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
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.