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SARS-CoV-2 Transmission Risk in the School Environment: a pilot case-ascertained prospective study to inform future
N L Siegfried1, A De Voux2, K Jona3
1Health Systems Research Unit, South African Medical Council, Tygerberg, South Africa. Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. nandi.siegfried@mrc.ac.za.
Summary
This pilot study explored SARS-CoV-2 transmission in South African schools. Active contact tracing in schools is feasible and can inform disease surveillance strategies for pathogen outbreaks.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Surveillance
Background:
- South Africa lacks active or passive disease surveillance in schools.
- This gap hinders rapid detection of pathogen outbreaks like SARS-CoV-2.
- The role of school transmission in community spread remains unclear.
Purpose of the Study:
- To assess the feasibility of intensive active contact tracing in schools.
- To lay groundwork for a larger study comparing school vs. community SARS-CoV-2 transmission risk.
- To inform national strategies for pathogen prevention and control in educational settings.
Main Methods:
- Pilot case-ascertained prospective study with enhanced surveillance.
- Identified index COVID-19 case (learner) via PCR or RAT.
- Followed up school-based close contacts via phone, symptom monitoring, and PCR testing.
Main Results:
- One index case identified; 6 of 11 close contacts participated.
- Secondary Attack Rate (SAR) was 18.18% among all contacts.
- SAR was 50.0% among symptomatic contacts who were tested.
Conclusions:
- This is the first South African school-based COVID-19 transmission study.
- Results indicate feasibility of school-based surveillance.
- Findings can guide national policy on school transmission and surveillance programs.
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