Community SARS-CoV-2 Surge and Within-School Transmission

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  • Zimmerman, Kanecia O.
    • Other Affiliation: Duke University School of Medicine
  • Brookhart, M. Alan
    • Other Affiliation: Duke University School of Medicine
  • Kalu, Ibukunoluwa C.
    • Other Affiliation: Duke University School of Medicine
  • Boutzoukas, Angelique E.
    • Other Affiliation: Duke University School of Medicine
  • McGann, Kathleen A.
    • Other Affiliation: Duke University School of Medicine
  • Smith, Michael J.
    • Other Affiliation: Duke University School of Medicine
  • Panayotti, Gabriela M. Maradiaga
    • Other Affiliation: Duke University School of Medicine
  • Armstrong, Sarah C.
    • Other Affiliation: Duke University School of Medicine
  • Weber, David J.
    • Affiliation: School of Medicine
  • Moorthy, Ganga S.
    • Other Affiliation: Duke University School of Medicine
  • Benjamin, Daniel K.
    • Other Affiliation: Duke University School of Medicine
Abstract
  • OBJECTIVES: When the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began, experts raised concerns about in-person instruction in the setting of high levels of community transmission. We describe secondary transmission of SARS-CoV-2 within North Carolina (NC) K-12 school districts during a winter surge to determine if mitigation strategies can hinder within-school transmission. METHODS: From 10/26/2020–02/28/2021, 13 NC school districts participating in the ABC Science Collaborative were open for in-person instruction, adhered to basic mitigation strategies, and tracked community- and school-acquired SARS-CoV-2 cases. Public health officials adjudicated each case. We combined these data with that from August 2020 to evaluate the effect of the SARS-CoV-2 winter surge on infection rates, as well as weekly community- and school-acquired cases. We evaluated the number of secondary cases generated by each primary case, as well as the role of athletic activities in school-acquired cases. RESULTS: More than 100,000 students and staff from 13 school districts attended school in-person; of these, 4,969 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, NC local health department staff identified an additional 209 infections among >26,000 school close contacts (secondary attack rate <1%). Most within-school transmissions in high schools (75%) were linked to school-sponsored sports. School-acquired cases slightly increased during the surge; however, within-school transmission rates remained constant, from pre-surge to surge, with approximately 1 school-acquired case for every 20 primary cases. CONCLUSIONS: With adherence to basic mitigation strategies, within-school transmission of SARS-CoV-2 can be interrupted, even during a surge of community infections.
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  • Article
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  • In Copyright
Journal title
  • Pediatrics
Language
  • English
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  • Postprint
ISSN
  • 0031-4005, 1098-4275

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