Chandra Ambarish, Høeg Tracy B
Department of Management, University of Toronto at Scarborough, Toronto, ON, Canada.
Rotman School of Management, University of Toronto, Toronto, ON, Canada.
Int J Epidemiol. 2025 Jun 11;54(4). doi: 10.1093/ije/dyaf113.
There is conflicting evidence from prior studies on the relationship between in-person schooling and transmission of SARS-CoV-2 among children. This may be due to multiple confounders in estimating this relationship, including the decision to close schools, community rates of infection, and rates of testing.
Regression-based observational study to estimate the relationship between school openings and COVID-19 case rates among children, while accounting for potential confounders including community case rates, mitigations in schools, and rates of testing among schoolchildren. The setting is US school districts in the Fall of 2021, from 3 weeks prior through 12 weeks after school opening, using restricted data obtained from the Centers for Disease Control and Prevention. Data were available for school districts in 2592 counties, containing 86% of the US population.
School openings were associated with a brief rise in cases among children relative to adults, with a peak of 39.3 [37.7, 40.9] additional cases per 100 000 per week. However, children were tested at higher rates when schools were in session. After adjusting for testing rates, case rates among children were significantly lower after schools reopened by 4.7 cases per 100 000 compared with over summer break.
School reopening in the USA in the 2021-22 academic year was accompanied by an increase in SARS-CoV-2 testing in children and a brief rise in pediatric cases. When testing rates are accounted for, school reopening was associated with a decrease in COVID-19 cases among children relative to adults. A lower threshold for testing in the school setting may be an important confounder in studies of SARS-CoV-2 transmission.
先前关于面对面授课与儿童中新冠病毒传播之间关系的研究证据相互矛盾。这可能是由于在评估这种关系时存在多个混杂因素，包括学校关闭的决定、社区感染率和检测率。
基于回归的观察性研究，以估计学校开学与儿童新冠病例率之间的关系，同时考虑潜在的混杂因素，包括社区病例率、学校的缓解措施以及学童的检测率。研究背景为2021年秋季的美国学区，从开学前3周至开学后12周，使用从疾病控制和预防中心获得的受限数据。有2592个县的学区数据可供使用，涵盖了86%的美国人口。
与成年人相比，学校开学与儿童病例的短暂上升有关，每周每10万人中额外病例数峰值为39.3[37.7,40.9]例。然而，在学校上课期间儿童的检测率更高。在调整检测率后，学校重新开放后儿童的病例率比暑假期间显著降低，每10万人中减少4.7例。
2021 - 22学年美国学校重新开学伴随着儿童新冠病毒检测增加以及儿科病例短暂上升。在考虑检测率后，学校重新开学与儿童中新冠病例相对于成年人减少有关。学校环境中较低的检测阈值可能是新冠病毒传播研究中的一个重要混杂因素。
