When schools were open for in-person teaching during the COVID-19 pandemic - the nordic experience on control measures and transmission in schools during the delta wave.

BACKGROUND: Extensive measures to control spread of SARS-CoV-2 have led to limited access to education for millions of children and adolescents during the COVID-19 pandemic. Education and access to schools is vital for children and adolescents' learning, health, and wellbeing. Based on high vaccine uptake and low incidence levels, the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) decided to start the academic year 2021/22 with schools open for in-person teaching and moderate mitigation measures. We describe trends in SARS-CoV-2 infections and vaccination coverage among students during the first 12 weeks of the fall semester. METHODS: In this multinational, retrospective, observational study, we have used surveillance and registry data from each of the Nordic countries to describe vaccine uptake (≥12 years), infection incidence (whole population) and transmission of SARS-CoV-2 among students. The study period, week 30 to 41 (Jul 26th - Oct 17th), represents the autumn semester from immediately before school started until fall break. In addition, we collected information on mitigation measures applied by the respective countries. RESULTS: There were slight variations between the countries regarding existing infection prevention and control (IPC) measures, testing strategies and vaccination start-up among adolescents. All countries had high vaccine uptake in the adult population, while uptake varied more in the younger age groups. Incidence in the school-aged population differed between countries and seemed to be influenced by both vaccine uptake and test activity. Infection clusters among school-aged children were described for Denmark and Norway, and the number of clusters per week reflected the incidence trend of the country. Most events consisted of only 1-2 cases. Larger clusters appeared more frequently in the higher grades in Norway and in lower grades in Denmark. CONCLUSION: Data from the Nordic countries indicate that vaccination of adults and adolescents, in addition to mitigation measures, enabled full in-person learning. As SARS-CoV-2 infection does not represent a severe medical risk for most children as previously thought, measures targeting this group should be carefully adjusted and kept at a minimum. Our data add to the evidence on incidence and transmission of SARS-CoV-2 among students in schools open for in-person teaching, and may be valuable for decision makers worldwide.

Perceptions of Tuberculosis Among Individuals Born in a High-Endemic Setting, Now Living in a Low-Endemic Setting.

Of all individuals diagnosed with tuberculosis (TB) in Sweden 2015 were 90% born in other countries. Early diagnosis and treatment is essential to avoid TB transmission. Lack of knowledge about TB and anticipated negative social consequences have proved to be significant contributing factors to delay in seeking health care. This study aimed to understand the perception of TB among people originating from a high-endemic region, currently living in a low-endemic region. A qualitative study design, with male and female participants from a high-endemic region divided into focus groups. A semi-structured interview guide was used to elicit their perceptions of TB. A qualitative content analysis was performed on the recorded material from the interviews. The informants noted that their attitude towards individuals with TB had changed, previously they had felt prejudiced towards them whereas now they felt supportive. It seems possible to diminish TB stigma by ensuring suitable health care is available in combination with correct information about transmission, infectiousness and treatment.