Clusters of SARS-CoV-2 Infection Among Elementary School Educators and Students in One School District — Georgia, December 2020–January 2021

Gold, Jeremy A. W.; Gettings, Jenna R.; Kimball, Anne; Franklin, Rachel; Rivera, Grant; Morris, Elana; Scott, Colleen; Marcet, Paula L.; Hast, Marisa; Swanson, Megan; McCloud, Jazmyn; Mehari, Lemlem; Thomas, Ebony S.; Kirking, Hannah L.; Tate, Jacqueline E.; Memark, Janet; Drenzek, Cherie; Vallabhaneni, Snigdha; Almendares, Olivia; Balajee, Abirami; Burnett, Eleanor; Chancey, Rebecca J.; Crosby, Deanna; Donadel, Morgane; Espinosa, Catherine; Evans, Mary E.; Fleming-Dutra, Katherine; Forero, Catalina; Forsberg, Kaitlin; Kukielka, Esther; Mitruka, Kiren; Nakayama, Jasmine Y.; Nakazawa, Yoshinori; O’Hegarty, Michelle; Oraka, Emeka; Pratt, Caroline; Rice, Marion E.; Roberts, Gurleen; Stewart, Roxana Rodriguez; Sabogal, Raquel; Sanchez, Emanny; Velasco-Villa, Andres; Weng, Mark K.

In-person learning benefits children and communities (1). Understanding the context in which transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), occurs in schools is critical to improving the safety of in-person learning. During December 1, 2020-January 22, 2021, Cobb and Douglas Public Health (CDPH), the Georgia Department of Public Health (GDPH), and CDC investigated SARS-CoV-2 transmission in eight public elementary schools in a single school district. COVID-19 cases* among educators and students were either self-reported or identified by local public health officials. Close contacts (contacts)†of persons with a COVID-19 case received testing. Among contacts who received positive test results, public health investigators assessed epidemiologic links, probable transmission directionality, and the likelihood of in-school transmission.§ Nine clusters of three or more epidemiologically linked COVID-19 cases were identified involving 13 educators and 32 students at six of the eight elementary schools. Two clusters involved probable educator-to-educator transmission that was followed by educator-to-student transmission and resulted in approximately one half (15 of 31) of school-associated cases. Sixty-nine household members of persons with school-associated cases were tested, and 18 (26%) received positive results. All nine transmission clusters involved less than ideal physical distancing, and five involved inadequate mask use by students. Educators were central to in-school transmission networks. Multifaceted mitigation measures in schools, including promotion of COVID-19 precautions outside of school, minimizing in-person adult interactions at school, and ensuring universal and correct mask use and physical distancing among educators and students when in-person interaction is unavoidable, are important in preventing in-school transmission of SARS-CoV-2. Although not required for reopening schools, COVID-19 vaccination should be considered as an additional mitigation measure to be added when available.