However, pupils were found to be at increased odds, following cases appearing within their own year group, where most of their contacts occur. Strong mitigation measures over the whole of the study period may have reduced wider spread within the school environment.
- SARS-CoV-2
- schools
- disease transmission
- public health
Data availability statement
Data are available upon reasonable request. The data used in this study are available in the Secure Anonymised Information Linkage (SAIL) Databank at Swansea University, Swansea, UK. All proposals to use SAIL data are subject to review by an independent Information Governance Review Panel (IGRP). Before any data can be accessed, approval must be given by the IGRP. The IGRP gives careful consideration to each project to ensure proper and appropriate use of SAIL data. When access has been approved, it is gained through a privacy-protecting safe haven and remote access system referred to as the SAIL Gateway. SAIL has established an application process to be followed by anyone who would like to access data via SAIL: https://www.saildatabank.com/application-processhttps://www.saildatabank.com/application-process.
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Data availability statement
Data are available upon reasonable request. The data used in this study are available in the Secure Anonymised Information Linkage (SAIL) Databank at Swansea University, Swansea, UK. All proposals to use SAIL data are subject to review by an independent Information Governance Review Panel (IGRP). Before any data can be accessed, approval must be given by the IGRP. The IGRP gives careful consideration to each project to ensure proper and appropriate use of SAIL data. When access has been approved, it is gained through a privacy-protecting safe haven and remote access system referred to as the SAIL Gateway. SAIL has established an application process to be followed by anyone who would like to access data via SAIL: https://www.saildatabank.com/application-processhttps://www.saildatabank.com/application-process.
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Footnotes
Twitter @richfry, @emily_marchant, @AshleyAkbari, @fatemetrb
Contributors DAT and HA led the design, analysis and drafting of the paper. All other authors contributed equally to the design, data acquisition and interpretation of the data and reviewed the manuscript contents. All authors have approved the final published version.
Funding This work was supported by the Medical Research Council (grant number: MR/V028367/1); Health Data Research UK (grant number: HDR-9006), which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; and Administrative Data Research UK, which is funded by the Economic and Social Research Council (grant number: ES/S007393/1).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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