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      SARS‐CoV‐2 Positivity rates are lower in school compared with local rates in Brooklyn, New York

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          Abstract

          The World Health Organization (WHO) classified the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) outbreak as a pandemic in March 2020. In‐person school instruction in the United States (U.S.) was closed to reduce social interaction and potentially minimise infectious disease transmission. 1 New York City (NYC) re‐opened public and private school in September 2020 with preventive measures. However, few reports have addressed the contribution of school safety protocols to rates of infection in private schools and their communities. In this study, incidental infection data were analysed from a representative private school located in high prevalence area in Brooklyn, N.Y. and corresponding local and regional community‐based testing (September 2020 to April 2021). School prevalence was low, while community and regional prevalence for SARS‐CoV‐2 was high, suggesting low infection risks in private school settings. For safety purposes, the NYC department of health and mental hygiene (DOHMH) set up a programme for weekly COVID‐19 screening in all schools to monitor coronavirus disease‐19 (COVID‐19) infection rates. COVID‐19 infection data were collected from a representative reopened private school in Brooklyn, N.Y., in the Homecrest neighborhood (microcluster red zone) and from the corresponding local and regional areas (September 2020 to April 2021). Data were collected from the school principal using deidentified data and from the NYC Health COVID‐19 data website https://www1.nyc.gov/site/doh/covid/covid‐19‐data.page. 2 Prevalence data were compared from testing done in school to community prevalence estimates determined from statistical models. Data shown in Figure 1 are the percent of people given a molecular test (RT‐PCR) who tested positive for SARS‐CoV‐2 in either the school, local, Brooklyn or N.Y.C. Population numbers for school, local, Brooklyn and NYC are 701, 83,119, 2.59 million and 8.419 million, respectively, for 2019. SARS‐CoV‐2 prevalence in schools was lower than prevalence in the corresponding local or general community for all months (Figure 1). FIGURE 1 Percent of people given a molecular test (RT‐PCR) who tested positive for SARS‐CoV‐2. School: triangle; NYC: square; Brooklyn: circle; Local: diamond The findings of this study suggest that in this community, children might have a limited role in virus transmission. Results of this study are consistent with prior studies that demonstrated COVID‐19 infection rates in schools were low. Varma et al., reported that people associated with NYC public schools had an overall burden of COVID‐19 infections that was no higher than the burden in the general community and that COVID‐19 transmission within public schools was uncommon. 3 However, Ismail et al. reported that SARS‐CoV‐2 infections and outbreaks were uncommon in education settings in England, and that there was an association with low COVID‐19 infection incidence in the corresponding region. 4 In the current study, in‐person SARS‐CoV‐2 prevalence was low while community prevalence was high. Even though this school might not be representative of other schools in different areas, strict COVID‐19 protocols and guidelines in this school might have contributed to preventing further cases. The CDC recommends schools continue to use the current COVID‐19 prevention strategies for the 2020–2021 school year. 5 CONFLICT OF INTEREST The authors have no conflict of interest to disclose.

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          SARS-CoV-2 infection and transmission in educational settings: a prospective, cross-sectional analysis of infection clusters and outbreaks in England

          Background Understanding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and transmission in educational settings is crucial for ensuring the safety of staff and children during the COVID-19 pandemic. We estimated the rate of SARS-CoV-2 infection and outbreaks among staff and students in educational settings during the summer half-term (June–July, 2020) in England. Methods In this prospective, cross-sectional analysis, Public Health England initiated enhanced national surveillance in educational settings in England that had reopened after the first national lockdown, from June 1 to July 17, 2020. Educational settings were categorised as early years settings (<5-year-olds), primary schools (5–11-year-olds; only years 1 and 6 allowed to return), secondary schools (11–18-year-olds; only years 10 and 12), or mixed-age settings (spanning a combination of the above). Further education colleges were excluded. Data were recorded in HPZone, an online national database for events that require public health management. RT-PCR-confirmed SARS-CoV-2 event rates and case rates were calculated for staff and students, and direction of transmission was inferred on the basis of symptom onset and testing dates. Events were classified as single cases, coprimary cases (at least two confirmed cases within 48 h, typically within the same household), and outbreaks (at least two epidemiologically linked cases, with sequential cases diagnosed within 14 days in the same educational setting). All events were followed up for 28 days after educational settings closed for the summer holidays. Negative binomial regression was used to correlate educational setting events with regional population, population density, and community incidence. Findings A median of 38 000 early years settings (IQR 35 500–41 500), 15 600 primary schools (13 450–17 300), and 4000 secondary schools (3700–4200) were open each day, with a median daily attendance of 928 000 students (630 000–1 230 000) overall. There were 113 single cases of SARS-CoV-2 infection, nine coprimary cases, and 55 outbreaks. The risk of an outbreak increased by 72% (95% CI 28–130) for every five cases per 100 000 population increase in community incidence (p<0·0001). Staff had higher incidence than students (27 cases [95% CI 23–32] per 100 000 per day among staff compared with 18 cases [14–24] in early years students, 6·0 cases [4·3–8·2] in primary schools students, and 6·8 cases [2·7–14] in secondary school students]), and most cases linked to outbreaks were in staff members (154 [73%] staff vs 56 [27%] children of 210 total cases). Probable direction of transmission was staff to staff in 26 outbreaks, staff to student in eight outbreaks, student to staff in 16 outbreaks, and student to student in five outbreaks. The median number of secondary cases in outbreaks was one (IQR 1–2) for student index cases and one (1–5) for staff index cases. Interpretation SARS-CoV-2 infections and outbreaks were uncommon in educational settings during the summer half-term in England. The strong association with regional COVID-19 incidence emphasises the importance of controlling community transmission to protect educational settings. Interventions should focus on reducing transmission in and among staff. Funding Public Health England.
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            Data and Policy to Guide Opening Schools Safely to Limit the Spread of SARS-CoV-2 Infection

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              COVID-19 Infections among Students and Staff in New York City Public Schools

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                Author and article information

                Contributors
                tamar.smith-norowitz@downstate.edu
                Journal
                Acta Paediatr
                Acta Paediatr
                10.1111/(ISSN)1651-2227
                APA
                Acta Paediatrica (Oslo, Norway : 1992)
                John Wiley and Sons Inc. (Hoboken )
                0803-5253
                1651-2227
                29 June 2021
                September 2021
                29 June 2021
                : 110
                : 9 ( doiID: 10.1111/apa.v110.9 )
                : 2576-2577
                Affiliations
                [ 1 ] Department of Pediatrics Division of Infectious Diseases State University of New York Downstate Medical Center Brooklyn NY USA
                Author notes
                [*] [* ] Correspondence

                Tamar A. Smith‐Norowitz, Department of Pediatrics, Box 49, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11203 USA.

                Email: tamar.smith-norowitz@ 123456downstate.edu

                Author information
                https://orcid.org/0000-0002-8204-6728
                Article
                APA16003
                10.1111/apa.16003
                8444930
                34160094
                6ddbd935-6940-4445-9152-ddb0970aa142
                ©2021 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 28 May 2021
                : 22 June 2021
                Page count
                Figures: 1, Tables: 0, Pages: 2, Words: 681
                Categories
                Brief Report
                Regular Articles & Brief Reports
                Covid‐19
                Custom metadata
                2.0
                September 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:16.09.2021

                Pediatrics
                brooklyn,new york,coronavirus disease‐19,severe acute respiratory syndrome coronavirus 2

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