Transmission of SARS-CoV-2 in educational settings in 2020: a review

Vardavas, Constantine; Nikitara, Katerina; Mathioudakis, Alexander; Hilton Boon, Michele; Phalkey, Revati; Leonardi-Bee, Jo; Pharris, Anastasia; Deogan, Charlotte; Suk, Jonathan E.

Abstract

Objectives: School closures have been used as a core non pharmaceutical intervention (NPI) during the COVID-19 pandemic. This review aims at identifying SARS-CoV-2 transmission in educational settings during the first waves of the pandemic.

Methods: This literature review assessed studies published between December 2019 and April 1, 2021 in Medline and Embase, which included studies that assessed educational settings from approximately January 2020 to January 2021. The inclusion criteria were based on the PCC framework (P-Population, C-Concept, C-Context). The study Population was restricted to people 1-17 years old (excluding neonatal transmission), the Concept was to assess child-to-child and child-to-adult transmission, while the Context was to assess specifically educational setting transmission.

Results: Fifteen studies met inclusion criteria, ranging from daycare centers to high schools and summer camps, while eight studies assessed the re-opening of schools in the 2020-2021 school year. In principle although there is sufficient evidence that children can both be infected by and transmit SARS-CoV-2 in school settings, the SAR remain relatively low -when NPI measures are implemented in parallel. Moreover, although the evidence was limited there was an indication that younger children may have a lower SAR than adolescents.

Conclusions: Transmission in educational settings in 2020 was minimal -when NPI measures were implemented in parallel. However, with an upsurge of cases related to variants of concern, continuous surveillance and assessment of the evidence is warranted to ensure the maximum protection of the health of students and the educational workforce, while also minimising the numerous negative impacts that school closures may have on children.

Citation

Vardavas, C., Nikitara, K., Mathioudakis, A., Hilton Boon, M., Phalkey, R., Leonardi-Bee, J., Pharris, A., Deogan, C., & Suk, J. E. (2022). Transmission of SARS-CoV-2 in educational settings in 2020: a review. BMJ Open, 12(4), Article e058308. https://doi.org/10.1136/bmjopen-2021-058308

• Journal Article Type: Article
• Acceptance Date: Mar 1, 2022
• Online Publication Date: Apr 5, 2022
• Publication Date: 2022-04
• Deposit Date: Mar 23, 2022
• Publicly Available Date: Apr 5, 2022
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 4
• Article Number: e058308
• DOI: https://doi.org/10.1136/bmjopen-2021-058308
• Keywords: SARS-CoV-2, COVID-19, pandemic, children, schools, household
• Public URL: https://nottingham-repository.worktribe.com/output/7647308
• Publisher URL: https://bmjopen.bmj.com/content/12/4/e058308