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 whilst minimising disruption to children’s education
and wellbeing.
Methods
Our national e-cohort (n=500,779) study used anonymised linked data for
pupils, staff and associated households linked via educational settings. We
estimated the risk 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 risk of testing positive (Staff OR per case 0.92,
95%CI 0.85, 1.00; Pupils OR per case 0.98, 95%CI 0.93, 1.02). Amongst
pupils, the number of recent cases within the same year group was
significantly associated with subsequent increased risk of testing positive
(OR per case 1.12, 95%CI 1.08 – 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, 45.38, pupil OR 9.39, 95%CI 8.94 –
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 risk, 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.
What is known
Evidence of the role schools play in the transmission of
SARS-CoV-2 is limited
Higher positivity rates are observed in school staff
compared to pupils
Lack of evidence on transmission pathways transmission
into and within schools
What this study adds
First UK national level study of transmission between
pupils and staff in a school environment during the
SARS-CoV-2 pandemic.
Schools opening September-December 2020 was not
associated with an increased subsequent risk of testing
positive in staff
Pupils were found to be at increased risk of testing
positive, following cases appearing within their own year
group