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COVID-19 Outbreaks in Nurseries During Rapid Spread of the B.1.1.7 Variant of SARS-CoV-2 in England: Cross-Sectional National Surveillance, November 2020 – January 2021

23 Pages Posted: 15 Apr 2021

See all articles by Felicity Aiano

Felicity Aiano

Government of the United Kingdom - Public Health England Colindale; UK Health Security Agency

Kelsey McOwat

Public Health England - Immunisation and Countermeasures Division

Chinelo Obi

Public Health England - Immunisation and Countermeasures Division

Annabel A. Powell

Public Health England - Immunisation and Countermeasures Division

Jessica S. Flood

Immunisation and Countermeasures Division, Public Health England

Shivraj Bhardwaj

Government of the United Kingdom - Public Health England Colindale

Kelly Stoker

Government of the United Kingdom - Public Health England Colindale

Donna Haskins

Government of the United Kingdom - Public Health England Colindale

Brian Wong

Government of the United Kingdom - Public Health England Colindale

Marta Bertran

Immunisation and Vaccine Preventable Diseases,UK Health Security Agency

Maria Zavala

Government of the United Kingdom - Public Health England Colindale

Johanna Bosowski

Public Health England - Immunisation and Countermeasures Division

Samuel E. I. Jones

Government of the United Kingdom - Public Health England Colindale

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division

Laura Cloughlan

Government of the United Kingdom - Public Health England Colindale

Mary Sinnathamby

Government of the United Kingdom - Public Health England

Asad Zaidi

Government of the United Kingdom - Public Health England; UK Health Security Agency - COVID-19 National Epidemiology Cell

Rachel Merrick

Government of the United Kingdom - Public Health England Colindale

Sharif Ismail

Government of the United Kingdom - Immunisation and Countermeasures Division

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department

Shamez N. Ladhani

Government of the United Kingdom - Immunisation and Countermeasures Division; St. George’s University of London - Paediatric Infectious Diseases Research Group

Vanessa Saliba

Government of the United Kingdom - Immunisation and Countermeasures Division

More...

Abstract

Background: The reopening of schools during the COVID-19 pandemic has raised concerns about widespread infection and transmission of SARS-CoV-2 in educational settings. In June 2020, Public Health England (PHE) initiated prospective national surveillance of SARS-CoV-2 in primary schools across England (sKIDs). We used this opportunity to assess the feasibility and agreeability of large-scale surveillance and testing for SARS-CoV-2 infections in school among staff, parents and students.

Methods: Staff and students in 131 primary schools were asked to complete a questionnaire at recruitment and provide weekly nasal swabs for SARS-CoV-2 RT-PCR testing (n=86) or swabs with blood samples for antibody testing (n=45) at the beginning and end the summer half-term. In six blood sampling schools, students were asked to complete a pictorial questionnaire before and after their investigations.

Results: In total, 134 children aged 4-7 years (n=40) or 8-11 years (n=95) completed the pictorial questionnaire fully or partially. Prior to sampling, oral fluid sampling was the most acceptable test (107/132, 81%) followed by throat swabs (80/134, 59%), nose swabs (77/132, 58%), and blood tests (48/130, 37%). Younger students were more nervous about all tests than older students but, after completing their tests, most children reported a “better than expected” experience with all the investigations. Students were more likely to agree to additional testing for nose swabs (93/113, 82%) and oral fluid (93/114, 82%), followed by throat swabs (85/113, 75%) and blood tests (72/108, 67%). Parents (n=3,994) and staff (n=2,580) selected a preference for weekly testing with nose swabs, throat swabs or oral fluid sampling, although staff were more flexible about testing frequency. 

Conclusions: Primary school staff and parents were supportive of regular tests for SARS-CoV-2 and selected a preference for weekly testing. Children preferred nose swabs and oral fluids over throat swabs or blood sampling.

Funding Statement: This surveillance was internally funded by PHE and did not receive any specific grant funding from agencies in the public, commercial or not-for-profit sectors.

Declaration of Interests: None.

Ethics Approval Statement: PHE has legal permission, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002, to process patient confidential information for national surveillance of communicable diseases and as such, individual patient consent is not required.

Suggested Citation

Aiano, Felicity and McOwat, Kelsey and Obi, Chinelo and Powell, Annabel A. and Flood, Jessica S. and Bhardwaj, Shivraj and Stoker, Kelly and Haskins, Donna and Wong, Brian and Bertran, Marta and Zavala, Maria and Bosowski, Johanna and Jones, Samuel E. I. and Amin-Chowdhury, Zahin and Cloughlan, Laura and Sinnathamby, Mary and Zaidi, Asad and Merrick, Rachel and Ismail, Sharif and Ramsay, Mary E. and Ladhani, Shamez N. and Saliba, Vanessa, COVID-19 Outbreaks in Nurseries During Rapid Spread of the B.1.1.7 Variant of SARS-CoV-2 in England: Cross-Sectional National Surveillance, November 2020 – January 2021. Available at SSRN: https://ssrn.com/abstract=3826200 or http://dx.doi.org/10.2139/ssrn.3826200

Felicity Aiano

Government of the United Kingdom - Public Health England Colindale ( email )

UK Health Security Agency ( email )

Kelsey McOwat

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Chinelo Obi

Public Health England - Immunisation and Countermeasures Division

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Annabel A. Powell

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Jessica S. Flood

Immunisation and Countermeasures Division, Public Health England ( email )

Shivraj Bhardwaj

Government of the United Kingdom - Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Kelly Stoker

Government of the United Kingdom - Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Donna Haskins

Government of the United Kingdom - Public Health England Colindale

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Brian Wong

Government of the United Kingdom - Public Health England Colindale

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Marta Bertran

Immunisation and Vaccine Preventable Diseases,UK Health Security Agency ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Maria Zavala

Government of the United Kingdom - Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Johanna Bosowski

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Samuel E. I. Jones

Government of the United Kingdom - Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Zahin Amin-Chowdhury

Public Health England - Immunisation and Countermeasures Division ( email )

London
United Kingdom

Laura Cloughlan

Government of the United Kingdom - Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Mary Sinnathamby

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

Asad Zaidi

Government of the United Kingdom - Public Health England ( email )

Wellington House
133-155 Waterloo Road
London, SE1 8UG
United Kingdom

UK Health Security Agency - COVID-19 National Epidemiology Cell ( email )

London
United Kingdom

Rachel Merrick

Government of the United Kingdom - Public Health England Colindale ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Sharif Ismail

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

Mary E. Ramsay

Public Health England - Immunisation, Hepatitis, and Blood Safety Department ( email )

United Kingdom

Shamez N. Ladhani (Contact Author)

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom

St. George’s University of London - Paediatric Infectious Diseases Research Group

London
United Kingdom

Vanessa Saliba

Government of the United Kingdom - Immunisation and Countermeasures Division ( email )

61 Colindale Avenue
London, NW9 5EQ
United Kingdom