Was the risk of death among the population of teachers and other school workers in England and Wales due to COVID-19 and all causes higher than other occupations during the pandemic in 2020? An ecological study using routinely collected data on deaths from the Office for National Statistics

  1. Sarah J Lewis
  2. Kyle Dack
  3. Caroline L Relton
  4. Marcus R Munafo
  5. George Davey Smith

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Abstract

To estimate occupation risk from COVID-19 among teachers and others working in schools using publicly available data on mortality in England and Wales.

Design

Analysis of national death registration data from the Office for National Statistics.

Setting

England and Wales, 8 March–28 December 2020, during the COVID-19 pandemic.

Participants

The total working age population in England and Wales plus those still working aged over 65 years.

Primary and secondary outcomes

Death with COVID-19 as a primary outcome and death from all causes as a secondary outcome.

Results

Across occupational groups, there was a strong correlation between COVID-19 mortality and both non-COVID-19 and all-cause mortality. The absolute mortality rates for deaths with COVID-19 were low among those working in schools (from 10 per 100 000 in female primary school teachers to 39 per 100 000 male secondary school teachers) relative to many other occupations (range: 9–50 per 100 000 in women; 10–143 per 100 000 in men). There was weak evidence that secondary school teachers had slightly higher risks of dying with COVID-19 compared with the average for all working-aged people, but stronger evidence of a higher risk compared with the average for all professionals; primary school teachers had a lower risk. All-cause mortality was also higher among all teachers compared with all professionals. Teaching and lunchtime assistants were not at higher risk of death from COVID-19 compared with all working-aged people.

Conclusion

There was weak evidence that COVID-19 mortality risk for secondary school teachers was above expectation, but in general school staff had COVID-19 mortality risks which were proportionate to their non-COVID-19 mortality risk.

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  1. Version published to 10.1136/bmjopen-2021-050656
  2. Version published to 10.1101/2021.02.23.21252143v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.02.23.21252143: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    RandomizationThe APS is the largest ongoing household survey in the UK, based on interviews with members of randomly selected households.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableWe also produced scatterplots of ‘all cause’ versus ‘with Covid19’ mortality and ‘all other causes’ versus ‘with Covid19’ mortality by occupational group for men and women separately and calculated Pearson’s correlation coefficient for these plots.

    Table 2: Resources

    No key resources detected.

    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:
    Strength and limitations of the study: We used routinely collected data on mortality which includes all deaths in England and Wales, and results are therefore unlikely to be due to ascertainment bias and will be representative of the working aged population of these countries. However, we did not have access to individual level mortality data so were not able to account for potential confounders such as comorbidities or household size. For our relative risk calculations our comparison group also included teachers (although they only made up a very small proportion of the total) because we did not have age adjusted mortality rates for all working aged adults and all professionals excluding teachers. The age adjusted mortality rates calculated by ONS were based on a survey conducted in 2019, if the teaching workforce has changed as a result of the pandemic these rates will be inaccurate, if any changes in the teaching workforce are systematically different to other professions the results will be biased. In addition, for many occupational groups of interest (such as teaching assistants and others working in schools) we had neither mortality rates per 100,000 nor total numbers within the group, we only had number of deaths and a 5-year average and we do not know whether the total number of staff within each occupation group changed over time. Whilst the size of the teaching workforce in England has remained fairly stable between 2015-2019, there was a marked decrease in the numb...

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.02.23.21252143v1 on medRxiv