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SARS-CoV-2 infection and transmission in school settings during the second COVID-19 wave: a cross-sectional study, Berlin, Germany, November 2020
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View Affiliations Hide AffiliationsFrank P Mockenhauptteststrategie charite.de
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BECOSS Study Group: Esna Bozkurt, Tanja Chylla, Melanie Bothmann, Esra Demirtas, llay Gülec, Verena Haack, Franziska Haniel, Philipp Horn, Sophia Kindzierski, Mandy Kollatzsch, Marco Kurzmann, Sascha Lieber, Elisabeth Linzbach, Frederike Peters, Heike Rössig, Rafael Santos de Oliveira, Julia Steger, Zümrüt Tuncer, Vanessa Voelskow, Christof WiesmannView Citation Hide Citation
Citation style for this article: . SARS-CoV-2 infection and transmission in school settings during the second COVID-19 wave: a cross-sectional study, Berlin, Germany, November 2020. Euro Surveill. 2021;26(34):pii=2100184. https://doi.org/10.2807/1560-7917.ES.2021.26.34.2100184 Received: 02 Feb 2021; Accepted: 05 May 2021
Abstract
School attendance during the COVID-19 pandemic is intensely debated.
In November 2020, we assessed SARS-CoV-2 infections and seroreactivity in 24 randomly selected school classes and connected households in Berlin, Germany.
We collected oro-nasopharyngeal swabs and blood samples, examining SARS-CoV-2 infection and IgG antibodies by RT-PCR and ELISA. Household members self-swabbed. We assessed individual and institutional prevention measures. Classes with SARS-CoV-2 infection and connected households were retested after 1 week.
We examined 1,119 participants, including 177 primary and 175 secondary school students, 142 staff and 625 household members. SARS-CoV-2 infection occurred in eight classes, affecting each 1–2 individuals. Infection prevalence was 2.7% (95% confidence interval (CI): 1.2–5.0; 9/338), 1.4% (95% CI: 0.2–5.1; 2/140), and 2.3% (95% CI: 1.3–3.8; 14/611) among students, staff and household members. Six of nine infected students were asymptomatic at testing. We detected IgG antibodies in 2.0% (95%CI: 0.8–4.1; 7/347), 1.4% (95% CI: 0.2–5.0; 2/141) and 1.4% (95% CI: 0.6–2.7; 8/576). Prevalence increased with inconsistent facemask-use in school, walking to school, and case-contacts outside school. For three of nine households with infection(s), origin in school seemed possible. After 1 week, no school-related secondary infections appeared in affected classes; the attack rate in connected households was 1.1%.
School attendance under rigorously implemented preventive measures seems reasonable. Balancing risks and benefits of school closures need to consider possible spill-over infection into households. Deeper insight is required into the infection risks due to being a schoolchild vs attending school.
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