1
|
Ramirez M, Bishop S, Ibarra G, Shah P, Duran MC, Chae HY, Hassell L, Garza L, Linde S, Garrison MM, Drain PK, Ko LK. An agricultural community's perspectives on COVID-19 testing to support safe school reopening. Front Public Health 2023; 11:1215385. [PMID: 37601218 PMCID: PMC10434621 DOI: 10.3389/fpubh.2023.1215385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction School-based COVID-19 testing may be an effective strategy for reducing transmission in schools and keeping schools open. The study objective was to examine community perspectives on school-based COVID-19 testing as a mitigation strategy to support safe school reopening. Methods We conducted a qualitative study in Yakima County, an agricultural region of Washington state, where over half of residents are Hispanic/Latino. From June to July 2021, we interviewed 18 students (13 years old, on average) and 19 school employees, and conducted four focus groups (2 in Spanish, 2 in English) with 26 parents. We audio-recorded the semi-structured interviews and focus group discussions which were then transcribed. We used an inductive, constant comparison approach to code the transcripts and conducted a thematic analysis to generate themes. Results We identified four main themes. Students, parents, and school employees desired a return to in-person learning (Theme 1). Schools implemented numerous COVID-19 mitigation strategies (e.g., masking) to facilitate a safe return to school but felt that adding testing would not be feasible due to a lack of resources and overworked staff (Theme 2). Parents and school employees' familiarity with COVID-19 testing procedures influenced their support for testing (Theme 3). Parents and school employees felt there were inadequate resources for individuals who test positive for COVID-19 (Theme 4). Discussion Schools require adequate resources and medical personnel to implement COVID-19 testing. Individuals also need resources after testing positive, including physical space to isolate, financial resources for those without paid time off, and delivery of food and other necessities to households in rural communities.
Collapse
Affiliation(s)
- Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
| | - Sonia Bishop
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
| | - Genoveva Ibarra
- Center for Community Health Promotion, Fred Hutchinson Cancer Center, Sunnyside, WA, United States
| | - Parth Shah
- Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Miriana C. Duran
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
| | - Hwa Young Chae
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
| | - Laurie Hassell
- Institute of Translational Health Sciences, Seattle, WA, United States
| | - Lorenzo Garza
- Sunnyside School District, Sunnyside, WA, United States
| | | | - Michelle M. Garrison
- Department of Public Health, Purdue University College of Health and Human Sciences, West Lafayette, IN, United States
| | - Paul K. Drain
- Department of Global Health, University of Washington School of Public Health, Seattle, WA, United States
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Linda K. Ko
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, United States
- Institute of Translational Health Sciences, Seattle, WA, United States
| |
Collapse
|
2
|
Singer J, Marsh JA, Menefee-Libey D, Alonso J, Bradley D, Tracy H. The Politics of School Reopening During COVID-19: A Multiple Case Study of Five Urban Districts in the 2020-21 School Year. Educ Adm Q 2023; 59:542-593. [PMID: 38602948 PMCID: PMC10186136 DOI: 10.1177/0013161x231168397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Purpose: Nearly all schools in the United States closed in spring 2020, at the onset of the COVID-19 pandemic. We analyze traditional public and charter school reopenings for the 2020-21 school year in five urban districts. We provide a rich and theoretically grounded description of how and why educational leaders made reopening decisions in each of our case districts. Research Methods: We used data from a multiple-case study from March 2020 to July 2021. The research team conducted 56 interviews with school, district, and system-level leaders; triangulated with publicly available data; and also drew on interview data from a subsample of parents and guardians in each of our sites. We analyzed these data through qualitative coding and memo writing and conducted detailed single- and cross-case analyses. Findings: School system leaders in our case sites generally consulted public health authorities, accounted for state-level health and educational guidance, and engaged with and were responsive to the interests of different stakeholders. Districts' adherence to and strategic uses of public health guidance, as well as a combination of union-district relations and labor market dynamics, influenced reopening. Parents, city, and state lawmakers, and local institutional conditions also played a role, helping to explain differences across cases. Implications: In contrast to the "politics or science" framing that has dominated research and public discourse on school reopening, we show that local pandemic conditions and local political dynamics both mattered and in fact were interrelated. Our findings have some implications for how educational leaders might navigate future crises.
Collapse
Affiliation(s)
| | | | | | - Jacob Alonso
- University of Southern California, Los Angeles, CA, USA
| | | | | |
Collapse
|
3
|
Gormley JM, Poirier V, Hassey KA, Van Pelt M, Ye L. School Nurses' Reports on Reopening Roles, Practices, and Concerns During the COVID-19 Pandemic at the Start of the 2020-2021 School Year. J Sch Nurs 2023; 39:143-149. [PMID: 34756130 PMCID: PMC9988617 DOI: 10.1177/10598405211054805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 pandemic has caused major disruptions to U.S. school systems since March 2020. To facilitate our understanding of how school nurses participated in school reopening and what support school nurses needed beginning the 2020-2021 school year during the COVID-19 pandemic, we conducted a national survey in late summer 2020. A sample of 747 school nurses from 43 states responded to an online survey about roles, practices, and concerns. Over one-third (36.9%) reported not being included in school reopening planning. Mitigation practices reported by respondents primarily included measuring temperatures of students before school (21.3%), mask wearing by students (79.9%), and 6 feet social distancing (76.7%). The respondents' greatest concerns were the educational impact on students with individualized education plans, parents sending children to school with COVID-19 symptoms, and the economic impact on families. Our results point to opportunities for greater school nurse involvement, improvements in practices, and measures to address school nurses' concerns.
Collapse
Affiliation(s)
- Jenny M Gormley
- 1848Northeastern University School of Nursing, Boston, Massachusetts, USA
| | - Vanessa Poirier
- 1848Northeastern University School of Nursing, Boston, Massachusetts, USA
| | - Kathleen A Hassey
- 1848Northeastern University School of Nursing, Boston, Massachusetts, USA
| | - Maria Van Pelt
- 1848Northeastern University School of Nursing, Boston, Massachusetts, USA
| | - Lichuan Ye
- 1848Northeastern University School of Nursing, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Valentine R, Valentine D, Valentine JL. Investigating the relationship of schools reopening to increases in COVID-19 infections using event study methodology: The case of the Delta variant. J Public Health (Oxf) 2023; 45:134-135. [PMID: 34741170 DOI: 10.1093/pubmed/fdab373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/02/2021] [Accepted: 09/16/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Hypothesis: School reopening had a significant impact on COVID-19 infection rates across USA states. METHODS Eight states with fully reopened public schools were studied. States who did not previously have stay-at-home orders for a minimum of 30 days were excluded from the study so that increases in infection rates would be solely due to the economies of reopening. This study used event study methodology with a 30-day estimation window. This allowed us to determine if increases in COVID-19 infection rates were significant following schools reopening. RESULTS Eight states were analyzed, and seven of the states had positive and significant COVID-19 infection increases. The other state's increase was negative and significant. CONCLUSIONS This study found that reopening of schools had an initial 5-day increase in COVID-19 infections in seven of eight states whose data were examined. With schools being re-opened nationwide in Fall 2021, this indicates that with the Delta variant there is an expected significant increase in infections.
Collapse
Affiliation(s)
- Randall Valentine
- Texas Tech University Rawls College of Business, Department of Finance, Lubbock, TX 79409, USA
| | - Dawn Valentine
- College of Business & Economic Development, School of Leadership, The University of Southern Mississippi, Long Beach, MS 39560, USA
| | - Jimmie L Valentine
- University of Arkansas for Medical Sciences, Department of Pediatrics, Section of Pediatric Clinical Pharmacology, and Arkansas Children's Hospital, Little Rock, AR 72205, USA
| |
Collapse
|
5
|
Collins JE. The Politics of Re-Opening Schools: Explaining Public Preferences Reopening Schools and Public Compliance with Reopening Orders During the COVID-19 Pandemic. Am Polit Res 2023; 51:223-234. [PMID: 38603294 PMCID: PMC9614594 DOI: 10.1177/1532673x221135521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Due to the COVID-19 Pandemic, the decision to reopen schools for in-person instruction has become a pressing policy issue. This study examines what overall factors drive public support for schools re-opening in person and whether members of the public are willing to comply with school re-opening decisions based on their own preferences and/or the level of government from which the order comes. Through two rounds of national surveys with an embedded experiment, I find consistent evidence that 1) trust in information from elites - not contact with COVID - best explain preferences for reopening, 2) political ideology and racial and class identification help explain preferences as well, and 3) the President of the United States is best positioned to generate compliance with a school reopening mandate. This study suggests that politics - not public health - drives public support for schools reopening and compliance with government orders to reopen.
Collapse
|
6
|
Jallul M, Elgriw N, Eltaib FI, Al Dwigen SM, Elfallah A, Elgheriani HM, Atwear WS, Milad MB, Alhudiri IM, Elzagheid A. Parents' concerns and attitudes towards school reopening during COVID-19 pandemic: a cross-sectional survey-Tripoli, Libya, 2021. Libyan J Med 2022; 17:2087847. [PMID: 35791596 PMCID: PMC9262368 DOI: 10.1080/19932820.2022.2087847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The issue of school reopening has raised several concerns; therefore, the parent’s opinion is essential to consider. This study aimed to evaluate the parent’s attitudes and concerns toward school reopening in the COVID-19 era. A cross-sectional survey was performed using in-person self-administered questionnaires, the data was collected in the period between January and April 2021 covering parents’ concerns and attitudes toward school reopening. A total of 402 parents participated in the survey. Analysis showed that 56.7% of parents have agreed with school reopening, but 54% have raised some legitimate concerns. Importantly, there was a strong correlation between parents’ opinions towards school reopening and their level of education, and their concerns about their children’s safety if the school was reopened. Despite parents’ concerns, it does seem that slightly over half were in favour of school reopening and would send their children to school only if the schools did apply strict precautions and restriction measures. Sharing parents’ views toward school reopening with school leaders and decision-makers is important to assess the feasibility and effectiveness of return to schools and to improve existing prevention programs.
Collapse
Affiliation(s)
- Mwada Jallul
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Nada Elgriw
- Department of Microbiology, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Farag I Eltaib
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Samira M Al Dwigen
- Department of Cell Biology, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Asma Elfallah
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Hajer M Elgheriani
- Department of Microbiology, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Wafeya S Atwear
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Mohamed Burid Milad
- Department of Cell Biology, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Inas M Alhudiri
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| | - Adam Elzagheid
- Department of Genetic Engineering, Libyan Centre for Biotechnology Research, Tripoli, Libya
| |
Collapse
|
7
|
Jani SG, Ma J, Pulendran U, Hsing JC, Altamirano J, Shah S, Toomarian EY, Maldonado Y, Wang CHJ. Prospective Pilot Study Evaluating SARS-CoV-2 Transmission-Limiting Measures in an On-Site School. Acad Pediatr 2022; 22:671-679. [PMID: 34896273 PMCID: PMC8651529 DOI: 10.1016/j.acap.2021.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/18/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of our study is to evaluate the feasibility and reliability of a comprehensive set of preventive measures in limiting secondary transmission of COVID-19 in schools. METHODS A prospective cohort study was conducted to evaluate SARS-CoV-2 transmission in an independent K-8 school in San Mateo County, California. The research was conducted between September 14, 2020 through March 22, 2021 and consisted of: 1) demographic and epidemiological questionnaires; 2) daily symptom reporting; 3) weekly RT-PCR testing; and 4) periodic on-site qualitative observations. RESULTS One hundred eighty (79%) students and 63 (74%) on-site staff/contractors were enrolled. Participants reported symptoms in 144 (<1%) daily surveys of the 19,409 collected. Among those who reported symptoms and exposures, none tested positive during the 22-week study period. Of all participants, a total of 6 tested positive for SARS-CoV-2 at least once by RT-PCR; all were asymptomatic at time of testing. No in-school transmission occurred. Mask adherence was high among all grades, and incidents of improper mask use mostly occurred during noninstruction time. Physical distancing was well-enforced during class time and snack breaks, although adherence during noninstruction time waned as the school year progressed. CONCLUSIONS Our comprehensive, prospective study following COVID-19 transmission over 22 weeks in a K-8 school demonstrates that: 1) surveillance testing is important for detecting asymptomatic infections in schools; 2) monitoring symptoms may not be necessary and/or sufficient for COVID-19; and 3) younger children can adhere to key mitigation measures (eg, masking) which have the potential to limit transmission.
Collapse
Affiliation(s)
- Shilpa G Jani
- Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif
| | - Jasmin Ma
- Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif
| | - Uma Pulendran
- Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif
| | - Julianna C Hsing
- Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif; Department of Epidemiology and Population Health (JC Hsing), Stanford University School of Medicine, Stanford, Calif
| | - Jonathan Altamirano
- Division of Infectious Diseases, Department of Pediatrics (Y Maldonado), Stanford University School of Medicine, Stanford, Calif
| | - Soleil Shah
- Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif
| | - Elizabeth Y Toomarian
- Graduate School of Education (EY Toomarian), Stanford University, Stanford, Calif; Synapse School (EY Toomarian), Menlo Park, Calif
| | - Yvonne Maldonado
- Division of Infectious Diseases, Department of Pediatrics (Y Maldonado), Stanford University School of Medicine, Stanford, Calif
| | - Chih-Hung Jason Wang
- Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif; Center for Health Policy, Freeman-Spogli Institute for International Studies (CJ Wang), Stanford University, Stanford, Calif; Department of Health Policy (CJ Wang), Stanford University School of Medicine, Stanford, Calif.
| |
Collapse
|
8
|
Pudjiadi AH, Putri ND, Sjakti HA, Yanuarso PB, Gunardi H, Roeslani RD, Pasaribu AD, Nurmalia LD, Sambo CM, Habibah L, Utami INA, Prawira Y, Kaswandani N, Alam A, Kadafi KT, Hanafi G, Tjahjadi AK, Aprianti SC, Salma NM, Wijaya S, Alatas FS, Pulungan AB. Parents' Perspectives Toward School Reopening During COVID-19 Pandemic in Indonesia-A National Survey. Front Public Health 2022; 10:757328. [PMID: 35444978 PMCID: PMC9014259 DOI: 10.3389/fpubh.2022.757328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background All sectors are affected due to COVID-19 pandemic occurring worldwide, including the education industry. School closure had been taking place for more than a year in Indonesia. Despite the controversies, Indonesian government had decided to begin school reopening. Objectives This study aims to assess parental readiness for school reopening, and factors affecting parental attitude toward school reopening. Methods A cross-sectional study using online questionnaire distributed via official Indonesian Pediatric Society (IPS) official social media account collected between March and April 2021. The questionnaire contained the general characteristics of study participants, parents' knowledge, and perspectives on COVID-19, and health protocols for school reopening. Results A total of 17,562 responses were collected, of which 55.7% parents were ready to send their children to school should school reopens. Factors significantly contribute to parental decision to keep their child at home were: presence of vulnerable population at home [OR = 1.18 (1.10–1.27), p < 0.001], children with comorbidities [OR = 2.56 (2.29–2.87), p < 0.001], perception of COVID-19 as a dangerous disease [OR = 28.87 (14.29–58.33), p < 0.001], experience with COVID-19 positive cases in the community [OR = 1.75 (1.61–1.90), p < 0.001], COVID-19 related death in the community [OR = 2.05 (1.90–2.21), P < 0.001], approval for adult COVID-19 vaccination [OR = 1.69 (1.53–1.87), p < 0.001], and ownership of private transportation [OR = 1.46 (1.30–1.66), p <0.001]. Conclusion We identified several factors affecting parental perception on school reopening during COVID-19 pandemic that should be addressed. This study can be used for policy-maker to make further recommendations and health educations prior to school reopening in Indonesia.
Collapse
Affiliation(s)
- Antonius Hocky Pudjiadi
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Nina Dwi Putri
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Hikari Ambara Sjakti
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Piprim Basarah Yanuarso
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Hartono Gunardi
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Rosalina Dewi Roeslani
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | | | | | | | | | - Yogi Prawira
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Nastiti Kaswandani
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Anggraini Alam
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Pediatrics, Hasan Sadikin Hospital, Faculty of Medicine Universitas Padjajaran, Bandung, Indonesia
| | - Kurniawan Taufiq Kadafi
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Pediatrics, Dr. Saiful Anwar Hospital, Faculty of Medicine Universitas Brawijaya, Malang, Indonesia
| | - Gryselda Hanafi
- Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Angela Kimberly Tjahjadi
- Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Shindy Claudya Aprianti
- Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Nabila Maudy Salma
- Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Stephanie Wijaya
- Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Fatima Safira Alatas
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Aman Bhakti Pulungan
- Indonesian Pediatric Society, Jakarta, Indonesia.,Department of Child Health, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| |
Collapse
|
9
|
Yuan P, Aruffo E, Gatov E, Tan Y, Li Q, Ogden N, Collier S, Nasri B, Moyles I, Zhu H. School and community reopening during the COVID-19 pandemic: a mathematical modelling study. R Soc Open Sci 2022; 9:211883. [PMID: 35127115 PMCID: PMC8808096 DOI: 10.1098/rsos.211883] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/04/2022] [Indexed: 05/03/2023]
Abstract
Operating schools safely during the COVID-19 pandemic requires a balance between health risks and the need for in-person learning. Using demographic and epidemiological data between 31 July and 23 November 2020 from Toronto, Canada, we developed a compartmental transmission model with age, household and setting structure to study the impact of schools reopening in September 2020. The model simulates transmission in the home, community and schools, accounting for differences in infectiousness between adults and children, and accounting for work-from-home and virtual learning. While we found a slight increase in infections among adults (2.2%) and children (4.5%) within the first eight weeks of school reopening, transmission in schools was not the key driver of the virus resurgence in autumn 2020. Rather, it was community spread that determined the outbreak trajectory, primarily due to increases in contact rates among adults in the community after school reopening. Analyses of cross-infection among households, communities and schools revealed that home transmission is crucial for epidemic progression and safely operating schools, while the degree of in-person attendance has a larger impact than other control measures in schools. This study suggests that safe school reopening requires the strict maintenance of public health measures in the community.
Collapse
Affiliation(s)
- Pei Yuan
- Laboratory of Mathematical Parallel Systems (LAMPS), Department of Mathematics and Statistics, York University, Toronto, Canada
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Elena Aruffo
- Laboratory of Mathematical Parallel Systems (LAMPS), Department of Mathematics and Statistics, York University, Toronto, Canada
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Evgenia Gatov
- Toronto Public Health, City of Toronto, Toronto, Ontario, Canada
| | - Yi Tan
- Laboratory of Mathematical Parallel Systems (LAMPS), Department of Mathematics and Statistics, York University, Toronto, Canada
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Qi Li
- Laboratory of Mathematical Parallel Systems (LAMPS), Department of Mathematics and Statistics, York University, Toronto, Canada
- Department of Mathematics, Shanghai Normal University, Shanghai, People's Republic of China
| | - Nick Ogden
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Quebec, Canada
| | - Sarah Collier
- Toronto Public Health, City of Toronto, Toronto, Ontario, Canada
| | - Bouchra Nasri
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Iain Moyles
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Huaiping Zhu
- Laboratory of Mathematical Parallel Systems (LAMPS), Department of Mathematics and Statistics, York University, Toronto, Canada
- Canadian Centre for Diseases Modeling (CCDM), York University, Toronto, Canada
- Department of Mathematics and Statistics, York University, Toronto, Canada
| |
Collapse
|
10
|
Michelson KA, Samuels-Kalow ME. Association of Elementary School Reopening Status and County COVID-19 Incidence. Acad Pediatr 2022; 22:667-670. [PMID: 34547519 PMCID: PMC8455308 DOI: 10.1016/j.acap.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/27/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the association between elementary school opening status (ESOS) and changes in pediatric COVID-19 incidence. METHODS We conducted a cross-sectional study of US counties with school districts with ≥500 elementary school students. The main exposure was ESOS in September, 2020. The outcome was county incidence of COVID-19. Age-stratified negative binomial regression models were constructed using county adult COVID-19 incidence. RESULTS Among 3220 US counties, 618 (19.2%) were remote, 391 (12.1%) were hybrid, 2022 (62.8%) were in-person. In unadjusted models, COVID-19 incidence after school started was higher among children in hybrid or in-person counties compared with remote counties. After adjustment for local adult incidence, among children aged 0 to 9, the incidence rate ratio of COVID-19 (IRR) compared with remote counties was 1.01 (95% confidence interval [CI] 0.93-1.08) in hybrid counties and 0.79 (95% CI 0.75-0.84) in in-person counties. CONCLUSIONS Counties with in-person learning did not have higher rates of COVID-19 after adjustment for local adult rates.
Collapse
Affiliation(s)
- Kenneth A. Michelson
- Division of Emergency Medicine, Boston Children's Hospital (KA Michelson), Boston, Mass,Address correspondence to Kenneth A Michelson, MD, MPH, Boston Children's Hospital, Division of Emergency Medicine, 300 Longwood Ave, BCH 3066, Boston, MA 02115
| | - Margaret E. Samuels-Kalow
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School Boston (ME Samuels-Kalow), Mass
| |
Collapse
|
11
|
Wang J, Wang Y, Lin H, Chen X, Wang H, Liang H, Guo X, Fu C. Mental Health Problems Among School-Aged Children After School Reopening: A Cross-Sectional Study During the COVID-19 Post-pandemic in East China. Front Psychol 2021; 12:773134. [PMID: 34858298 PMCID: PMC8631808 DOI: 10.3389/fpsyg.2021.773134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Most studies on mental health problems caused by COVID-19 crisis in children were limited to the period of home quarantine. It remained unclear what adverse impact of the psychosocial stressors caused by school reopening, as well as the transitions in daily activities and social interactions had on mental health in children. Methods: A total of 6400 students in primary schools were enrolled in a cross-sectional study conducted in East China, between June 26 and July 6, 2020, when schools reopened. Children’s mental health status was assessed by the parent version of Strengths and Difficulties Questionnaire (SDQ). Ultimately, data on a total of 6017 children with completed information on mental health, psychosocial stressors, daily activities, and social interactions were eligible for analysis. The associations of mental health with psychosocial stressors, daily activities, and social interactions were determined by ordinal logistic regression models. Stratified analyses were conducted according to grade, gender, school level, area, and caregiver–child relationship to further observe the effects of stressors on mental status. Results: The prevalence of borderline, moderately abnormal, and prominently abnormal scores were 7.16, 3.34, and 1.96% for total difficulties, and 13.83, 13.45, and 17.85% for prosocial behavior, respectively. Children with psychological stressors had a significantly higher risk of being in a worse category of mental health status, with the maximum adjusted OR of 7.90 (95% CI 3.33–18.75) in those definitely afraid of inadaptation to study and life styles. Time used in home work and computer games was positively related to mental health problems, while physical exercises and frequency of communication with others was negatively related. The effects of psychological stressors on total difficulties were more evident in middle-high grade students (OR = 7.52, 95% CI 4.16–8.61), boys (OR = 6.95, 95% CI 4.83–8.55), those who lived in Taizhou (OR = 7.62, 95% CI 4.72–8.61) and with poor caregiver–child relationship (OR = 7.79, 95% CI 2.26–8.65). Conclusion: Emotional and behavioral difficulties, especially less prosocial behavior, were prevalent in primary school children after schools reopened. The Chinese government, communities, schools, and families need to provide more effective support for students’ transition back into the school building and address emotional and behavioral problems for children with difficulties.
Collapse
Affiliation(s)
- Jingyi Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Yingying Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Haijiang Lin
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
| | - Xiaoxiao Chen
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
| | - Hao Wang
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| | - Hongbiao Liang
- Taizhou City Center for Disease Prevention and Control, Taizhou, China
| | - Xiaoqin Guo
- Songjiang District Center for Disease Prevention and Control, Shanghai, China
| | - Chaowei Fu
- Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China
| |
Collapse
|
12
|
Stage HB, Shingleton J, Ghosh S, Scarabel F, Pellis L, Finnie T. Shut and re-open: the role of schools in the spread of COVID-19 in Europe. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200277. [PMID: 34053270 PMCID: PMC8165592 DOI: 10.1098/rstb.2020.0277] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 12/21/2022] Open
Abstract
We investigate the effect of school closure and subsequent reopening on the transmission of COVID-19, by considering Denmark, Norway, Sweden and German states as case studies. By comparing the growth rates in daily hospitalizations or confirmed cases under different interventions, we provide evidence that school closures contribute to a reduction in the growth rate approximately 7 days after implementation. Limited school attendance, such as older students sitting exams or the partial return of younger year groups, does not appear to significantly affect community transmission. In countries where community transmission is generally low, such as Denmark or Norway, a large-scale reopening of schools while controlling or suppressing the epidemic appears feasible. However, school reopening can contribute to statistically significant increases in the growth rate in countries like Germany, where community transmission is relatively high. In all regions, a combination of low classroom occupancy and robust test-and-trace measures were in place. Our findings underscore the need for a cautious evaluation of reopening strategies. This article is part of the theme issue 'Modelling that shaped the early COVID-19 pandemic response in the UK'.
Collapse
Affiliation(s)
- Helena B. Stage
- Department of Mathematics, University of Manchester, Manchester, UK
| | | | - Sanmitra Ghosh
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Francesca Scarabel
- Department of Mathematics, University of Manchester, Manchester, UK
- Laboratory of Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto Ontario, Canada
- CDLab - Computational Dynamics Laboratory, Department of Mathematics, Computer Science and Physics, University of Udine, Italy
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, UK
- The Alan Turing Institute, London, UK
| | - Thomas Finnie
- Emergency Response Department, Public Health England, London, UK
| |
Collapse
|
13
|
Liu D, Lin G, Sun X, Du Y, Liu H, Qu M. Different School Reopening Plans on Coronavirus Disease 2019 Case Growth Rates in the School Setting in the United States. J Sch Health 2021; 91:370-375. [PMID: 33768584 PMCID: PMC8250982 DOI: 10.1111/josh.13009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/01/2021] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In fall 2020, all public K-12 schools reopened in broadly 3 learning models. The hybrid model was considered a mid-risk option compared with remote and in-person learning models. The current study assesses school-based coronavirus disease 2019 (COVID-19) spread in the early fall using a national data set. METHODS We assess COVID-19 case growth rates from August 10 to October 14, 2020 based on a crowdsourcing data set from the National Education Association. The study follows a retrospective cohort design with the baseline exposures being 3 teaching models: remote learning only, hybrid, and in-person learning. To assess the consistency of our findings, we estimated the overall, as well as region-specific (Northeast, Midwest, South, and West) and poverty-specific (low, mid, and high) COVID-19 case-growth rates. In addition, we validated our study sample using another national sample survey data. RESULTS The baseline was from 617 school districts in 48 states, where 47% of school districts were in hybrid, 13% were in remote, and 40% were in-person. Controlling for state-level risk and rural-urban difference, the case growth rates for remote and in-person were lower than the hybrid (odds ratio [OR]: 0.963, 95% confidence interval [CI]: 0.960-0.965 and OR: 0.986, 95% CI: 0.984-0.988, respectively). A consistent result was found among school districts in all 4 regions and each poverty level. CONCLUSIONS Hybrid may not necessarily be the next logical option when transitioning from the remote to in-person learning models due to its consistent higher case growth rates than the other 2 learning models.
Collapse
Affiliation(s)
- Dong Liu
- Data analyst, , Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha., USA
| | - Ge Lin
- Professor, ( Xiaoting), Department of Environmental and Occupational Health, University of Nevada, Las Vegas, Las Vegas., USA
| | - Xiaoting Sun
- Postdoctoral researcher, , Tenth people's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Du
- Epidemiology assistant, , Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha., USA
| | - Han Liu
- GIS coordinator, , Epidemiology Informatics, Nebraska Department of Health and Human Service, Lincoln., USA
| | - Ming Qu
- Senior Epidemiologist/ Research liaison, , Epidemiology Informatics, Nebraska Department of Health and Human Service, Lincoln., USA
| |
Collapse
|
14
|
Pattison KL, Hoke AM, Schaefer EW, Alter J, Sekhar DL. National Survey of School Employees: COVID-19, School Reopening, and Student Wellness. J Sch Health 2021; 91:376-383. [PMID: 33655549 PMCID: PMC8014727 DOI: 10.1111/josh.13010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND During spring 2020, COVID-19 forced widespread United States school building closures in an unprecedented disruption for K-12 students and staff. Partnering with the American School Health Association (ASHA), we sought to identify areas of concern among school staff planning for school reopening with the goal of addressing gaps in resources and education. METHODS This 16-item web-based survey was distributed via email to 7467 ASHA members from May to June 2020. Topics focused on 3 Whole School, Whole Community, Whole Child components: physical environment, health services, and mental health. Chi-square tests were used to identify differences in responses by school characteristics and school role on each survey item. RESULTS A total of 375 respondents representing 45 states completed the survey. The majority were female (91.7%), white (83.4%) and non-Hispanic (92.2%), and school nurses (58.7%). Priority concerns were feasibility of social distancing (93.6%), resurgence of COVID-19 (92.8%), and the availability of health supplies (88.8%). CONCLUSION Understanding staff concerns in the context of the Whole School, Whole Community, Whole Child model better positions the school community to address ongoing gaps and changing needs as schools continue to address COVID-19 complications.
Collapse
Affiliation(s)
- Krista L Pattison
- Project Manager, , Penn State PRO Wellness, 90 Hope Drive, Hershey, PA, 17033., USA
| | - Alicia M Hoke
- Project Manager, , Penn State PRO Wellness, 90 Hope Drive, Hershey, PA, 17033., USA
| | - Eric W Schaefer
- Biostatistician, , Penn State College of Medicine, 90 Hope Drive, Hershey, PA, 17033., USA
| | - Jeanie Alter
- Executive Director, , The American School Health Association, 501 N Morton Street, Suite 110, Bloomington, IN, 47404., USA
| | - Deepa L Sekhar
- Associate Professor of Pediatrics, , Penn State College of Medicine, 500 University Drive, HS83, Hershey, PA, 17033., USA
| |
Collapse
|
15
|
Kwon I, Kang S, Kim JS. School-Based Participatory Response for Reopening During the COVID-19 Pandemic: A Case Study of a Metropolitan High School Implementing the Health Promoting School. Front Public Health 2021; 9:578200. [PMID: 33889556 PMCID: PMC8055834 DOI: 10.3389/fpubh.2021.578200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/05/2021] [Indexed: 11/14/2022] Open
Abstract
Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a “school disinfection strategy” to ensure the students' right to study in a safe environment, and also to analyze the lessons learned from this process. Methods: This was a case study of school health in a community-based school reopening during the COVID-19 pandemic. The study target was a 64-year-old private high school with 12 classes for each grade with a total of 1,100 students. Results: A “school disinfection strategy” was set up at individual and class environment levels to protect students from the risk of infection. In addition, school health activities were carried out with a “personal protection safety belt” and “community protection safety belt” for effective implementation. To ensure a safe educational environment for high school students and to ensure smooth execution of face-to-face classes (in-person teaching), the “prevention safety belt strategy” was introduced in accordance with governmental guidelines to sequentially implement various preventive measures necessary to guarantee environmental safety of schools. Activating personal prevention safety belts by checking the symptoms of students when entering the school and during each class, and providing self-made disinfectants by spraying alcohol on wet-wipes were cost-effective and sustainable methods used in this school to prevent the spread of infection. Conclusions: The experience of developing a prevention safety belt strategy to adapt the guidelines of the local education office to the school situation was presented. Focusing on the school community, as well as individual students and teachers, the concept of prevention safety belts helped to unite and stimulate voluntary participation of students in health promotion activities.
Collapse
Affiliation(s)
- Insook Kwon
- Ewha Womans University High School, Seoul, South Korea
| | - Sunjoo Kang
- Department of Global Health, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Jin Sun Kim
- Department of Nursing, Chosun University, Gwangju, South Korea
| |
Collapse
|
16
|
Akiba D. Reopening America's Schools During the COVID-19 Pandemic: Protecting Asian Students From Stigma and Discrimination. Front Sociol 2020; 5:588936. [PMID: 33869517 PMCID: PMC8022472 DOI: 10.3389/fsoc.2020.588936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
The COVID-19 outbreak has prompted a rise in stigma and discrimination against people of Asian descent in many areas in the world, including the United States. Anti-Asian hate incidents, which have ranged from verbal attacks, refusal of service to physical assault, continue to transpire in the U.S., and they put psychological and physical well-being of Asian children at increased risk. Discussions toward reopening of U.S. schools thus far, however, seem to have exclusively included the infection-related concerns and pedagogical consequences of continued disruptions in face-to-face instructions. Hence, educators, policymakers, and other stakeholders need to have plans in place to ensure that reopening of schools will be a smooth experience for students of all backgrounds.
Collapse
Affiliation(s)
- Daisuke Akiba
- School of Education, Queens College and The Graduate Center of The City University of New York, Queens, NY, United States
| |
Collapse
|
17
|
Downes KJ, Danziger-Isakov LA, Cousino MK, Green M, Michaels MG, Muller WJ, Orscheln RC, Sharma TS, Statler VA, Wattier RL, Ardura MI. Return to School for Pediatric Solid Organ Transplant Recipients in the United States During the Coronavirus Disease 2019 Pandemic: Expert Opinion on Key Considerations and Best Practices. J Pediatric Infect Dis Soc 2020; 9:551-563. [PMID: 32750142 PMCID: PMC7454776 DOI: 10.1093/jpids/piaa095] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/01/2020] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has created many challenges for pediatric solid organ transplant (SOT) recipients and their families. As the pandemic persists, patients and their families struggle to identify the best and safest practices for resuming activities as areas reopen. Notably, decisions about returning to school remain difficult. We assembled a team of pediatric infectious diseases (ID), transplant ID, public health, transplant psychology, and infection prevention and control specialists to address the primary concerns about school reentry for pediatric SOT recipients in the United States. Based on available literature and guidance from national organizations, we generated consensus statements pertaining to school reentry specific to pediatric SOT recipients. Although data are limited and the COVID-19 pandemic is highly dynamic, our goal was to create a framework from which providers and caregivers can identify the most important considerations for each pediatric SOT recipient to promote a safe return to school.
Collapse
Affiliation(s)
- Kevin J Downes
- Division of Infectious Diseases, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lara A Danziger-Isakov
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Melissa K Cousino
- Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan, USA
- University of Michigan Transplant Center, Ann Arbor, Michigan, USA
| | - Michael Green
- Division of Pediatric Infectious Diseases, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Pediatrics and Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Marian G Michaels
- Division of Pediatric Infectious Diseases, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Pediatrics and Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - William J Muller
- Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rachel C Orscheln
- Division of Pediatric Infectious Diseases, St. Louis Children’s Hospital, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University, St. Louis, Missouri, USA
| | - Tanvi S Sharma
- Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Victoria A Statler
- Division of Infectious Diseases, Norton Children’s Hospital, Louisville, Kentucky, USA
- Department of Pediatrics, University of Louisville, Louisville, Kentucky, USA
| | - Rachel L Wattier
- Division of Infectious Diseases and Global Health, Department of Pediatrics, University of California–San Francisco, San Francisco, California, USA
| | - Monica I Ardura
- Division of Infectious Diseases and Host Defense, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Department of Pediatrics, Ohio State University, Columbus, Ohio, USA
| |
Collapse
|