Surveillance of SARS-CoV-2 transmission in educational institutions, August to December 2020, Germany

Schoeps, Anja; Hoffmann, Dietmar; Tamm, Claudia; Vollmer, Bianca; Haag, Sabine; Kaffenberger, Tina; Ferguson-Beiser, Kimberly; Kohlhase-Griebel, Berit; Basenach, Silke; Missal, Andrea; Höfling, Katja; Michels, Harald; Schall, Anett; Kappes, Holger; Vogt, Manfred; Jahn, Klaus; Bärnighausen, Till; Zanger, Philipp

This study aims at providing estimates on the transmission risk of SARS-CoV-2 in schools and day-care centres. We calculated secondary attack rates (SARs) using individual-level data from state-wide mandatory notification of index cases in educational institutions, followed by contact tracing and PCR-testing of high-risk contacts. From August to December 2020, every sixth of overall 784 independent index cases was associated with secondary cases in educational institutions. Monitoring of 14 594 institutional high-risk contacts (89% PCR-tested) of 441 index cases during quarantine revealed 196 secondary cases (SAR 1.34%, 0.99–1.78). SARS-CoV-2 infection among high-risk contacts was more likely around teacher-indexes compared to student-/child-indexes (incidence rate ratio (IRR) 3.17, 1.79–5.59), and in day-care centres compared to secondary schools (IRR 3.23, 1.76–5.91), mainly due to clusters around teacher-indexes in day-care containing a higher mean number of secondary cases per index case (142/113 = 1.26) than clusters around student-indexes in schools (82/474 = 0.17). In 2020, SARS-CoV-2 transmission risk in educational settings was low overall, but varied strongly between setting and role of the index case, indicating the chance for targeted intervention. Surveillance of SARS-CoV-2 transmission in educational institutions can powerfully inform public health policy and improve educational justice during the pandemic.