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. 2021 Oct;148(4):e2021052686.
doi: 10.1542/peds.2021-052686. Epub 2021 Jul 28.

Community SARS-CoV-2 Surge and Within-School Transmission

Kanecia O Zimmerman  1   2   3 , M Alan Brookhart  4 , Ibukunoluwa C Kalu  3 , Angelique E Boutzoukas  3 , Kathleen A McGann  3 , Michael J Smith  3 , Gabriela M Maradiaga Panayotti  3 , Sarah C Armstrong  2 , David J Weber  5 , Ganga S Moorthy  3 , Daniel K Benjamin Jr; ABC Science Collaborative
Affiliations

Community SARS-CoV-2 Surge and Within-School Transmission

Kanecia O Zimmerman et al. Pediatrics. 2021 Oct.

Abstract

Objectives: When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in the setting of high levels of community transmission. We describe secondary transmission of SARS-CoV-2 within North Carolina kindergarten through 12th-grade school districts during a winter surge to determine if mitigation strategies can hinder within-school transmission.

Methods: From October 26, 2020, to February 28, 2021, 13 North Carolina school districts participating in The ABC Science Collaborative were open for in-person instruction, adhered to basic mitigation strategies, and tracked community- and school-acquired SARS-CoV-2 cases. Public health officials adjudicated each case. We combined these data with that from August 2020 to evaluate the effect of the SARS-CoV-2 winter surge on infection rates as well as weekly community- and school-acquired cases. We evaluated the number of secondary cases generated by each primary case as well as the role of athletic activities in school-acquired cases.

Results: More than 100 000 students and staff from 13 school districts attended school in person; of these, 4969 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, North Carolina local health department staff identified an additional 209 infections among >26 000 school close contacts (secondary attack rate <1%). Most within-school transmissions in high schools (75%) were linked to school-sponsored sports. School-acquired cases slightly increased during the surge; however, within-school transmission rates remained constant, from presurge to surge, with ∼1 school-acquired case for every 20 primary cases.

Conclusions: With adherence to basic mitigation strategies, within-school transmission of SARS-CoV-2 can be interrupted, even during a surge of community infections.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. Community Rates vs. Community- and School-acquired Infections
Community rates of infection vs. community-acquired (primary) and school-acquired (secondary) infections in school buildings.
See this image and copyright information in PMC

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