ABSTRACT
ObjectivesExamine if pre-COVID-19 pandemic (prior March 2020) health-related behaviours during primary school are associated with i) being tested for SARS-CoV-2 and ii) testing positive between 1 March 2020 to 31 August 2021. DesignRetrospective cohort study using an online cohort survey (January 2018 to February 2020) linked to routine PCR SARS-CoV-2 test results. SettingChildren attending primary schools in Wales (2018-2020), UK who were part of the HAPPEN school network. ParticipantsComplete linked records of eligible participants were obtained for n=7,062 individuals. 39.1% (n=2,764) were tested (age 10.6{+/-}0.9, 48.9% girls) and 8.1% (n=569) tested positive for SARS-CoV-2 (age 10.6{+/-}1.0, 54.5% girls). Main outcome measuresLogistic regression of health-related behaviours and demographics were used to determine Odds Ratios (OR) of factors associated with i) being tested for SARS-CoV-2 and ii) testing positive for SARS-CoV-2. ResultsConsuming sugary snacks (1-2 days/week OR=1.24, 95% CI 1.04 - 1.49; 5-6 days/week 1.31, 1.07 - 1.61; reference 0 days) can swim 25m (1.21, 1.06 - 1.39) and age (1.25, 1.16 - 1.35) were associated with an increased likelihood of being tested for SARS-CoV-2. Eating breakfast (1.52, 1.01 - 2.27), weekly physical activity [≥] 60 mins (1-2 days 1.69, 1.04 - 2.74; 3-4 days 1.76, 1.10 - 2.82, reference 0 days), out of school club participation (1.06, 1.02 - 1.10), can ride a bike (1.39, 1.00 - 1.93), age (1.16, 1.05 - 1.28) and girls (1.21, 1.00 - 1.46) were associated with an increased likelihood of testing positive for SARS-CoV-2. Living in least deprived quintiles 4 (0.64, 0.46 - 0.90) and 5 (0.64, 0.46 - 0.89) compared to the most deprived quintile was associated with a decreased likelihood. ConclusionsAssociations may be related to parental health literacy and monitoring behaviours. Physically active behaviours may include co-participation with others, and exposure to SARS-CoV-2. A risk versus benefit approach must be considered given the importance of health-related behaviours for development. STRENGTHS AND LIMITATIONSO_LIInvestigation of the association of pre-pandemic child health-related behaviour measures with subsequent SARS-CoV-2 testing and infection. C_LIO_LIReporting of multiple child health behaviours linked at an individual-level to routine records of SARS-CoV-2 testing data through the SAIL Databank. C_LIO_LIChild-reported health behaviours were measured before the COVID-19 pandemic (1 January 2018 to 28 February 2020) which may not reflect behaviours during COVID-19. C_LIO_LIHealth behaviours captured through the national-scale HAPPEN survey represent children attending schools that engaged with the HAPPEN Wales primary school network and may not be representative of the whole population of Wales. C_LIO_LIThe period of study for PCR-testing for and testing positive for SARS-CoV-2 includes a time frame with varying prevalence rates, approaches to testing children (targeted and mass testing) and restrictions which were not measured in this study. C_LI
ABSTRACT
COVID-19 infection and the resultant restrictions has impacted all aspects of life across the world. This study explores factors that promote or support wellbeing for young people during the pandemic, how they differ by age, using a self-reported online survey with those aged 8 - 25 in Wales between September 2020 and February 2021. Open-ended responses were analysed via thematic analysis to provide further context. A total of 6,291 responses were obtained from 81 education settings across Wales (including primary and secondary schools as well as sixth form, colleges and universities). Wellbeing was highest in primary school children and boys and lowest in those who were at secondary school children, who were girls and, those who preferred not to give a gender. Among primary school children, higher wellbeing was seen for those who played with others (rather than alone), were of Asian ethnicity (OR 2.3, 95% CI: 1.26 to 4.3), lived in a safe area (OR: 2.0, 95% CI: 1.67 to 2.5) and had more sleep. To support their wellbeing young people reported they would like to be able to play with their friends more. Among secondary school children those who were of mixed ethnicity reported lower wellbeing (OR: 5.10, 95% CI: 1.70 to 15.80). To support their wellbeing they reported they would like more support with mental health (due to anxiety and pressure to achieve when learning online). This study found self-reported wellbeing differed by gender, ethnicity and deprivation and found younger children report the need for play and to see friends to support wellbeing but older children/young people wanted more support with anxiety and educational pressures.
ABSTRACT
IntroductionIn response to the COVID-19 pandemic, school closures were implemented across the United Kingdom. This study aimed to explore the impact of school closures on childrens health by comparing health and wellbeing outcomes collected during school closures (April - June 2020) with data from the same period in 2019 and 2018. MethodsData were collected online via the HAPPEN At Home survey, which captured the typical health behaviours of children aged 8 - 11 years between April - June 2020. These data were compared with data in 2018 and 2019 also collected between April-June, from HAPPEN. Free school meal (FSM) status was used as a proxy for socio-economic deprivation. Analyses were repeated stratifying by FSM. ResultsComparing responses between April - June in 2020 (n=1068), 2019 (n=1150) and 2018 (n=475), there were improvements in physical activity levels, sleep time, happiness and general wellbeing for children during school closures compared to previous years. However, children on FSM ate less fruit and vegetables (21% (95%CI (5.7% to 37%)) and had lower self-assessed school competence compared to 2019. Compared to those not on FSM they also spent less time doing physical activity (13.03% (95%CI: 3.3% to 21.7%) and consumed more takeaways (16.3% (95%CI: 2%-30%)) during school closures. ConclusionThis study suggests that schools play an important role in reducing inequalities in physical health. The physical health (e.g. physical activity and diet) of children eligible for FSM may be impacted by prolonged school closures. What is already known on this subject?In response to the COVID-19 pandemic, by mid-March 2020, 138 countries had implemented national school closures to reduce the number of social contacts between pupils, therefore interrupting the transmission of COVID-19 as part of pandemic plans. UNESCO warned that the global scale and speed of the educational disruption would be unparalleled. There is an ongoing debate with regard to the effectiveness of schools closures on transmission rates, but the fact schools are closed for a long period of time could have detrimental impacts on pupils physical and mental health. This study provides evidence of any differences in the health and wellbeing of children prior to and during the COVID-19 enforced lockdown and school closures between March and June 2020. These findings could have a significant impact for the future and support schools to better understand their pupils physical, psychological, emotional and social health. It also contributes to a significant literature gap regarding the impact of school closures on school-aged children. What this study adds?Improvements in physical activity levels, sleep time, happiness and general wellbeing were observed in general for children during school closures compared to previous years. However, children on FSM reported eating less fruit and vegetables and had lower self-assessed school competence compared to 2019. Compared to those not on FSM they also spent less time doing physical activity and consumed more takeaways during school closures. These trends are not evident among children not on FSM. All children reported improvements in wellbeing during lockdown especially on the happiness with family measure. Overall, findings suggest schools help to reduce inequalities in physical health for socio-economically deprived children. During school closures children from deprived backgrounds are likely to have poorer physical health (e.g. less time spent doing physical activities and poorer diet) and this is not observed in children who are not in receipt of FSM. This research suggests that school closures will result in widening health inequalities and when schools return measures will need to be in place to readdress the widened gap in physical health.
ABSTRACT
BackgroundBetter understanding of the role that children and school staff play in the transmission of SARS-CoV-2 is essential to guide policy development on controlling infection whilst minimising disruption to childrens education and wellbeing. MethodsOur national e-cohort (n=500,779) study used anonymised linked data for pupils, staff and associated households linked via educational settings. We estimated the risk of testing positive for SARS-CoV-2 infection for staff and pupils over the period August - December 2020, dependent on measures of recent exposure to known cases linked to their educational settings. ResultsThe total number of cases in a school was not associated with a subsequent increase in the risk of testing positive (Staff OR per case 0.92, 95%CI 0.85, 1.00; Pupils OR per case 0.98, 95%CI 0.93, 1.02). Amongst pupils, the number of recent cases within the same year group was significantly associated with subsequent increased risk of testing positive (OR per case 1.12, 95%CI 1.08 - 1.15). These effects were adjusted for a range of demographic covariates, and in particular any known cases within the same household, which had the strongest association with testing positive (Staff OR 39.86, 95%CI 35.01, 45.38, pupil OR 9.39, 95%CI 8.94 - 9.88). ConclusionsIn a national school cohort, the odds of staff testing positive for SARS-CoV-2 infection were not significantly increased in the 14-day period after case detection in the school. However, pupils were found to be at increased risk, following cases appearing within their own year group, where most of their contacts occur. Strong mitigation measures over the whole of the study period may have reduced wider spread within the school environment. O_TEXTBOXWhat is knownO_LIEvidence of the role schools play in the transmission of SARS-CoV-2 is limited C_LIO_LIHigher positivity rates are observed in school staff compared to pupils C_LIO_LILack of evidence on transmission pathways transmission into and within schools C_LI What this study addsO_LIFirst UK national level study of transmission between pupils and staff in a school environment during the SARS-CoV-2 pandemic. C_LIO_LISchools opening September-December 2020 was not associated with an increased subsequent risk of testing positive in staff C_LIO_LIPupils were found to be at increased risk of testing positive, following cases appearing within their own year group C_LI C_TEXTBOX
ABSTRACT
School closures due to the COVID-19 global pandemic are likely to have a range of negative consequences spanning the domains of child development, education and health, in addition to the widening of inequalities and inequities. Research is required to improve understanding of the impact of school closures on the education, health and wellbeing of pupils and school staff, the challenges posed during reopening and importantly to identify how countries can return to in-school education and to inform policy. This qualitative study aimed to reflect on the perspectives and experiences of primary school staff (pupils aged 3-11) in Wales regarding school closures and the initial reopening of schools and to identify recommendations for the future. A total of 208 school staff completed a national online survey through the HAPPEN primary school network, consisting of questions about school closures (March to June 2020), the phased reopening of schools (June to July 2020) and a return to full-time education. Thematic analysis of survey responses highlighted that primary school staff perceive that gaps in learning, health and wellbeing have increased and inequalities have widened during school closures. Findings from this study identified five recommendations; (i) prioritise the health and wellbeing of pupils and staff; (ii) focus on enabling parental engagement and support; (iii) improve digital competence amongst pupils, teachers and parents; (iv) consider opportunities for smaller class sizes and additional staffing; and (v) improve the mechanism of communication between schools and families, and between government and schools.
