A cross-sectional and prospective cohort study of the role of schools in the SARS-CoV-2 second wave in Italy.
cross_sectional · Level IV
Where this comes from
- Record sourced from PubMed, PMID 34104904.
- Also identified by DOI 10.1016/j.lanepe.2021.100092 and PMC identifier 7995620.
- Licence recorded as CC BY-NC-ND.
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Abstract
During COVID-19 pandemic, school closure has been mandated in analogy to its effect against influenza, but it is unclear whether schools are early COVID-19 amplifiers. We performed a cross-sectional and prospective cohort study in Italy during the second COVID-19 wave (from September 30, 2020 until at least February 28, 2021). We used databases from the Italian Ministry of Education, the Veneto region systems of SARS-CoV-2 cases notification and of schools' secondary cases tracing to compare SARS-CoV-2 incidence in students/school staff and general population and incidence across age groups. Number of tests, secondary infections by type of index case and ratio cases/ tests per school were estimated using an adjusted multivariable generalized linear regression model. Regional reproduction numbers R<sub>t</sub> were estimated from Italian Civil Protection daily incidence data with a method of posterior distribution using a Markov Chain Monte Carlo algorithm. SARS-CoV-2 incidence among students was lower than in the general population. Secondary infections at school were <1%, and clusters of ≥2 secondary cases occurred in 5-7% of the analysed schools. Incidence among teachers was comparable to the population of similar age (<i>P</i> = 0.23). Secondary infections among teachers were rare, occurring more frequently when the index case was a teacher than a student (37% vs. 10%, <i>P</i> = 0.007). Before and around the date of school opening in Veneto, SARS-CoV-2 incidence grew maximally in 20-29- and 45-49-years old individuals, not among students. The lag between school opening dates in Italian regions and the increase in the regional COVID-19 R<sub>t</sub> was not uniform. Finally, school closures in two regions where they were implemented before other measures did not affect R<sub>t</sub> decrease. This analysis does not support a role for school opening as a driver of the second COVID-19 wave in Italy, a large European country with high SARS-CoV-2 incidence. Fondazione MITE.