Point of care SARS-CoV-2 nucleic acid testing in schools improves school attendance

Background: National lockdowns have led to significant interruption to children’s education globally. In the Autumn term in 2020, school absence in England and Wales was almost five times higher than the same period in 2019. Transmission of SARS-CoV-2 in schools and ongoing interruption to education remains a concern. However, evaluation of rapid point of care (POC) polymerase chain reaction (PCR) testing in British schools has not been undertaken. Methods: This is a survey of secondary schools in England that implemented PCR-based rapid POC testing. The study aims to measure the prevalence of SARS-CoV-2 infection in schools, to assess the impact of this testing on school attendance and closures, and to describe schools experiences with testing. All schools utilised the SAMBA II SARS-CoV-2 testing platform. Results: 12 fee-paying secondary schools in England were included. Between September 1st 2020 and December 16th 2020, 697 on site rapid POC PCR tests were performed and 6.7% of these were positive for SARS-CoV-2 infection. There were five outbreaks in three schools during this time which were contained. Seven groups of close contacts within the school known as bubbles had to quarantine but there were no school closures. 84% of those tested were absent from school for less than one day whilst awaiting their test result. This potentially saved between 1047 and 1570 days off school in those testing negative compared to the NHS PCR laboratory test. Schools reported a positive impact of having a rapid testing platform as it allowed them to function as fully as possible during this pandemic. Conclusions: Rapid POC PCR testing platforms should be widely available and utilised in school settings. Reliable positive tests will prevent outbreaks and uncontrolled spread of infection within school settings. Reliable negative test results will reassure students, parents and staff and prevent disruption to education.

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The effects of school closures on SARS-CoV-2 among parents and teachers

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2020834118 ◽

2021 ◽

Vol 118 (9) ◽

pp. e2020834118 ◽

Cited By ~ 2

Author(s):

Jonas Vlachos ◽

Edvin Hertegård ◽

Helena B. Svaleryd

Keyword(s):

Secondary Schools ◽

Secondary Teachers ◽

Infection Rate ◽

Online Instruction ◽

School Closures ◽

Upper Secondary ◽

Containment Measure ◽

The Impact ◽

Upper Secondary Schools ◽

Lower Secondary Schools

To reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), most countries closed schools, despite uncertainty if school closures are an effective containment measure. At the onset of the pandemic, Swedish upper-secondary schools moved to online instruction, while lower-secondary schools remained open. This allows for a comparison of parents and teachers differently exposed to open and closed schools, but otherwise facing similar conditions. Leveraging rich Swedish register data, we connect all students and teachers in Sweden to their families and study the impact of moving to online instruction on the incidence of SARS-CoV-2 and COVID-19. We find that, among parents, exposure to open rather than closed schools resulted in a small increase in PCR-confirmed infections (odds ratio [OR] 1.17; 95% CI [CI95] 1.03 to 1.32). Among lower-secondary teachers, the infection rate doubled relative to upper-secondary teachers (OR 2.01; CI95 1.52 to 2.67). This spilled over to the partners of lower-secondary teachers, who had a higher infection rate than their upper-secondary counterparts (OR 1.29; CI95 1.00 to 1.67). When analyzing COVID-19 diagnoses from healthcare visits and the incidence of severe health outcomes, results are similar for teachers, but weaker for parents and teachers’ partners. The results for parents indicate that keeping lower-secondary schools open had minor consequences for the overall transmission of SARS-CoV-2 in society. The results for teachers suggest that measures to protect teachers could be considered.

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The impact of unplanned school closure on children’s social contact: Rapid evidence review

10.31219/osf.io/2txsr ◽

2020 ◽

Author(s):

Samantha Brooks ◽

Louise Smith ◽

Rebecca Webster ◽

Dale Weston ◽

Lisa Woodland ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Relevant Literature ◽

Disease Outbreaks ◽

Social Contact ◽

School Closure ◽

School Closures ◽

Infectious Disease Outbreaks ◽

Spread Of Infection ◽

The Impact

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective. ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted. Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact. ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

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Emergence of SARS-CoV-2 Alpha (B.1.1.7) variant, infection rates, antibody seroconversion and seroprevalence rates in secondary school students and staff: active prospective surveillance, December 2020 to March 2021, England

10.1101/2021.07.14.21260496 ◽

2021 ◽

Author(s):

Shamez N Ladhani ◽

Georgina Ireland ◽

Frances Baawuah ◽

Joanne Beckmann ◽

Ifeanyichukwu O Okike ◽

...

Keyword(s):

Secondary School ◽

Secondary Schools ◽

Secondary School Students ◽

School Students ◽

School Closures ◽

Rapid Spread ◽

Nasal Swabs ◽

Regional Community ◽

The Impact ◽

Prior Infection

Background In England, the rapid spread of the SARS-Cov-2 Alpha (B.1.1.7) variant from November 2020 led to national lockdown, including school closures in January 2021. We assessed SARS-CoV-2 infection, seroprevalence and seroconversion in students and staff when secondary schools reopened in March 2021. Methods Public Health England initiated SARS-CoV-2 surveillance in 18 secondary schools across six regions in September 2020. Participants provided nasal swabs for RT-PCR and blood samples for SARS-CoV-2 antibodies at the beginning (September 2020) and end (December 2020) of the autumn term and at the start of the spring term (March 2021). Findings In March 2021, 1895 participants (1100 students, 795 staff) were tested; 5.6% (61/1094) students and 4.4% (35/792) staff had laboratory-confirmed SARS-CoV-2 infection between December 2020 and March 2021. Nucleoprotein antibody seroprevalence was 36.3% (370/1018) in students and 31.9% (245/769) in staff, while spike protein antibody prevalence was 39.5% (402/1018) and 59.8% (459/769), respectively, similar to regional community seroprevalence. Between December 2020 and March 2021 (median 15.9 weeks), 14.8% (97/656; 95% CI: 12.2-17.7) students and 10.0% (59/590; 95% CI: 7.7-12.7) staff seroconverted. Weekly seroconversion rates were similar from September to December 2020 (8.0/1000) and from December 2020 to March 2021 (7.9/1000; students: 9.3/1,000; staff: 6.3/1,000). Interpretation By March 2021, a third of secondary school students and staff had serological evidence of prior infection based on N-antibody seropositivity, and an additional third of staff had evidence of vaccine-induced immunity based on S-antibody seropositivity. Further studies are needed to assess the impact of the Delta variant.

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The impact of unplanned school closure on children’s social contact: Rapid evidence review

10.1101/2020.03.17.20037457 ◽

2020 ◽

Cited By ~ 1

Author(s):

Samantha K. Brooks ◽

Louise E. Smith ◽

Rebecca K. Webster ◽

Dale Weston ◽

Lisa Woodland ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Relevant Literature ◽

Disease Outbreaks ◽

Social Contact ◽

School Closure ◽

School Closures ◽

Infectious Disease Outbreaks ◽

Spread Of Infection ◽

The Impact

AbstractBackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks in an attempt to minimise the spread of infection. However, if children continue to mix with others outside the home during the closures, these measures are unlikely to be effective.ObjectivesThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsWe searched four databases from inception to February 2020 for relevant literature. Main findings were extracted.Results3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures but contact was still common. All studies reported children leaving the house or being looked after by non-household members. There was some evidence that older child age and parental disagreement with closure were predictive of children leaving the house, and mixed evidence regarding the relationship between infection status and leaving the home. Parental agreement with closure was generally high, but some parents disagreed due to perceived low risk of infection and practical issues regarding childcare and financial impact.ConclusionsEvidence suggests that many children continue to leave the house and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

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Secondary transmission of COVID-19 in preschool and school settings after their reopening in northern Italy: a population-based study

10.1101/2020.11.17.20229583 ◽

2020 ◽

Author(s):

Elisabetta Larosa ◽

Olivera Djuric ◽

Mariateresa Cassinadri ◽

Silvia Cilloni ◽

Eufemia Bisaccia ◽

...

Keyword(s):

Secondary Schools ◽

Close Contact ◽

Population Based ◽

Reggio Emilia ◽

Positive Case ◽

School Closures ◽

Population Based Study ◽

Secondary Transmission ◽

School Settings ◽

Source Of Infection

AbstractBackgroundSchool closures was one of the main measures undertaken to reduce the number of social contacts during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. We aimed to describe the data on secondary transmission of SARS-CoV-2 among students and teachers/personnel after the reopening of preschools and schools in Reggio Emilia, Italy.MethodsThis prospective population-based study included all consecutive cases leading to an investigation in 41 classes of 36 educational institutions (8 infant-toddler centres and preschools, 10 primary and 18 secondary schools) in the period September 1 – October 15, 2020, in Reggio Emilia province, Italy. We report the characteristics of the school, of the index case, including the possible source of infection, the number of contacts (students and teachers/personnel) that were identified and tested and the characteristics of secondary cases.ResultsIn the study period, 994 students and 204 teachers were tested during related investigations due to notification of 43 primary cases (38 among students and 5 among teachers). Of these, 10 students and two teachers created 39 secondary cases, resulting in an attack rate of 3.9%. There were no secondary cases among teachers/stuff. Secondary transmission occurred in one primary school and 8 secondary schools. Except for two students and one teacher, the possible source of infection for all index cases was identified as they had all had previous contact with a positive case; the majority of secondary cases did not report any previous close contact with a positive case. The clusters ranged from one to 22 secondary cases.ConclusionsTransmission at school occurred in a non-negligible number of cases, particularly in secondary schools. Prompt testing and isolation of classmates could probably reduce the risk of transmission in school settings.

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Introduction of Cobas Liat Influenza A/B for rapid point-of-care diagnosis of influenza infection in an acute trust

Journal of Infection Prevention ◽

10.1177/1757177419853342 ◽

2019 ◽

Vol 20 (6) ◽

pp. 297-300 ◽

Cited By ~ 3

Author(s):

Fran Brooke-Pearce ◽

Elli Demertzi

Keyword(s):

Influenza A ◽

Positive Impact ◽

Point Of Care ◽

Influenza Infection ◽

Cost Savings ◽

Potential Cost ◽

Bed Management ◽

Point Of Care Test ◽

The Impact ◽

Acute Trust

Background: We aimed to evaluate the impact of a new molecular point-of-care test (POCT), the Cobas Liat Influenza A/B for rapid diagnosis of influenza within 20 min, on the operational workflow of the Trust, accurate diagnosis and potential cost savings during the winter of 2017–2018. Methods: A retrospective cohort study was conducted on all patients aged > 18 years tested for flu A/B by laboratory PCR in January 2017 and by POCT in January 2018. Results: From 21 December 2017 to 30 April 2018, a total of 1375 POCTs were performed with a total of 479 (35%) influenza-positive cases. Results demonstrated that 1046 (76%) suspected cases did not require isolation or were able to be discharged from Emergency Department (ED), once other risks had been ruled out. We particularly looked into the differences between the month of January 2017 (before POCT) and the month of January 2018. Discussion: Results demonstrate that influenza POCT had a positive impact on the Trust regarding prompt patient diagnosis and treatment, discharge decisions, improvement of patient bed management by avoiding unnecessary patient isolation and reducing bay closures, and significant reduction in length of stay in both positive and negative cases. Estimated cost savings were significant.

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Mental healthcare clinician engagement with point of care testing; a qualitative study

BMC Psychiatry ◽

10.1186/s12888-021-03067-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Joseph Butler ◽

Simone de Cassan ◽

Phil Turner ◽

Belinda Lennox ◽

Gail Hayward ◽

...

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Mental Health Professionals ◽

Positive Impact ◽

Point Of Care ◽

Mental Healthcare ◽

Successful Implementation ◽

Point Of Care Testing ◽

Structured Interviews ◽

The Impact

Abstract Background Point of Care Testing (POCT) is being increasingly used to augment the delivery of physical health care in a variety of settings, but their use in mental health has been limited. Research into understanding the barriers faced for successful implementation of POCT in these settings is lacking. We aimed to identify factors affecting engagement and implementation of POCT within mental health teams by exploring the attitudes to POCT, and the perceived impact POCT has on the practice of mental healthcare clinicians. Methods Alongside a study evaluating the impact of a point of care device in Community Mental Health Teams (CMHTs), qualitative interviews were carried out with CMHT clinicians using POCT as part of annual physical checks for patients with severe and enduring mental illness. Data were collected using semi-structured interviews and analysed using thematic analysis. Results Fifteen clinicians were interviewed across a range of professional backgrounds. Clinicians identified usability of the technology, positive impact on their patient’s experience and improved self-efficacy as drivers for successful implementation of POCT into their clinical practice. Issues with device functioning and the potential for a negative effect on the therapeutic relationship with their patients were identified as barriers. Level of physical heath training was not found to be a barrier by mental health professionals to using POCT. Conclusions Understanding barriers and drivers for engagement is important to allow co-production of POCT and guidelines to facilitate introduction of POCT into routine clinical practice.

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School closures and SARS-CoV-2. Evidence from Sweden’s partial school closure

10.1101/2020.10.13.20211359 ◽

2020 ◽

Author(s):

Jonas Vlachos ◽

Edvin Hertegård ◽

Helena Svaleryd

Keyword(s):

Secondary Schools ◽

Secondary Teachers ◽

Infection Rate ◽

Online Instruction ◽

School Closure ◽

School Closures ◽

Upper Secondary ◽

Containment Measure ◽

The Impact ◽

Upper Secondary Schools

AbstractTo reduce the transmission of SARS-CoV-2 most countries closed schools, despite uncertainty if school closures are an effective containment measure. At the onset of the pandemic, Swedish upper secondary schools moved to online instruction while lower secondary school remained open. This allows for a comparison of parents and teachers differently exposed to open and closed schools, but otherwise facing similar conditions. Leveraging rich Swedish register data, we connect all students and teachers in Sweden to their families and study the impact of moving to online instruction on the incidence of SARS-CoV-2 and COVID-19. We find that among parents, exposure to open rather than closed schools resulted in a small increase in PCR-confirmed infections [OR 1.17; CI95 1.03–1.32]. Among lower secondary teachers the infection rate doubled relative to upper secondary teachers [OR 2.01; CI95 1.52–2.67]. This spilled over to the partners of lower secondary teachers who had a higher infection rate than their upper secondary counterparts [OR 1.29; CI95 1.00–1.67]. When analyzing COVID-19 diagnoses from healthcare visits and the incidence of severe health outcomes, results are similar for teachers but weaker for parents and teachers’ partners. The results for parents indicate that keeping lower secondary schools open had minor consequences for the overall transmission of SARS-CoV-2 in society. The results for teachers suggest that measures to protect teachers could be considered.

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The impact of unplanned school closure on children’s social contact: rapid evidence review

Eurosurveillance ◽

10.2807/1560-7917.es.2020.25.13.2000188 ◽

2020 ◽

Vol 25 (13) ◽

Cited By ~ 16

Author(s):

Samantha K Brooks ◽

Louise E Smith ◽

Rebecca K Webster ◽

Dale Weston ◽

Lisa Woodland ◽

...

Keyword(s):

Public Health ◽

Infectious Disease ◽

Disease Outbreaks ◽

Social Contact ◽

School Closure ◽

School Closures ◽

Infectious Disease Outbreaks ◽

Evidence Review ◽

Spread Of Infection ◽

The Impact

Background Emergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited. Aim This review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures. Methods In February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted. Results A total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact. Conclusion Evidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

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Sex and Careers of University Students in Educational Practices as Factors of Individual Differences in Learning Environment and Psychological Factors during COVID-19

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145036 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5036 ◽

Cited By ~ 4

Author(s):

María del Carmen Olmos-Gómez

Keyword(s):

Individual Differences ◽

Quantitative Analysis ◽

University Students ◽

Learning Environments ◽

Delphi Method ◽

Psychological Factors ◽

Social Education ◽

School Closures ◽

Spread Of Infection ◽

The Impact

The present research was carried out in Spain during the COVID-19 pandemic following emergency school closures in an attempt to avoid the spread of infection. As a result, university students undertaking the final year of education degrees (teaching placements) have been obliged to deliver their teaching from home, adapting their teaching contexts to learning in virtual settings. A novel instrument was designed and validated in order to analyze the impact of learning environments and psychological factors in university students during a period of teaching placements. This took place in an adaptive context (state of confinement). Associations were determined between learning environments and psychological factors in adaptive contexts, in relation to the group to which they belonged (whether undertaking a degree in primary education, physical education and sport, early education or social education), and sex. The present study used a Delphi method, alongside a descriptive and quantitative analysis. The data demonstrate that learning environments differ according to the degree studied. The four analyzed groups revealed significant differences in relation to learning environments and psychological factors in adaptive confinement contexts. The subjects of Primary and Social Education were seen to be related with a greater possibility of being overwhelmed and reporting difficulties. Those more used to physical exercise showed more positive psychological indices. Females reported more negative responses. The conclusion reached is that the results of the present research will enable future additional multi-dimensional analysis to be conducted.

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