COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020

Felicity Aiano; Anna A. Mensah; Kelsey McOwat; Chinelo Obi; Amoolya Vusirikala; Annabel A. Powell; Jessica Flood; Johanna Bosowski; Louise Letley; Samuel Jones; Zahin Amin-Chowdhury; Joanne Lacy; Iain Hayden; Sharif A. Ismail; Mary E. Ramsay; Shamez N. Ladhani; Vanessa Saliba

doi:10.1016/j.lanepe.2021.100120

COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020

Felicity Aiano
, Anna A. Mensah
, Kelsey McOwat
, Chinelo Obi
, Amoolya Vusirikala
, Annabel A. Powell
, Jessica Flood
, Johanna Bosowski
, Louise Letley
, Samuel Jones
, Zahin Amin-Chowdhury
, Joanne Lacy
, Iain Hayden
, Sharif A. Ismail
, Mary E. Ramsay
, Shamez N. Ladhani^*
, Vanessa Saliba

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

31 Citations (Scopus)

19 Downloads (Pure)

Abstract

Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England.

Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire.

Interpretation: There were 969 school outbreaks reported to PHE, comprising 2% (n = 450) of primary schools and 10% (n = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48%) than secondary (25/79, 32%) school outbreaks (P = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95%CI, 4.75–5.41) than students, especially primary school teaching staff (378/3852; 9.81%; 95%CI, 8.90–10.82%) compared to secondary school teaching staff (284/7146; 3.97%; 95%CI, 3.79–5.69%). Secondary school students (1105/91,919; 1.20%; 95%CI, 1.13–1.28%) had higher attack rates than primary school students (328/39,027; 0.84%; 95%CI, 0.75–0.94%).

Conclusions: A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed.

Funding: PHE

Original language	English
Article number	100120
Journal	The Lancet Regional Health - Europe
Volume	6
Early online date	19 May 2021
DOIs	https://doi.org/10.1016/j.lanepe.2021.100120
Publication status	Published - Jul 2021

Bibliographical note

Funding Information: This surveillance was internally funded by PHE and did not
receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors. All authors had access to the data; the first and final authors verified the data and had final responsibility for the decision to submit for publication.

Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd.

Citation: Felicity Aiano, Anna A Mensah, Kelsey McOwat, Chinelo Obi, Amoolya Vusirikala, Annabel A Powell, Jessica Flood, Johanna Bosowski, Louise Letley, Samuel Jones, Zahin Amin-Chowdhury, Joanne Lacy, Iain Hayden, Sharif A Ismail, Mary E Ramsay, Shamez N Ladhani, Vanessa Saliba, COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020, The Lancet Regional Health - Europe, Volume 6, 2021, 100120, ISSN 2666-7762.

DOI: https://doi.org/10.1016/j.lanepe.2021.100120.

Keywords

COVID-19
Children
Outbreak
SARS-CoV-2
Schools
Transmission

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Aiano2021COVID-19OutbreaksFollowingFullReopeningOfPrimaryAndSecondarySchoolsInEnglandLancetRegHealthEurFinal published version, 288 KBLicence: CC BY-NC-ND

Cite this

Aiano, F., Mensah, A. A., McOwat, K., Obi, C., Vusirikala, A., Powell, A. A., Flood, J., Bosowski, J., Letley, L., Jones, S., Amin-Chowdhury, Z., Lacy, J., Hayden, I., Ismail, S. A., Ramsay, M. E., Ladhani, S. N., & Saliba, V. (2021). COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020. The Lancet Regional Health - Europe, 6, Article 100120. https://doi.org/10.1016/j.lanepe.2021.100120

@article{135b84481ed14979ab82bcf3e612df11,

title = "COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020",

abstract = "Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England. Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire. Interpretation: There were 969 school outbreaks reported to PHE, comprising 2\% (n = 450) of primary schools and 10\% (n = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48\%) than secondary (25/79, 32\%) school outbreaks (P = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95\%CI, 4.75–5.41) than students, especially primary school teaching staff (378/3852; 9.81\%; 95\%CI, 8.90–10.82\%) compared to secondary school teaching staff (284/7146; 3.97\%; 95\%CI, 3.79–5.69\%). Secondary school students (1105/91,919; 1.20\%; 95\%CI, 1.13–1.28\%) had higher attack rates than primary school students (328/39,027; 0.84\%; 95\%CI, 0.75–0.94\%). Conclusions: A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed. Funding: PHE",

keywords = "COVID-19, Children, Outbreak, SARS-CoV-2, Schools, Transmission",

author = "Felicity Aiano and Mensah, \{Anna A.\} and Kelsey McOwat and Chinelo Obi and Amoolya Vusirikala and Powell, \{Annabel A.\} and Jessica Flood and Johanna Bosowski and Louise Letley and Samuel Jones and Zahin Amin-Chowdhury and Joanne Lacy and Iain Hayden and Ismail, \{Sharif A.\} and Ramsay, \{Mary E.\} and Ladhani, \{Shamez N.\} and Vanessa Saliba",

note = "Funding Information: This surveillance was internally funded by PHE and did not receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors. All authors had access to the data; the first and final authors verified the data and had final responsibility for the decision to submit for publication. Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Publisher Copyright: Crown Copyright {\textcopyright} 2021 Published by Elsevier Ltd. Citation: Felicity Aiano, Anna A Mensah, Kelsey McOwat, Chinelo Obi, Amoolya Vusirikala, Annabel A Powell, Jessica Flood, Johanna Bosowski, Louise Letley, Samuel Jones, Zahin Amin-Chowdhury, Joanne Lacy, Iain Hayden, Sharif A Ismail, Mary E Ramsay, Shamez N Ladhani, Vanessa Saliba, COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020, The Lancet Regional Health - Europe, Volume 6, 2021, 100120, ISSN 2666-7762. DOI: https://doi.org/10.1016/j.lanepe.2021.100120.",

year = "2021",

month = jul,

doi = "10.1016/j.lanepe.2021.100120",

language = "English",

volume = "6",

journal = "The Lancet Regional Health - Europe",

issn = "2666-7762",

publisher = "Elsevier Ltd.",

}

Aiano, F, Mensah, AA, McOwat, K, Obi, C, Vusirikala, A, Powell, AA, Flood, J, Bosowski, J, Letley, L, Jones, S, Amin-Chowdhury, Z, Lacy, J, Hayden, I, Ismail, SA, Ramsay, ME , Ladhani, SN & Saliba, V 2021, 'COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020', The Lancet Regional Health - Europe, vol. 6, 100120. https://doi.org/10.1016/j.lanepe.2021.100120

TY - JOUR

T1 - COVID-19 outbreaks following full reopening of primary and secondary schools in England

T2 - Cross-sectional national surveillance, November 2020

AU - Aiano, Felicity

AU - Mensah, Anna A.

AU - McOwat, Kelsey

AU - Obi, Chinelo

AU - Vusirikala, Amoolya

AU - Powell, Annabel A.

AU - Flood, Jessica

AU - Bosowski, Johanna

AU - Letley, Louise

AU - Jones, Samuel

AU - Amin-Chowdhury, Zahin

AU - Lacy, Joanne

AU - Hayden, Iain

AU - Ismail, Sharif A.

AU - Ramsay, Mary E.

AU - Ladhani, Shamez N.

AU - Saliba, Vanessa

N1 - Funding Information: This surveillance was internally funded by PHE and did not receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors. All authors had access to the data; the first and final authors verified the data and had final responsibility for the decision to submit for publication. Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd. Citation: Felicity Aiano, Anna A Mensah, Kelsey McOwat, Chinelo Obi, Amoolya Vusirikala, Annabel A Powell, Jessica Flood, Johanna Bosowski, Louise Letley, Samuel Jones, Zahin Amin-Chowdhury, Joanne Lacy, Iain Hayden, Sharif A Ismail, Mary E Ramsay, Shamez N Ladhani, Vanessa Saliba, COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020, The Lancet Regional Health - Europe, Volume 6, 2021, 100120, ISSN 2666-7762. DOI: https://doi.org/10.1016/j.lanepe.2021.100120.

PY - 2021/7

Y1 - 2021/7

N2 - Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England. Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire. Interpretation: There were 969 school outbreaks reported to PHE, comprising 2% (n = 450) of primary schools and 10% (n = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48%) than secondary (25/79, 32%) school outbreaks (P = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95%CI, 4.75–5.41) than students, especially primary school teaching staff (378/3852; 9.81%; 95%CI, 8.90–10.82%) compared to secondary school teaching staff (284/7146; 3.97%; 95%CI, 3.79–5.69%). Secondary school students (1105/91,919; 1.20%; 95%CI, 1.13–1.28%) had higher attack rates than primary school students (328/39,027; 0.84%; 95%CI, 0.75–0.94%). Conclusions: A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed. Funding: PHE

AB - Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England. Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire. Interpretation: There were 969 school outbreaks reported to PHE, comprising 2% (n = 450) of primary schools and 10% (n = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48%) than secondary (25/79, 32%) school outbreaks (P = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95%CI, 4.75–5.41) than students, especially primary school teaching staff (378/3852; 9.81%; 95%CI, 8.90–10.82%) compared to secondary school teaching staff (284/7146; 3.97%; 95%CI, 3.79–5.69%). Secondary school students (1105/91,919; 1.20%; 95%CI, 1.13–1.28%) had higher attack rates than primary school students (328/39,027; 0.84%; 95%CI, 0.75–0.94%). Conclusions: A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed. Funding: PHE

KW - COVID-19

KW - Children

KW - Outbreak

KW - SARS-CoV-2

KW - Schools

KW - Transmission

UR - https://www.scopus.com/pages/publications/85107762717

U2 - 10.1016/j.lanepe.2021.100120

DO - 10.1016/j.lanepe.2021.100120

M3 - Article

AN - SCOPUS:85107762717

SN - 2666-7762

VL - 6

JO - The Lancet Regional Health - Europe

JF - The Lancet Regional Health - Europe

M1 - 100120

ER -

COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020

Abstract

Bibliographical note

Keywords

UN SDGs

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