Incidence and secondary transmission of SARS-CoV-2 infections in schools
Open accessAbstract
BACKGROUND: In an effort to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), North Carolina closed prekindergarten through grade 12 public schools to in-person instruction on March 14, 2020. On July 15, 2020, North Carolina’s governor announced schools could open via remote learning or a hybrid model that combined in-person and remote instruction. In August 2020, 56 of 115 North Carolina school districts joined The ABC Science Collaborative (ABCs) to implement public health measures to prevent SARS-CoV-2 transmission and share lessons learned. We describe secondary transmission of SARS-CoV-2 within participating school districts during the first 9 weeks of in-person instruction in the 2020–2021 academic year. METHODS: From August 15, 2020 to October 23, 2020, 11 of 56 school districts participating in ABCs were open for in-person instruction for all 9 weeks of the first quarter and agreed to track incidence and secondary transmission of SARS-CoV-2. Local health department staff adjudicated secondary transmission. Superintendents met weekly with ABCs faculty to share lessons learned and develop prevention methods. RESULTS: Over 9 weeks, 11 participating school districts had >90 000 students and staff attend school in person. Among these students and staff, 773 community-acquired SARS-CoV-2 infections were documented by molecular testing. Through contact tracing, health department staff determined an additional 32 infections were acquired within schools. No instances of child-to-adult transmission of SARS-CoV-2 were reported within schools. CONCLUSIONS: In the first 9 weeks of in-person instruction in North Carolina schools, we found extremely limited within-school secondary transmission of SARS-CoV-2, as determined by contact tracing.
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It is possible to keep schools open without putting students and adults at excessive risk.
“it is possible to keep schools open without putting students and adults at excessive risk.”
From The Lancet Commission on lessons for the future from the COVID-19 pandemic (2022) · cites this paper as [320]
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SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020
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Multiple COVID-19 Clusters on a University Campus — North Carolina, August 2020
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The Lancet Commission on lessons for the future from the COVID-19 pandemic
Sachs, J. D., Karim, S. S. A., Aknin, L., Allen, J., Brosbøl, K., Colombo, F., Barron, G. C., Espinosa, M. F., Gaspar, V., Gaviria, A., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(22)01585-9 · Cited by 842 · see citing works
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Self-citation
- Authors
- Zimmerman, K. O., Akinboyo, I. C., Brookhart, M. A., Boutzoukas, A. E., McGann, K. A., Smith, M. J., Maradiaga Panayotti, G., Armstrong, S. C., Bristow, H., Parker, D., Zadrozny, S., Weber, D. J., Benjamin, D. K., & COLLABORATIVE, F. T. A. S.
- Affiliations
- Duke Clinical Research Institute (US)
- Duke Clinical Research Institute and
- Duke University (US)
- Departments of Pediatrics and
- University of North Carolina at Chapel Hill (US)
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2021-04-01
- Volume
- 147
- Issue
- 4
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC8015158
- OpenAlex
- W3118777904
- Cited by
- 223
- References
- 8
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 11 · 2023: 31 · 2022: 56 · 2021: 114 · 2020: 2
- FWCI
- 20.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- University of Pittsburgh
- National Institutes of Health (U24TR001608, HHSN275201000003I)
- School of Medicine, Duke University
- National Institute of Child Health and Human Development (HHSN-275201000003I, 275201000003I)
- National Center for Advancing Translational Sciences (HHSN275201000003I)
- Duke Clinical Research Institute
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (OT2HD107559, HHSN275201000003C, HHSN275201000003I)
- Topics
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Keywords
- SARS-CoV-2, COVID-19 pandemic, secondary transmission, school outbreak, face-to-face teaching, contact tracing, school reopening, COVID-19 prevention measures, school districts, North Carolina
- MeSH terms
- COVID-19, Adolescent, Child, Child, Preschool, Humans, North Carolina, Schools, Cohort Studies, Incidence, Education, Distance
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