Disease Elimination Program, Burnet Institute, Melbourne, VIC, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Front Public Health. 2023 Jun 2;11:1150810. doi: 10.3389/fpubh.2023.1150810. eCollection 2023.
In 2021, the Australian Government Department of Health commissioned a consortium of modelling groups to generate evidence assisting the transition from a goal of no community COVID-19 transmission to 'living with COVID-19', with adverse health and social consequences limited by vaccination and other measures. Due to the extended school closures over 2020-21, maximizing face-to-face teaching was a major objective during this transition. The consortium was tasked with informing school surveillance and contact management strategies to minimize infections and support this goal.
Outcomes considered were infections and days of face-to-face teaching lost in the 45 days following an outbreak within an otherwise COVID-naïve school setting. A stochastic agent-based model of COVID-19 transmission was used to evaluate a 'test-to-stay' strategy using daily rapid antigen tests (RATs) for close contacts of a case for 7 days compared with home quarantine; and an asymptomatic surveillance strategy involving twice-weekly screening of all students and/or teachers using RATs.
Test-to-stay had similar effectiveness for reducing school infections as extended home quarantine, without the associated days of face-to-face teaching lost. Asymptomatic screening was beneficial in reducing both infections and days of face-to-face teaching lost and was most beneficial when community prevalence was high.
Use of RATs in school settings for surveillance and contact management can help to maximize face-to-face teaching and minimize outbreaks. This evidence supported the implementation of surveillance testing in schools in several Australian jurisdictions from January 2022.
2021 年，澳大利亚卫生部委托一个建模小组联盟，生成有助于从无社区 COVID-19 传播目标过渡到“与 COVID-19 共存”的证据，通过疫苗接种和其他措施限制不良健康和社会后果。由于 2020-21 年学校长期关闭，最大限度地进行面对面教学是这一过渡的主要目标。该联盟的任务是为学校监测和接触管理策略提供信息，以最大程度地减少感染，并支持这一目标。
考虑的结果是在 COVID-19 无经验的学校环境中发生疫情后的 45 天内，感染和面对面教学天数的损失。使用 COVID-19 传播的随机代理基模型来评估“检测后留校”策略，即对病例的密切接触者使用每日快速抗原检测（RAT）进行 7 天的检测，而不是进行家庭隔离；以及涉及所有学生和/或教师使用 RAT 进行两周两次筛查的无症状监测策略。
检测后留校策略在减少学校感染方面与延长家庭隔离的效果相似，而不会导致面对面教学天数的损失。无症状筛查在减少感染和面对面教学天数的损失方面是有益的，当社区流行率较高时，其益处最大。
在学校环境中使用 RAT 进行监测和接触管理有助于最大限度地进行面对面教学，并最大限度地减少疫情爆发。该证据支持从 2022 年 1 月起，在澳大利亚几个司法管辖区实施学校监测检测。
