SARS-CoV-2 infection, antibody positivity and seroconversion rates in staff and students following full reopening of secondary schools in England: A prospective cohort study, September-December 2020

Shamez N Ladhani; Georgina Ireland; Frances Baawuah; Joanne Beckmann; Ifeanyichukwu O Okike; Shazaad Ahmad; Joanna Garstang; Andrew J Brent; Bernadette Brent; Jemma Walker; Felicity Aiano; Zahin Amin-Chowdhury; Louise Letley; Jessica Flood; Samuel E I Jones; Meaghan Kall; Ray Borrow; Ezra Linley; Maria Zambon; John Poh; Angie Lackenby; Joanna Ellis; Gayatri Amirthalingam; Kevin E Brown; Mary E Ramsay

doi:10.1016/j.eclinm.2021.100948

SARS-CoV-2 infection, antibody positivity and seroconversion rates in staff and students following full reopening of secondary schools in England: A prospective cohort study, September-December 2020

EClinicalMedicine. 2021 Jun 9:37:100948. doi: 10.1016/j.eclinm.2021.100948. eCollection 2021 Jul.

Authors

Shamez N Ladhani^{1

2}, Georgina Ireland¹, Frances Baawuah¹, Joanne Beckmann³, Ifeanyichukwu O Okike^{1

4}, Shazaad Ahmad⁵, Joanna Garstang⁶, Andrew J Brent^{7

8}, Bernadette Brent⁷, Jemma Walker¹, Felicity Aiano¹, Zahin Amin-Chowdhury¹, Louise Letley¹, Jessica Flood¹, Samuel E I Jones¹, Meaghan Kall¹, Ray Borrow⁹, Ezra Linley⁹, Maria Zambon¹, John Poh¹, Angie Lackenby¹, Joanna Ellis¹, Gayatri Amirthalingam¹, Kevin E Brown¹, Mary E Ramsay¹

Affiliations

¹ National Infection Service, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK.
² Paediatric Infectious Diseases Research Group, St. George's University of London, London SW17 0RE, UK.
³ East London NHS Foundation Trust, 9 Allie Street, London E1 8DE, UK.
⁴ University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK, 201 London Road, Derby DE1 2TZ, UK.
⁵ Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK.
⁶ Birmingham Community Healthcare NHS Trust, Holt Street, Aston B7 4BN, UK.
⁷ Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford OX3 7HE, UK.
⁸ Nuffield Department of Medicine, University of Oxford, Wellington Square, Oxford OX1 2JD, UK.
⁹ Public Health England, Manchester Royal Infirmary, Manchester, UK.

Abstract

Background: Older children have higher SARS-CoV-2 infection rates than younger children. We investigated SARS-CoV-2 infection, seroprevalence and seroconversion rates in staff and students following the full reopening of all secondary schools in England.

Methods: Public Health England (PHE) invited secondary schools in six regions (East and West London, Hertfordshire, Derbyshire, Manchester and Birmingham) to participate in SARS-CoV-2 surveillance during the 2020/21 academic year. Participants had nasal swabs for RT-PCR and blood samples for SARS-CoV-2 antibodies at the beginning (September 2020) and end (December 2020) of the autumn term. Multivariable logistic regression was used to assess independent risk factors for seropositivity and seroconversion.

Findings: Eighteen schools in six regions enrolled 2,209 participants, including 1,189 (53.8%) students and 1,020 (46.2%) staff. SARS-CoV-2 infection rates were not significantly different between students and staff in round one (5/948; [0.53%] vs. 2/876 [0.23%]; p = 0.46) or round two (10/948 [1.05%] vs. 7/886 [0.79%]; p = 0.63), and similar to national prevalence. None of four and 7/15 (47%) sequenced strains in rounds 1 and 2 were the highly transmissible SARS-CoV-2 B.1.1.7 variant. In round 1, antibody seropositivity was higher in students than staff (114/893 [12.8%] vs. 79/861 [9.2%]; p = 0.016), but similar in round 2 (117/893 [13.1%] vs.117/872 [13.3%]; p = 0.85), comparable to local community seroprevalence. Between the two rounds, 8.7% (57/652) staff and 6.6% (36/549) students seroconverted (p = 0.16).

Interpretation: In secondary schools, SARS-CoV-2 infection, seropositivity and seroconversion rates were similar in staff and students, and comparable to local community rates. Ongoing surveillance will be important for monitoring the impact of new variants in educational settings.