Assessment of a Program for SARS-CoV-2 Screening and Environmental Monitoring in an Urban Public School District
Importance: Scalable programs for school-based SARS-CoV-2 testing and surveillance are needed to guide in-person learning practices and inform risk assessments in kindergarten through 12th grade settings.
Objectives: To characterize SARS-CoV-2 infections in staff and students in an urban public school setting and evaluate test-based strategies to support ongoing risk assessment and mitigation for kindergarten through 12th grade in-person learning.
Design, Setting, and Participants: This pilot quality improvement program engaged 3 schools in Omaha, Nebraska, for weekly saliva polymerase chain reaction testing of staff and students participating in in-person learning over a 5-week period from November 9 to December 11, 2020. Wastewater, air, and surface samples were collected weekly and tested for SARS-CoV-2 RNA to evaluate surrogacy for case detection and interrogate transmission risk of in-building activities.
Main Outcomes and Measures: SARS-CoV-2 detection in saliva and environmental samples and risk factors for SARS-CoV-2 infection.
Results: A total of 2885 supervised, self-collected saliva samples were tested from 458 asymptomatic staff members (mean [SD] age, 42.9 [12.4] years; 303 women [66.2%]; 25 Black or African American [5.5%], 83 Hispanic [18.1%], 312 White [68.1%], and 35 other or not provided [7.6%]) and 315 students (mean age, 14.2 [0.7] years; 151 female students [48%]; 20 Black or African American [6.3%], 201 Hispanic [63.8%], 75 White [23.8%], and 19 other race or not provided [6.0%]). A total of 46 cases of SARS-CoV-2 (22 students and 24 staff members) were detected, representing an increase in cumulative case detection rates from 1.2% (12 of 1000) to 7.0% (70 of 1000) among students and from 2.1% (21 of 1000) to 5.3% (53 of 1000) among staff compared with conventional reporting mechanisms during the pilot period. SARS-CoV-2 RNA was detected in wastewater samples from all pilot schools as well as in air samples collected from 2 choir rooms. Sequencing of 21 viral genomes in saliva specimens demonstrated minimal clustering associated with 1 school. Geographical analysis of SARS-CoV-2 cases reported district-wide demonstrated higher community risk in zip codes proximal to the pilot schools.
Conclusions and Relevance: In this study of staff and students in 3 urban public schools in Omaha, Nebraska, weekly screening of asymptomatic staff and students by saliva polymerase chain reaction testing was associated with increased SARS-CoV-2 case detection, exceeding infection rates reported at the county level. Experiences differed among schools, and virus sequencing and geographical analyses suggested a dynamic interplay of school-based and community-derived transmission risk. Collectively, these findings provide insight into the performance and community value of test-based SARS-CoV-2 screening and surveillance strategies in the kindergarten through 12th grade educational setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:4 |
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| Enthalten in: |
JAMA network open - 4(2021), 9 vom: 01. Sept., Seite e2126447 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Crowe, John [VerfasserIn] |
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| Anmerkungen: |
Date Completed 29.09.2021 Date Revised 03.04.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1001/jamanetworkopen.2021.26447 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM330921711 |
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| 245 | 1 | 0 | |a Assessment of a Program for SARS-CoV-2 Screening and Environmental Monitoring in an Urban Public School District |
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| 500 | |a Date Completed 29.09.2021 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Importance: Scalable programs for school-based SARS-CoV-2 testing and surveillance are needed to guide in-person learning practices and inform risk assessments in kindergarten through 12th grade settings | ||
| 520 | |a Objectives: To characterize SARS-CoV-2 infections in staff and students in an urban public school setting and evaluate test-based strategies to support ongoing risk assessment and mitigation for kindergarten through 12th grade in-person learning | ||
| 520 | |a Design, Setting, and Participants: This pilot quality improvement program engaged 3 schools in Omaha, Nebraska, for weekly saliva polymerase chain reaction testing of staff and students participating in in-person learning over a 5-week period from November 9 to December 11, 2020. Wastewater, air, and surface samples were collected weekly and tested for SARS-CoV-2 RNA to evaluate surrogacy for case detection and interrogate transmission risk of in-building activities | ||
| 520 | |a Main Outcomes and Measures: SARS-CoV-2 detection in saliva and environmental samples and risk factors for SARS-CoV-2 infection | ||
| 520 | |a Results: A total of 2885 supervised, self-collected saliva samples were tested from 458 asymptomatic staff members (mean [SD] age, 42.9 [12.4] years; 303 women [66.2%]; 25 Black or African American [5.5%], 83 Hispanic [18.1%], 312 White [68.1%], and 35 other or not provided [7.6%]) and 315 students (mean age, 14.2 [0.7] years; 151 female students [48%]; 20 Black or African American [6.3%], 201 Hispanic [63.8%], 75 White [23.8%], and 19 other race or not provided [6.0%]). A total of 46 cases of SARS-CoV-2 (22 students and 24 staff members) were detected, representing an increase in cumulative case detection rates from 1.2% (12 of 1000) to 7.0% (70 of 1000) among students and from 2.1% (21 of 1000) to 5.3% (53 of 1000) among staff compared with conventional reporting mechanisms during the pilot period. SARS-CoV-2 RNA was detected in wastewater samples from all pilot schools as well as in air samples collected from 2 choir rooms. Sequencing of 21 viral genomes in saliva specimens demonstrated minimal clustering associated with 1 school. Geographical analysis of SARS-CoV-2 cases reported district-wide demonstrated higher community risk in zip codes proximal to the pilot schools | ||
| 520 | |a Conclusions and Relevance: In this study of staff and students in 3 urban public schools in Omaha, Nebraska, weekly screening of asymptomatic staff and students by saliva polymerase chain reaction testing was associated with increased SARS-CoV-2 case detection, exceeding infection rates reported at the county level. Experiences differed among schools, and virus sequencing and geographical analyses suggested a dynamic interplay of school-based and community-derived transmission risk. Collectively, these findings provide insight into the performance and community value of test-based SARS-CoV-2 screening and surveillance strategies in the kindergarten through 12th grade educational setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 700 | 1 | |a SchmidtBonne, Scott |e verfasserin |4 aut | |
| 700 | 1 | |a Angell, Kathleen |e verfasserin |4 aut | |
| 700 | 1 | |a Bai, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Eske, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Nicklin, Molly |e verfasserin |4 aut | |
| 700 | 1 | |a Pratt, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a White, Bailey |e verfasserin |4 aut | |
| 700 | 1 | |a Crotts-Hannibal, Brodie |e verfasserin |4 aut | |
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| 700 | 1 | |a Herrera, Vicki |e verfasserin |4 aut | |
| 700 | 1 | |a Cobb, Jeramie |e verfasserin |4 aut | |
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| 700 | 1 | |a Carstens, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Tempero, Jonell |e verfasserin |4 aut | |
| 700 | 1 | |a Bouda, Lori |e verfasserin |4 aut | |
| 700 | 1 | |a Ray, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Lawler, James V |e verfasserin |4 aut | |
| 700 | 1 | |a Campbell, W Scott |e verfasserin |4 aut | |
| 700 | 1 | |a Lowe, John-Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Santarpia, Joshua |e verfasserin |4 aut | |
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| 700 | 1 | |a Logan, Cheryl |e verfasserin |4 aut | |
| 700 | 1 | |a Broadhurst, M Jana |e verfasserin |4 aut | |
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