Modifications to student quarantine policies in K–12 schools implementing multiple COVID-19 prevention strategies restores in-person education without increasing SARS-CoV-2 transmission risk, January-March 2021
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Abstract
To determine whether modified K–12 student quarantine policies that allow some students to continue in-person education during their quarantine period increase schoolwide SARS-CoV-2 transmission risk following the increase in cases in winter 2020–2021.
Methods
We conducted a prospective cohort study of COVID-19 cases and close contacts among students and staff (n = 65,621) in 103 Missouri public schools. Participants were offered free, saliva-based RT-PCR testing. The projected number of school-based transmission events among untested close contacts was extrapolated from the percentage of events detected among tested asymptomatic close contacts and summed with the number of detected events for a projected total. An adjusted Cox regression model compared hazard rates of school-based SARS-CoV-2 infections between schools with a modified versus standard quarantine policy.
Results
From January–March 2021, a projected 23 (1%) school-based transmission events occurred among 1,636 school close contacts. There was no difference in the adjusted hazard rates of school-based SARS-CoV-2 infections between schools with a modified versus standard quarantine policy (hazard ratio = 1.00; 95% confidence interval: 0.97–1.03).
Discussion
School-based SARS-CoV-2 transmission was rare in 103 K–12 schools implementing multiple COVID-19 prevention strategies. Modified student quarantine policies were not associated with increased school incidence of COVID-19. Modifications to student quarantine policies may be a useful strategy for K–12 schools to safely reduce disruptions to in-person education during times of increased COVID-19 community incidence.
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SciScore for 10.1101/2022.03.18.22272631: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The project was reviewed and approved by the Washington University in St. Louis Institutional Review Board and conducted consistent with applicable federal law and U.S. Centers for Disease Control and Prevention (CDC) policy (
Field Sample Permit: Specimens were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) as previously described.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources All contact tracing data from school officials were collected in Microsoft Excel and entered into a REDCap database (hosted by Washington … SciScore for 10.1101/2022.03.18.22272631: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The project was reviewed and approved by the Washington University in St. Louis Institutional Review Board and conducted consistent with applicable federal law and U.S. Centers for Disease Control and Prevention (CDC) policy (
Field Sample Permit: Specimens were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (RT-PCR) as previously described.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources All contact tracing data from school officials were collected in Microsoft Excel and entered into a REDCap database (hosted by Washington University in St. Microsoft Excelsuggested: (Microsoft Excel, RRID:SCR_016137)REDCapsuggested: (REDCap, RRID:SCR_003445)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are several limitations to this report. First, school contact tracing may have not identified all persons exposed to someone with COVID-19 in a school setting. Second, we did not test all identified contacts for SARS-CoV-2 following exposure, and therefore the observed number and incidence of school-based SARS-CoV-2 infections is possibly an underestimation. However, positive test results outside of the enhanced investigation were reported to school officials and we projected the number of asymptomatic infections among those without test results to minimize underestimation. Third, due to low variability in school-level prevention strategies and the low number of identified school-based transmission events, analyses of the effect of specific prevention strategies on SARS-CoV-2 transmission were underpowered. Fourth, sequencing data and interview data were not available for all identified school index case-positive contact pairs, and in these instances, all persons who received a positive test result during the 14-day window were presumed to have been infected in school. For the six contacts with a positive test result who had paired sequencing data, it was determined that two (33%) were not infected from their school-based index case; it is possible that if sequencing data were available, school-based transmission may have been ruled out for some of the other contacts with a positive test result. Public Health Implications: In this two-month investigation of SARS-CoV-2 t...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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