COVID-19 infections in day care centres in Germany: social and organisational determinants of infections in children and staff in the second and third wave of the pandemic
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Abstract
Background
During the SARS-CoV-2 pandemic, German early childhood education and care (ECEC) centres organised children’s attendance in different ways, they reduced opening hours, provided emergency support for a few children, or closed completely. Further, protection and hygiene measures like fixed children-staff groups, ventilation and surface disinfection were introduced in ECEC centres. To inform or modify public health measures in ECEC, we investigate the occurrence of SARS-CoV-2 infections among children and staff in ECEC centres in light of social determinants (i.e. the socioeconomic status of the children) and recommended structural and hygiene measures. We focus on the question if the relevant factors differ between the 2nd (when no variant of concern (VOC) circulated) and the 3rd wave (when VOC B.1.1.7 (Alpha) predominated).
Methods
Based on panel data from a weekly online survey of ECEC centre managers (calendar week 36/2020 to 22/2021, ongoing) including approx. 8500 centres, we estimate the number of SARS-CoV-2 infections in children and staff using random-effect-within-between (REWB) panel models for count data in the 2nd and 3rd wave.
Results
ECEC centres with a high proportion of children with low socioeconomic status (SES) have a higher risk of infections in staff and children. Strict contact restrictions between groups like fixed group assignments for children and fixed staff assignments to groups prevent infections. Both effects tend to be stronger in the 3rd wave.
Conclusion
ECEC centres with a large proportion of children with a low SES background and lack of using fixed child/staff cohorts experience higher COVID-19 rates. Over the long run, centres should be supported in maintaining recommended measures. Preventive measures such as the vaccination of staff should be prioritised in centres with large proportions of low SES children.
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SciScore for 10.1101/2021.06.07.21257958: (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: 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:This limitation does not hold true for the effect of fixed staff assignment on infections in staff, which remains significant in wave 3 in all robustness checks. We therefore strongly support the recommendation to keep up fixed staff assignment in all ECEC centres wherever possible. We acknowledge as a general limitation that a managers …
SciScore for 10.1101/2021.06.07.21257958: (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: 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:This limitation does not hold true for the effect of fixed staff assignment on infections in staff, which remains significant in wave 3 in all robustness checks. We therefore strongly support the recommendation to keep up fixed staff assignment in all ECEC centres wherever possible. We acknowledge as a general limitation that a managers decision to implement specific measures in their ECEC centre (and the according report in our questionnaires) is not always followed and translated into every-day practice by all staff members. Further, some measures are conceptually similar, e.g. a fixed group concept (with consequent separation of children) and a fixed staff assignment which includes that also staff does not move between groups. As both show significant effects, this suggests that strict contact restrictions are likely to be one of the most effective protective measures, especially in the 3rd wave. Although it is unknown which infections are due to a VOC or not, the 3rd wave was dominated increasingly by the VOC B.1.1.7, which is associated with increased transmissibility [31]. This again is in line with our finding that the effects of SES are stronger in wave 3, and we find stronger effects of contact restrictions in wave 3. In this situation of VOC predominance in which vaccinations of ECEC staff have started but the vaccinations of young children are not predictable, the implementation of contact restrictions between groups of children seem to gain priority to keep ECEC s...
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.
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- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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