Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021
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Abstract
Background
Schools and preschools have largely remained open in Norway throughout the pandemic, with flexible mitigation measures in place. This contrasts with many other high-income countries that closed schools for long periods of time. Here we describe cases and outbreaks of COVID-19 in schools and preschools during the academic year 2020/2021, to evaluate the strategy of keeping these open with infection prevention control measures in place.
Methods
In this descriptive study, the Norwegian Institute of Public Health initiated systematic surveillance for COVID-19 cases and outbreaks in schools and preschools in October 2020. Data was compiled from the national outbreak alert system VESUV, municipality websites, and media scanning combined with the national emergency preparedness register Beredt C-19. An outbreak was defined as ≥ 2 cases among pupils or staff within 14 days at the same educational setting. Settings were categorized as preschool (1–5-years), primary school (6–12-years), lower secondary school (13–15-years) and upper secondary school (16–18- years). We reported the incidence rate among preschool and school-aged pupils and gave a descriptive overview of outbreaks and included cases per educational setting.
Results
During the whole academic year, a total of 1203 outbreaks in preschools and school settings were identified, out of a total of 8311 preschools and schools nationwide. The incidence of COVID-19 in preschool- and school-aged children and the rates of outbreaks in these settings largely followed the community trend. Most of the outbreaks occurred in primary schools (40%) and preschools (25%). Outbreaks across all settings were mostly small (median 3 cases, range 2 to 72), however, 40 outbreaks (3% of total) included 20 or more cases. The larger outbreaks were predominantly seen in primary schools (43%).
Conclusions
We observed few large outbreaks in open schools and preschools in Norway during the academic year of 2020/2021, also when the Alpha variant was predominant. This illustrates that it is possible to keep schools and preschools open even during periods of high community transmission of COVID-19. Adherence to targeted IPC measures adaptable to the local situation has been essential to keep educational settings open, and thus reduce the total burden on children and adolescents.
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SciScore for 10.1101/2021.11.16.21265186: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: In addition, a study protocol which covers the current work, was granted approval by the Ethics Committee of South-East Norway (28th June 2021, #240725). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. 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:The manual data collection done in the NCTT surveillance has some limitations and is resource-intensive. First, …
SciScore for 10.1101/2021.11.16.21265186: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: In addition, a study protocol which covers the current work, was granted approval by the Ethics Committee of South-East Norway (28th June 2021, #240725). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. 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:The manual data collection done in the NCTT surveillance has some limitations and is resource-intensive. First, reporting outbreaks in the national outbreak system VESUV is mandatory. However, we are aware that not all outbreaks were notified, particularly during the transmission peaks throughout the study period. Secondly, the quality of information available through municipality websites and news media varied. During periods with high transmission, the reports may have been less accurate due to capacity challenges. Thirdly, some outbreaks were excluded due to missing information regarding the number of cases, whereas the majority occurred during and after the third wave. These factors may have led to an underreporting of outbreaks during the study period. However, as NIPH is regularly consulted by municipalities when they experience larger outbreaks, we believe the outbreaks we may have missed were mainly small, with limited need for comprehensive measures. In all, we believe that combining different data sources provided sufficient and adequate data to allow us to expand existing information regarding transmission and outbreak trends in schools and preschools during the academic year of 2020/2021.
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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