SARS-CoV-2 transmission in schools in Korea: nationwide cohort study

Lessons from inter-disciplinary collaboration to mitigate SARS-CoV-2 transmission in schools, Ireland, 2020/2021, to inform health systems and multisectoral recovery

Introduction

School closures associated with the COVID-19 pandemic resulted in the loss of educational and social supports for up to 1,000,000 students in Ireland and disproportionately affected students from lower socio-economic backgrounds. For the 2020/2021 school year, multisectoral and interdisciplinary "Schools Teams" were established within Public Health departments to maintain in-person education by minimizing transmission of SARS-CoV-2 in schools. This study aimed to describe this model and explore the experiences of Schools Team members in the East of Ireland to identify factors that influenced effective working that can be sustained in the context of health systems and multisectoral recovery.

Methods

Schools Teams were comprised of multidisciplinary staff from regional Public Health departments and redeployed staff from the Education sector. Governance rested with Public Health departments. All staff operated to nationally agreed protocols following training. The experiences of the East Schools Team members were explored through an online survey and semi-structured interviews.

Results

The survey response rate was 53/70 (75.7%). Participants reported clear channels of communication within the team (44, 83.0%), feeling comfortable in their role following training (43, 82.7%) and a positive team culture (51, 96.2%) as key facilitators of effective inter-disciplinary working. Insufficient administrative support and mixed messaging to schools were identified as barriers to efficient team collaboration.

Discussion

The Schools Team model illustrates the potential for multisectoral partnerships to effectively address complex public health priorities and contribute toward health system resilience to health threats. By recognizing and leveraging the ability of allied sectors such as the education sector, to contribute to public health goals, countries can move toward the kind of whole-of-government approach to health recognized as key to health system resilience. The strong links between the education and public health sectors developed through this collaboration could be extended and strengthened to more effectively pursue public health priorities in school settings. More broadly, mechanisms to support multisectoral working should be developed, expanding beyond reactive interventions to proactively address key health priorities and build resilience across health systems and communities. Such collaborations would promote healthier populations by promoting and encouraging a public health perspective among other sectors and embedding "health in all policies".

Transmisión del SARS-CoV-2 en escolares durante el primer trimestre del curso 2021/2022 en la provincia de Albacete: incidencia e impacto de las nuevas variantes

OBJECTIVE

The objective of this study was to know the evolution of the COVID-19 pandemic in the school setting, and the effect of the new variants on it.

DESIGN

It is an observational longitudinal descriptive study during the first term of the academic year 21/22. SITE: Community health services.

PARTICIPANTS

Preschool, elementary, secondary, and high school students.

INTERVENTIONS

none.

MAIN MEASUREMENTS

We calculated cumulative incidence stratified by grade, source of infection and follow-up period, percentage of vaccinated cases and correlation between cumulative incidence in schooled children per week and cumulative incidence in the general population.

RESULTS

1526 cases were reported, and the cumulative incidence was 3,17% and 0,48% in within-school acquired cases. 20,9% were vaccinated. During follow-up, there was an important change in incidence from weeks 49/21 on, at the time Omicron began to appear in Spain, with an increase in secondary cases, mostly high school students. We found a high correlation between general population and schooled children's cumulative incidence (R2 = 0,59).

CONCLUSIONS

SARS-CoV-2 transmission in school settings has been affected by new circulating variants. Two propagation scenarios were identified, and they were like the community propagation pattern. This supports the hypothesis that school settings reflect the transmission in the community. Reinforcement of preventive measures and surveillance would have a positive effect on school settings.

Short Term Impact of Coronavirus Disease 2019 Vaccination in Children in Korea

BACKGROUND

The epidemiology of coronavirus disease 2019 (COVID-19) has changed continuously throughout the pandemic.

METHODS

We analyzed changes in the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection according to the age group in South Korea from February 2020 to December 2021.

RESULTS

Since the COVID-19 pandemic, the incidence among adults aged ≥ 18 years was higher than all the other age groups in 2020; however, a shift toward younger ages occurred in June 2021. In addition, we found significant changes in epidemiology after the introduction of SARS-CoV-2 vaccines in adults aged ≥ 18 and children 12-17 years. Until recently, children were not regarded as the drive for the pandemic; however, children aged 5-11 and 0-4 years had the highest incidence among all the age groups.

CONCLUSION

Therefore, policies for clinical support for an increase in COVID-19 cases among young children and age-specific preventive measures are needed.

Spatial distribution of SARS-CoV-2 infection in schools, South Korea

Identification of geographical areas with high burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in schools using spatial analyses has become an important tool to guide targeted interventions in educational setting. In this study, we aimed to explore the spatial distribution and determinants of coronavirus disease 2019 (COVID-19) among students aged 3-18 years in South Korea. We analysed the nationwide epidemiological data on laboratory-confirmed COVID-19 cases in schools and in the communities between January 2020 and October 2021 in South Korea. To explore the spatial distribution, the global Moran's I and Getis-Ord's G using incidence rates among the districts of aged 3-18 years and 30-59 years. Spatial regression analysis was performed to find sociodemographic predictors of the COVID-19 attack rate in schools and in the communities. The global spatial correlation estimated by Moran's I was 0.647 for the community population and 0.350 for the student population, suggesting that the students were spatially less correlated than the community-level outbreak of SARS-CoV-2. In schools, attack rate of adults aged 30-59 years in the community was associated with increased risk of transmission (P < 0.0001). Number of students per class (in kindergartens, primary schools, middle schools and high schools) did not show significant association with the school transmission of SARS-CoV-2. In South Korea, COVID-19 in students had spatial variations across the country. Statistically significant high hotspots of SARS-CoV-2 transmission among students were found in the capital area, with dense population level and high COVID-19 burden among adults aged 30-59 years. Our finding suggests that controlling community-level burden of COVID-19 can help in preventing SARS-CoV-2 infection in school-aged children.