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Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | COVID-19 | Research

Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021

Authors: Sara Stebbings, Torill Alise Rotevatn, Vilde Bergstad Larsen, Pål Surén, Petter Elstrøm, Margrethe Greve-Isdahl, Tone Bjordal Johansen, Elisabeth Astrup

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

Schools and preschools have largely remained open in Norway throughout the pandemic, with flexible mitigation measures in place. This contrasts with many other high-income countries that closed schools for long periods of time. Here we describe cases and outbreaks of COVID-19 in schools and preschools during the academic year 2020/2021, to evaluate the strategy of keeping these open with infection prevention control measures in place.

Methods

In this descriptive study, the Norwegian Institute of Public Health initiated systematic surveillance for COVID-19 cases and outbreaks in schools and preschools in October 2020. Data was compiled from the national outbreak alert system VESUV, municipality websites, and media scanning combined with the national emergency preparedness register Beredt C-19. An outbreak was defined as ≥ 2 cases among pupils or staff within 14 days at the same educational setting. Settings were categorized as preschool (1–5-years), primary school (6–12-years), lower secondary school (13–15-years) and upper secondary school (16–18- years). We reported the incidence rate among preschool and school-aged pupils and gave a descriptive overview of outbreaks and included cases per educational setting.

Results

During the whole academic year, a total of 1203 outbreaks in preschools and school settings were identified, out of a total of 8311 preschools and schools nationwide. The incidence of COVID-19 in preschool- and school-aged children and the rates of outbreaks in these settings largely followed the community trend. Most of the outbreaks occurred in primary schools (40%) and preschools (25%). Outbreaks across all settings were mostly small (median 3 cases, range 2 to 72), however, 40 outbreaks (3% of total) included 20 or more cases. The larger outbreaks were predominantly seen in primary schools (43%).

Conclusions

We observed few large outbreaks in open schools and preschools in Norway during the academic year of 2020/2021, also when the Alpha variant was predominant. This illustrates that it is possible to keep schools and preschools open even during periods of high community transmission of COVID-19. Adherence to targeted IPC measures adaptable to the local situation has been essential to keep educational settings open, and thus reduce the total burden on children and adolescents.
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Literature
2.
go back to reference United Nations Commission on Human Rights. Convention on the Rights of the Child. Geneva: UN Commission on Human Rights; 1990. United Nations Commission on Human Rights. Convention on the Rights of the Child. Geneva: UN Commission on Human Rights; 1990.
3.
go back to reference Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 2020;4(5):397–404.CrossRef Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. Lancet Child Adolesc Health. 2020;4(5):397–404.CrossRef
4.
go back to reference Viner RM, Mytton OT, Bonell C, Melendez-Torres GJ, Ward J, Hudson L, et al. Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults: A Systematic Review and Meta-analysis. JAMA Pediatr. 2021;175(2):143–56.CrossRef Viner RM, Mytton OT, Bonell C, Melendez-Torres GJ, Ward J, Hudson L, et al. Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults: A Systematic Review and Meta-analysis. JAMA Pediatr. 2021;175(2):143–56.CrossRef
5.
go back to reference Gaythorpe KAM, Bhatia S, Mangal T, Unwin HJT, Imai N, Cuomo-Dannenburg G, et al. Children’s role in the COVID-19 pandemic: a systematic review of early surveillance data on susceptibility, severity, and transmissibility. Sci Rep. 2021;11(1):13903.CrossRef Gaythorpe KAM, Bhatia S, Mangal T, Unwin HJT, Imai N, Cuomo-Dannenburg G, et al. Children’s role in the COVID-19 pandemic: a systematic review of early surveillance data on susceptibility, severity, and transmissibility. Sci Rep. 2021;11(1):13903.CrossRef
9.
go back to reference Johansen TB, Astrup E, Jore S, Nilssen H, Dahlberg BB, Klingenberg C, et al. Infection prevention guidelines and considerations for paediatric risk groups when reopening primary schools during COVID-19 pandemic, Norway, April 2020. Eurosurveillance. 2020;25(22):2000921.CrossRef Johansen TB, Astrup E, Jore S, Nilssen H, Dahlberg BB, Klingenberg C, et al. Infection prevention guidelines and considerations for paediatric risk groups when reopening primary schools during COVID-19 pandemic, Norway, April 2020. Eurosurveillance. 2020;25(22):2000921.CrossRef
12.
go back to reference Guzman-Herrador B, Vold L, Berg T, Berglund TM, Heier B, Kapperud G, et al. The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006–2013. Epidemiol Infect. 2016;144(1):215–24.CrossRef Guzman-Herrador B, Vold L, Berg T, Berglund TM, Heier B, Kapperud G, et al. The national web-based outbreak rapid alert system in Norway: eight years of experience, 2006–2013. Epidemiol Infect. 2016;144(1):215–24.CrossRef
18.
go back to reference Telle K, Jørgensen SB, Hart R, Greve-Isdahl M, Kacelnik O. Secondary attack rates of COVID-19 in Norwegian families: a nation-wide register-based study. Eur J Epidemiol. 2021;36(7):741–8.CrossRef Telle K, Jørgensen SB, Hart R, Greve-Isdahl M, Kacelnik O. Secondary attack rates of COVID-19 in Norwegian families: a nation-wide register-based study. Eur J Epidemiol. 2021;36(7):741–8.CrossRef
19.
go back to reference Engzell P, Frey A, Verhagen MD. Learning loss due to school closures during the COVID-19 pandemic. Proc Natl Acad Sci USA.2021;118(17):e2022376118. Engzell P, Frey A, Verhagen MD. Learning loss due to school closures during the COVID-19 pandemic. Proc Natl Acad Sci USA.2021;118(17):e2022376118.
20.
go back to reference Larsen L, Helland MS, Holt T. The impact of school closure and social isolation on children in vulnerable families during COVID-19: a focus on children’s reactions. Eur Child Adolesc Psychiatry. 2021:1–11. Larsen L, Helland MS, Holt T. The impact of school closure and social isolation on children in vulnerable families during COVID-19: a focus on children’s reactions. Eur Child Adolesc Psychiatry. 2021:1–11.
21.
go back to reference Viner RM, Bonell C, Drake L, Jourdan D, Davies N, Baltag V, et al. Reopening schools during the COVID-19 pandemic: governments must balance the uncertainty and risks of reopening schools against the clear harms associated with prolonged closure. Arch Dis Child. 2021;106(2):111–3.CrossRef Viner RM, Bonell C, Drake L, Jourdan D, Davies N, Baltag V, et al. Reopening schools during the COVID-19 pandemic: governments must balance the uncertainty and risks of reopening schools against the clear harms associated with prolonged closure. Arch Dis Child. 2021;106(2):111–3.CrossRef
22.
go back to reference Walsh S, Chowdhury A, Braithwaite V, Russell S, Birch J, Ward J, et al. Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies. BMJ Ope. 2021;11(8):e053371. Walsh S, Chowdhury A, Braithwaite V, Russell S, Birch J, Ward J, et al. Do school closures and school reopenings affect community transmission of COVID-19? A systematic review of observational studies. BMJ Ope. 2021;11(8):e053371.
25.
go back to reference Rotevatn TA, Larsen VB, Bjordal Johansen TK, Astrup E, Surén P, Greve-Isdahl M, et al. Transmission of SARS-CoV-2 in Norwegian schools: A population-wide register-based cohort study on characteristics of the index case and secondary attack rates. medRxiv. 2021:2021.10.04.21264496. Rotevatn TA, Larsen VB, Bjordal Johansen TK, Astrup E, Surén P, Greve-Isdahl M, et al. Transmission of SARS-CoV-2 in Norwegian schools: A population-wide register-based cohort study on characteristics of the index case and secondary attack rates. medRxiv. 2021:2021.10.04.21264496.
26.
go back to reference Ertem Z, Schechter-Perkins E, Oster E, van den Berg P, Epshtein I, Chaiyakunapruk N, et al. The Impact of School Opening Model on SARS-CoV-2 Community Incidence and Mortality: A Nationwide Cohort Study. Res Sq [Internet]. 2021:rs.3.rs-712725. Available from: http://europepmc.org/abstract/MED/34282412. Ertem Z, Schechter-Perkins E, Oster E, van den Berg P, Epshtein I, Chaiyakunapruk N, et al. The Impact of School Opening Model on SARS-CoV-2 Community Incidence and Mortality: A Nationwide Cohort Study. Res Sq [Internet]. 2021:rs.3.rs-712725. Available from: http://​europepmc.​org/​abstract/​MED/​34282412.
27.
go back to reference Fukumoto K, McClean CT, Nakagawa K. No causal effect of school closures in Japan on the spread of COVID-19 in spring 2020. Nat Med. 2021;27(12):2111–9. Fukumoto K, McClean CT, Nakagawa K. No causal effect of school closures in Japan on the spread of COVID-19 in spring 2020. Nat Med. 2021;27(12):2111–9.
28.
go back to reference Juutinen A, Sarvikivi E, Laukkanen-Nevala P, Helve O. Closing lower secondary schools had no impact on COVID-19 incidence in 13–15-year-olds in Finland. Epidemiol Infect. 2021;149:e233.CrossRef Juutinen A, Sarvikivi E, Laukkanen-Nevala P, Helve O. Closing lower secondary schools had no impact on COVID-19 incidence in 13–15-year-olds in Finland. Epidemiol Infect. 2021;149:e233.CrossRef
29.
go back to reference Lewis SJ, Munro APS, Smith GD, Pollock AM. Closing schools is not evidence based and harms children. BMJ. 2021;372:n521.CrossRef Lewis SJ, Munro APS, Smith GD, Pollock AM. Closing schools is not evidence based and harms children. BMJ. 2021;372:n521.CrossRef
Metadata
Title
Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021
Authors
Sara Stebbings
Torill Alise Rotevatn
Vilde Bergstad Larsen
Pål Surén
Petter Elstrøm
Margrethe Greve-Isdahl
Tone Bjordal Johansen
Elisabeth Astrup
Publication date
01-12-2022
Publisher
BioMed Central
Keywords
COVID-19
COVID-19
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13868-5

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