Seasonal patterns of SARS-CoV-2 transmission in secondary schools: a modelling study
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Abstract
Background
The Omicron variant has caused a new wave of SARS-CoV-2 infections worldwide. We explore crucial epidemiological parameters driving seasonal patterns of SARS-CoV-2 transmission in secondary schools and assess various infection control interventions over a 2.5-year time frame.
Methods
We developed an agent-based model parameterised with data from secondary schools in the Netherlands. We modelled the circulation of Omicron assuming a stable introduction rate of infections and accounted for uncertainty in epidemiological parameters describing virus transmissibility, susceptibility to reinfection, vaccine immune escape, and waning of sterilising immunity. We quantified the SARS-CoV-2 health burden defined as number of symptomatic student days. We further evaluated the cost-benefit (number of prevented infected students per absent student) for reactive quarantine interventions, regular screening using antigen tests, and annual booster vaccinations.
Findings
Durability of sterilising immunity is a key parameter that governs temporal SARS-CoV-2 transmission patterns in secondary schools. Our model predicts pronounced within-school seasonal patterns with dominant autumn outbreaks and smaller winter outbreaks and a maximum prevalence of 2.9% (95% CI: 0.7%-6.6%) symptomatic students during infection peaks. Regular screening and annual booster vaccination may reduce the health burden up to 15% (95% CI: 1.5%-27.8%) and have a higher cost-benefit ratio than reactive quarantine interventions (reduction: 4.3%; 95% CI: -10.1% to 17.6%).
Interpretation
Immunity waning will determine the intensity and pattern of SARS-CoV-2 transmission in secondary schools in the medium-term future. If mitigation strategies are needed, screening and annual booster vaccination have the highest cost-benefit by reducing viral transmission with little educational disruption.
Article activity feed
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SciScore for 10.1101/2022.04.21.22273952: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The interpretation of our results has, therefore, limitations. We assumed no further introduction of new variants with substantially different epidemiological characteristics. The timing of such introductions and respective epidemiological characteristics are highly uncertain. Projections on how new variants of concern would impact ongoing transmission dynamics are, therefore, more relevant and feasible on a shorter time scale. Since …
SciScore for 10.1101/2022.04.21.22273952: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:The interpretation of our results has, therefore, limitations. We assumed no further introduction of new variants with substantially different epidemiological characteristics. The timing of such introductions and respective epidemiological characteristics are highly uncertain. Projections on how new variants of concern would impact ongoing transmission dynamics are, therefore, more relevant and feasible on a shorter time scale. Since community incidence on a longer time horizon is difficult to predict, we, further, assumed a constant infection risk for students and teachers from the community throughout the study period. The extent of outbreaks of SARS-CoV-2 infections in schools will depend on the infection risk students and teachers are exposed to outside the school setting. In our model, 33% of symptomatically infected individuals would adhere to self-isolation. These values might vary across different schools and countries, and may impact the predictions on absenteeism and infection prevalence. Finally, in our main analysis, we assumed that vaccine efficacy reducing susceptibility to infection increased by 20% for booster vaccinations. While previous studies have shown an increase in vaccine efficacy against symptomatic disease after booster vaccinations against Omicron,7 there is no similar data on efficacy against infection, yet. We performed various sensitivity analyses and showed that our general conclusions remained unaffected. In conclusion, our results highlight th...
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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