Departments of Pediatrics.
Duke Clinical Research Institute, School of Medicine, Duke University, Durham, North Carolina.
Pediatrics. 2022 Feb 1;149(12 Suppl 2). doi: 10.1542/peds.2021-054268J.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related quarantines, which are required after close contact with infected individuals, have substantially disrupted in-person education for kindergarten through 12th grade (K-12) students. In recent recommendations, shortened durations of quarantine are allowed if a negative SARS-CoV-2 test result is obtained at 5 to 7 days postexposure, but access to testing remains limited. We hypothesized that providing access to in-school SARS-CoV-2 testing postexposure would increase testing and reduce missed school days.
This prospective cohort study was conducted in one large public K-12 school district in North Carolina and included 2 periods: preimplementation (March 15, 2021, to April 21, 2021) and postimplementation (April 22, 2021, to June 4, 2021), defined around initiation of an in-school SARS-CoV-2 testing program in which on-site access to testing is provided. Number of quarantined students and staff, testing uptake, test results, and number of missed school days were analyzed and compared between the preimplementation and postimplementation periods.
Twenty-four schools, including 12 251 in-person learners, participated in the study. During preimplementation, 446 close contacts were quarantined for school-related exposures; 708 close contacts were quarantined postimplementation. Testing uptake after school-related exposures increased from 6% to 40% (95% confidence interval: 23% to 45%) after implementation, and 89% of tests were conducted in-school. After in-school testing implementation, close contacts missed ∼1.5 fewer days of school (95% confidence interval: -2 to -1).
Providing access to in-school testing may be a worthwhile mechanism to increase testing uptake after in-school exposures and minimize missed days of in-person learning, thereby mitigating the pandemic's ongoing impact on children.
与感染者密切接触后需要进行的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)相关隔离,极大地扰乱了幼儿园至 12 年级(K-12)学生的面授教育。在最近的建议中,如果在接触后 5 至 7 天获得 SARS-CoV-2 检测阴性结果,则允许缩短隔离期,但检测仍然有限。我们假设在接触后提供校内 SARS-CoV-2 检测可以增加检测并减少缺课天数。
这项前瞻性队列研究在北卡罗来纳州的一个大型公立 K-12 学区进行,包括两个时期:实施前(2021 年 3 月 15 日至 4 月 21 日)和实施后(2021 年 4 月 22 日至 6 月 4 日),这两个时期是围绕校内 SARS-CoV-2 检测计划的启动定义的,该计划提供现场检测。分析并比较了实施前和实施后期间被隔离的学生和教职员工人数、检测采用率、检测结果和缺课天数。
24 所学校,包括 12251 名面授学习者参与了研究。在实施前,有 446 名密切接触者因学校相关暴露而被隔离;实施后有 708 名密切接触者被隔离。学校相关暴露后检测采用率从 6%增加到 40%(95%置信区间:23%至 45%),89%的检测是在学校内进行的。实施校内检测后,密切接触者缺课天数减少了约 1.5 天(95%置信区间:-2 至-1)。
提供校内检测机会可能是一种增加校内暴露后检测采用率并最大限度减少面授学习缺课天数的有效机制,从而减轻大流行对儿童的持续影响。