Public Health Scotland, Glasgow, G2 6QE, UK.
Department of Statistics, Glasgow Caledonian University, Glasgow, UK.
BMJ. 2021 Sep 1;374:n2060. doi: 10.1136/bmj.n2060.
To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population.
Population based nested case-control study.
Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19.
All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age.
The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death.
Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed.
Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching.
确定教师及其家庭成员因 covid-19 和重症 covid-19 住院的风险，以及与医护人员和一般人群中劳动年龄成年人相比的风险。
基于人群的嵌套病例对照研究。
2020 年 3 月至 2021 年 7 月，苏格兰在应对 covid-19 期间经历了学校关闭和全面开放的不同时期。
所有 21 至 65 岁成年人（n=132420）的 covid-19 病例和年龄、性别和普通科医生匹配的随机对照样本（n=1306566）。成年人被苏格兰教学委员会认定为积极在苏格兰学校任教，其家庭成员通过独特的物业参考号码确定。比较组是在苏格兰被认定为医护人员的成年人及其家庭成员，以及其余劳动年龄的一般人群。
主要结果是因 covid-19 住院，定义为在住院期间 SARS-CoV-2 检测结果呈阳性，在阳性检测结果后 28 天内住院，或在出院时被诊断为 covid-19。重症 covid-19 被定义为入住重症监护病房或在阳性检测结果后 28 天内死亡，或将 covid-19 归因于死亡原因。
大多数教师年龄较小（平均年龄 42 岁），为女性（80%），无合并症（84%）。在一般劳动年龄人群中，因 covid-19 住院的风险（累积发病率）<1%。在研究期间，在调整年龄、性别、普通科医生、种族/民族、贫困、合并症数量和家庭成年人数量的条件逻辑回归模型中，教师因 covid-19 住院的风险（率比 0.77，95%置信区间 0.64 至 0.92）和严重 covid-19（0.56，0.33 至 0.97）的风险低于一般人群。在 2020 年秋季苏格兰学校重新开学的第一阶段，教师因住院的比率比为 1.20（0.89 至 1.61），重症 covid-19 的比率比为 0.45（0.13 至 1.55）。教师家庭成员的相应发现为 0.91（0.67 至 1.23）和 0.73（0.37 至 1.44），而面向患者的医护人员为 2.08（1.73 至 2.50）和 2.26（1.43 至 3.59）。在 2021 年夏季学校重新开学的第二阶段也观察到了类似的风险。这些值高于 2020 年春季/夏季学校大部分关闭时的观察值。
与其他方面相似的劳动年龄成年人相比，教师及其家庭成员因 covid-19 住院的风险没有增加，重症 covid-19 的风险较低。这些发现应该让那些从事面对面教学的人放心。
