Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England

Annabel A. Powell; Georgina Ireland; Frances Baawuah; Joanne Beckmann; Ifeanyichukwu O. Okike; Shazaad Ahmad; Joanna Garstang; Andrew J. Brent; Bernadette Brent; Felicity Aiano; James Hargreaves; Sinéad M. Langan; Punam Mangtani; Patrick Nguipdop-Djomo; Joanna Sturgess; William Oswald; Katherine Halliday; Emma Rourke; Fiona Dawe; Zahin Amin-Chowdhury; Meaghan Kall; Maria Zambon; John Poh; Samreen Ijaz; Angie Lackenby; Joanna Elli; Kevin E. Brown; Sir Ian Diamond; Mary E. Ramsay; Shamez N. Ladhani

doi:10.1371/journal.pone.0262515

Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England

Annabel A. Powell, Georgina Ireland, Frances Baawuah, Joanne Beckmann, Ifeanyichukwu O. Okike, Shazaad Ahmad, Joanna Garstang, Andrew J. Brent, Bernadette Brent, Felicity Aiano, James Hargreaves, Sinéad M. Langan, Punam Mangtani, Patrick Nguipdop-Djomo, Joanna Sturgess, William Oswald, Katherine Halliday, Emma Rourke, Fiona Dawe, Zahin Amin-ChowdhuryMeaghan Kall, Maria Zambon, John Poh, Samreen Ijaz, Angie Lackenby, Joanna Elli, Kevin E. Brown, Sir Ian Diamond, Mary E. Ramsay, Shamez N. Ladhani^*

^*Corresponding author for this work

UK Health Security Agency

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

5 Citations (Scopus)

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Abstract

Background: Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members.

Methods: Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies.

Results: During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6/60) in primary and 3.9% (4/102) in secondary school students, compared to 6.3% (1/16) and 0% (0/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12/183) and 3.7% (1/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11/317) and 0% (0/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts.

Interpretation: Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.

Original language	English
Article number	e0262515
Journal	PLoS ONE
Volume	17
Issue number	2 February
DOIs	https://doi.org/10.1371/journal.pone.0262515
Publication status	Published - 16 Feb 2022

Bibliographical note

Funding Information: The Department of Health and Social Care (DHSC) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The UK Health Security Agency (UKHSA), formally known as Public Health England (PHE), had responsibility for study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publisher Copyright: © 2022 Powell et al.

Citation: Powell AA, Ireland G, Baawuah F, Beckmann J, Okike IO, Ahmad S, et al. (2022) Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England. PLoS ONE 17(2): e0262515.

DOI: https://doi.org/10.1371/journal.pone.0262515

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Powell2022SecondaryAttackRatesInPrimaryAndSecondarySchoolBubblesPLoSOneFinal published version, 523 KBLicence: CC BY

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Powell, A. A., Ireland, G., Baawuah, F., Beckmann, J., Okike, I. O., Ahmad, S., Garstang, J., Brent, A. J., Brent, B., Aiano, F., Hargreaves, J., Langan, S. M., Mangtani, P., Nguipdop-Djomo, P., Sturgess, J., Oswald, W., Halliday, K., Rourke, E., Dawe, F., ... Ladhani, S. N. (2022). Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England. PLoS ONE, 17(2 February), Article e0262515. https://doi.org/10.1371/journal.pone.0262515

@article{a23081563c5a4f3ca7243ce83cf08e78,

title = "Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England",

abstract = "Background: Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members. Methods: Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies. Results: During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6/60) in primary and 3.9% (4/102) in secondary school students, compared to 6.3% (1/16) and 0% (0/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12/183) and 3.7% (1/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11/317) and 0% (0/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts. Interpretation: Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.",

author = "Powell, {Annabel A.} and Georgina Ireland and Frances Baawuah and Joanne Beckmann and Okike, {Ifeanyichukwu O.} and Shazaad Ahmad and Joanna Garstang and Brent, {Andrew J.} and Bernadette Brent and Felicity Aiano and James Hargreaves and Langan, {Sin{\'e}ad M.} and Punam Mangtani and Patrick Nguipdop-Djomo and Joanna Sturgess and William Oswald and Katherine Halliday and Emma Rourke and Fiona Dawe and Zahin Amin-Chowdhury and Meaghan Kall and Maria Zambon and John Poh and Samreen Ijaz and Angie Lackenby and Joanna Elli and Brown, {Kevin E.} and Diamond, {Sir Ian} and Ramsay, {Mary E.} and Ladhani, {Shamez N.}",

note = "Funding Information: The Department of Health and Social Care (DHSC) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The UK Health Security Agency (UKHSA), formally known as Public Health England (PHE), had responsibility for study design, data collection and analysis, decision to publish, or preparation of the manuscript. Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Publisher Copyright: {\textcopyright} 2022 Powell et al. Citation: Powell AA, Ireland G, Baawuah F, Beckmann J, Okike IO, Ahmad S, et al. (2022) Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England. PLoS ONE 17(2): e0262515. DOI: https://doi.org/10.1371/journal.pone.0262515 ",

year = "2022",

month = feb,

day = "16",

doi = "10.1371/journal.pone.0262515",

language = "English",

volume = "17",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "2 February",

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Powell, AA, Ireland, G, Baawuah, F, Beckmann, J, Okike, IO, Ahmad, S, Garstang, J, Brent, AJ, Brent, B, Aiano, F, Hargreaves, J, Langan, SM, Mangtani, P, Nguipdop-Djomo, P, Sturgess, J, Oswald, W, Halliday, K, Rourke, E, Dawe, F, Amin-Chowdhury, Z, Kall, M, Zambon, M, Poh, J, Ijaz, S , Lackenby, A, Elli, J, Brown, KE, Diamond, SI, Ramsay, ME & Ladhani, SN 2022, 'Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England', PLoS ONE, vol. 17, no. 2 February, e0262515. https://doi.org/10.1371/journal.pone.0262515

TY - JOUR

T1 - Secondary attack rates in primary and secondary school bubbles following a confirmed case

T2 - Active, prospective national surveillance, November to December 2020, England

AU - Powell, Annabel A.

AU - Ireland, Georgina

AU - Baawuah, Frances

AU - Beckmann, Joanne

AU - Okike, Ifeanyichukwu O.

AU - Ahmad, Shazaad

AU - Garstang, Joanna

AU - Brent, Andrew J.

AU - Brent, Bernadette

AU - Aiano, Felicity

AU - Hargreaves, James

AU - Langan, Sinéad M.

AU - Mangtani, Punam

AU - Nguipdop-Djomo, Patrick

AU - Sturgess, Joanna

AU - Oswald, William

AU - Halliday, Katherine

AU - Rourke, Emma

AU - Dawe, Fiona

AU - Amin-Chowdhury, Zahin

AU - Kall, Meaghan

AU - Zambon, Maria

AU - Poh, John

AU - Ijaz, Samreen

AU - Lackenby, Angie

AU - Elli, Joanna

AU - Brown, Kevin E.

AU - Diamond, Sir Ian

AU - Ramsay, Mary E.

AU - Ladhani, Shamez N.

N1 - Funding Information: The Department of Health and Social Care (DHSC) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The UK Health Security Agency (UKHSA), formally known as Public Health England (PHE), had responsibility for study design, data collection and analysis, decision to publish, or preparation of the manuscript. Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Publisher Copyright: © 2022 Powell et al. Citation: Powell AA, Ireland G, Baawuah F, Beckmann J, Okike IO, Ahmad S, et al. (2022) Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England. PLoS ONE 17(2): e0262515. DOI: https://doi.org/10.1371/journal.pone.0262515

PY - 2022/2/16

Y1 - 2022/2/16

N2 - Background: Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members. Methods: Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies. Results: During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6/60) in primary and 3.9% (4/102) in secondary school students, compared to 6.3% (1/16) and 0% (0/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12/183) and 3.7% (1/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11/317) and 0% (0/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts. Interpretation: Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.

AB - Background: Following the full re-opening of schools in England and emergence of the SARS-CoV-2 Alpha variant, we investigated the risk of SARS-CoV-2 infection in students and staff who were contacts of a confirmed case in a school bubble (school groupings with limited interactions), along with their household members. Methods: Primary and secondary school bubbles were recruited into sKIDsBUBBLE after being sent home to self-isolate following a confirmed case of COVID-19 in the bubble. Bubble participants and their household members were sent home-testing kits comprising nasal swabs for RT-PCR testing and whole genome sequencing, and oral fluid swabs for SARS-CoV-2 antibodies. Results: During November-December 2020, 14 bubbles were recruited from 7 schools, including 269 bubble contacts (248 students, 21 staff) and 823 household contacts (524 adults, 299 children). The secondary attack rate was 10.0% (6/60) in primary and 3.9% (4/102) in secondary school students, compared to 6.3% (1/16) and 0% (0/1) among staff, respectively. The incidence rate for household contacts of primary school students was 6.6% (12/183) and 3.7% (1/27) for household contacts of primary school staff. In secondary schools, this was 3.5% (11/317) and 0% (0/1), respectively. Household contacts were more likely to test positive if their bubble contact tested positive although there were new infections among household contacts of uninfected bubble contacts. Interpretation: Compared to other institutional settings, the overall risk of secondary infection in school bubbles and their household contacts was low. Our findings are important for developing evidence-based infection prevention guidelines for educational settings.

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JO - PLoS ONE

JF - PLoS ONE

IS - 2 February

M1 - e0262515

ER -

Secondary attack rates in primary and secondary school bubbles following a confirmed case: Active, prospective national surveillance, November to December 2020, England

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