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A cross-sectional and prospective cohort study of the role of schools in the SARS-CoV-2 second wave in Italy.
Gandini, Sara; Rainisio, Maurizio; Iannuzzo, Maria Luisa; Bellerba, Federica; Cecconi, Francesco; Scorrano, Luca.
  • Gandini S; Department of Experimental Oncology, European Institute of Oncology, IRCCS, Via Adamello 16, 20139 Milano, Italy.
  • Rainisio M; AbaNovus srl, Sanremo, Italy.
  • Iannuzzo ML; AULSS 9 Scaligera-Dipartimento di Prevenzione-UOC Medicina Legale, Italy.
  • Bellerba F; Department of Experimental Oncology, European Institute of Oncology, IRCCS, Via Adamello 16, 20139 Milano, Italy.
  • Cecconi F; Department of Biology, University of Rome 'Tor Vergata', 00133 Rome, Italy.
  • Scorrano L; Department of Biology, University of Padua, Via U. Bassi 58B, 35131 Padova, Italy.
Lancet Reg Health Eur ; 5: 100092, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1157575
ABSTRACT

BACKGROUND:

During COVID-19 pandemic, school closure has been mandated in analogy to its effect against influenza, but it is unclear whether schools are early COVID-19 amplifiers.

METHODS:

We performed a cross-sectional and prospective cohort study in Italy during the second COVID-19 wave (from September 30, 2020 until at least February 28, 2021). We used databases from the Italian Ministry of Education, the Veneto region systems of SARS-CoV-2 cases notification and of schools' secondary cases tracing to compare SARS-CoV-2 incidence in students/school staff and general population and incidence across age groups. Number of tests, secondary infections by type of index case and ratio cases/ tests per school were estimated using an adjusted multivariable generalized linear regression model. Regional reproduction numbers Rt were estimated from Italian Civil Protection daily incidence data with a method of posterior distribution using a Markov Chain Monte Carlo algorithm.

FINDINGS:

SARS-CoV-2 incidence among students was lower than in the general population. Secondary infections at school were <1%, and clusters of ≥2 secondary cases occurred in 5-7% of the analysed schools. Incidence among teachers was comparable to the population of similar age (P = 0.23). Secondary infections among teachers were rare, occurring more frequently when the index case was a teacher than a student (37% vs. 10%, P = 0.007). Before and around the date of school opening in Veneto, SARS-CoV-2 incidence grew maximally in 20-29- and 45-49-years old individuals, not among students. The lag between school opening dates in Italian regions and the increase in the regional COVID-19 Rt was not uniform. Finally, school closures in two regions where they were implemented before other measures did not affect Rt decrease.

INTERPRETATION:

This analysis does not support a role for school opening as a driver of the second COVID-19 wave in Italy, a large European country with high SARS-CoV-2 incidence.

FUNDING:

Fondazione MITE.

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Lancet Reg Health Eur Year: 2021 Document Type: Article Affiliation country: J.lanepe.2021.100092

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Lancet Reg Health Eur Year: 2021 Document Type: Article Affiliation country: J.lanepe.2021.100092