He C, Goss M D, Norton D, Chen G, Uzicanin A, Temte J L
Department of Family Medicine and Community Health, University of Wisconsin, Madison, Wisconsin, USA.
Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA.
Influenza Other Respir Viruses. 2025 Jul;19(7):e70139. doi: 10.1111/irv.70139.
Responding to the COVID-19 pandemic, kindergarten through 12th grade schools implemented nonpharmaceutical interventions (NPIs). The effects of school-based NPIs on broader community levels of acute respiratory infection (ARI) have not been defined. We utilized an existing longitudinal cohort of households reporting weekly ARI cases to evaluate the effects of evolving school districtwide NPIs on ARI activity at eight transition points from December 2019 through October 2022.
Household ARI data were reported through the GReat Oregon Child Absenteeism due to Respiratory Disease Study (ORCHARDS) Vaccine Effectiveness Study-a prospective cohort study based in the Oregon School District (OSD) (GROVES). Participating GROVES families completed weekly online surveys with respiratory illness updates. Mixed effects logistic regression was used to examine the association between eight school-related transition events during the COVID-19 pandemic and changes in the trajectory of ARI risk for GROVES family members, while accounting for family clusters. Transition events were assessed using a ±4-week window of community data.
Opening schools with maximal NPIs (mandated masking and physical distancing, with hybrid education) was not associated with increased community ARI activity. The four transition events associated with significant ARI risk trajectory increases included summer breaks (June 2020, p = 0.001; June 2021, p = 0.002), and the start of school with mandatory masking only (September 2021, p < 0.001) or without NPIs (September 2022, p < 0.001).
School-based NPI implementation was associated with reduced risks for community ARI activity. Enhanced surveillance platforms such as the weekly online surveys used in this study are valuable tools for better understanding and monitoring SARS-CoV-2 and respiratory virus transmission in schools and surrounding communities.
为应对新冠疫情，幼儿园至12年级的学校实施了非药物干预措施（NPIs）。基于学校的NPIs对更广泛社区层面急性呼吸道感染（ARI）的影响尚未明确。我们利用一个现有的纵向队列，该队列中的家庭每周报告ARI病例，以评估2019年12月至2022年10月期间学区范围内不断演变的NPIs在八个时间节点对ARI活动的影响。
家庭ARI数据通过俄勒冈州因呼吸道疾病导致儿童缺勤情况研究（ORCHARDS）疫苗有效性研究报告，这是一项基于俄勒冈学区（OSD）的前瞻性队列研究（GROVES）。参与GROVES研究的家庭每周完成在线调查，更新呼吸道疾病情况。使用混合效应逻辑回归来检验新冠疫情期间八个与学校相关的过渡事件与GROVES家庭成员ARI风险轨迹变化之间的关联，同时考虑家庭集群因素。过渡事件使用社区数据的±4周窗口进行评估。
以最大程度的NPIs（强制佩戴口罩和保持社交距离，采用混合式教育）开学与社区ARI活动增加无关。与ARI风险轨迹显著增加相关的四个过渡事件包括暑假（2020年6月，p = 0.001；2021年6月，p = 0.002），以及仅强制佩戴口罩开学（2021年9月，p < 0.001）或未实施NPIs开学（2022年9月，p < 0.001）。
基于学校的NPIs实施与社区ARI活动风险降低相关。本研究中使用的每周在线调查等强化监测平台是更好地理解和监测学校及周边社区中SARS-CoV-2和呼吸道病毒传播的宝贵工具。
