现场学校内评估 SARS-CoV-2 传播限制措施的前瞻性试点研究。
Prospective Pilot Study Evaluating SARS-CoV-2 Transmission-Limiting Measures in an On-Site School.
机构信息
Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif.
Center for Policy, Outcomes, and Prevention, and Division of General Pediatrics (SG Jani, J Ma, U Pulendran, JC Hsing, S Shah and CJ Wang), Stanford University School of Medicine, Stanford, Calif; Department of Epidemiology and Population Health (JC Hsing), Stanford University School of Medicine, Stanford, Calif.
出版信息
Acad Pediatr. 2022 May-Jun;22(4):671-679. doi: 10.1016/j.acap.2021.11.019. Epub 2021 Dec 8.
OBJECTIVES
The purpose of our study is to evaluate the feasibility and reliability of a comprehensive set of preventive measures in limiting secondary transmission of COVID-19 in schools.
METHODS
A prospective cohort study was conducted to evaluate SARS-CoV-2 transmission in an independent K-8 school in San Mateo County, California. The research was conducted between September 14, 2020 through March 22, 2021 and consisted of: 1) demographic and epidemiological questionnaires; 2) daily symptom reporting; 3) weekly RT-PCR testing; and 4) periodic on-site qualitative observations.
RESULTS
One hundred eighty (79%) students and 63 (74%) on-site staff/contractors were enrolled. Participants reported symptoms in 144 (<1%) daily surveys of the 19,409 collected. Among those who reported symptoms and exposures, none tested positive during the 22-week study period. Of all participants, a total of 6 tested positive for SARS-CoV-2 at least once by RT-PCR; all were asymptomatic at time of testing. No in-school transmission occurred. Mask adherence was high among all grades, and incidents of improper mask use mostly occurred during noninstruction time. Physical distancing was well-enforced during class time and snack breaks, although adherence during noninstruction time waned as the school year progressed.
CONCLUSIONS
Our comprehensive, prospective study following COVID-19 transmission over 22 weeks in a K-8 school demonstrates that: 1) surveillance testing is important for detecting asymptomatic infections in schools; 2) monitoring symptoms may not be necessary and/or sufficient for COVID-19; and 3) younger children can adhere to key mitigation measures (eg, masking) which have the potential to limit transmission.
目的
我们研究的目的是评估一整套预防措施在限制 COVID-19 在学校中二次传播的可行性和可靠性。
方法
我们进行了一项前瞻性队列研究，以评估加利福尼亚州圣马特奥县一所独立的 K-8 学校中 SARS-CoV-2 的传播情况。该研究于 2020 年 9 月 14 日至 2021 年 3 月 22 日进行，包括：1）人口统计学和流行病学问卷调查；2）每日症状报告；3）每周 RT-PCR 检测；和 4）定期现场定性观察。
结果
共有 180 名（79%）学生和 63 名（74%）现场工作人员/承包商入组。在收集的 19409 份每日调查中，有 144 份（<1%）报告了症状。在报告症状和接触者中，在 22 周的研究期间，没有人在 RT-PCR 检测中呈阳性。所有参与者中，共有 6 人至少通过 RT-PCR 一次检测出 SARS-CoV-2 阳性；所有在检测时均无症状。校内未发生传播。所有年级的口罩佩戴率都很高，只有在非教学时间，才会出现口罩使用不当的情况。在上课时和课间休息期间，身体距离保持良好，尽管随着学年的进展，非教学时间的遵守情况有所减弱。
结论
我们在一所 K-8 学校进行了为期 22 周的 COVID-19 传播的综合前瞻性研究，结果表明：1）监测检测对于在学校中检测无症状感染很重要；2）监测症状可能对于 COVID-19 而言既不必要也不充分；3）年龄较小的儿童可以遵守关键的缓解措施（例如戴口罩），这有可能限制传播。
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