Clinical Infectious Diseases 2021

Transmission of SARS-CoV-2 infection among children in summer schools applying stringent control measures in Barcelona, Spain.

Jordan I, de Sevilla MF, Fumadó V, Bassat Q, Bonet-Carne E, Fortuny C, Garcia-Miquel A, Jou C, Adroher C, Casas MM, Girona-Alarcon M, Garcia MH, Tomas GP, Ajanovic S, Arias S, Balanza N, Baro B, Millat-Martínez P, Varo R, Alonso S, Álvarez-Lacalle E, LÓPEZ D, Claverol J, Cubells M, Brotons P, Codina A, Cuadras D, Bruijning-Verhagen P, Faust S, Munro A, Muñoz-Almagro C, Català M, Prats C, Garcia-Garcia JJ, Gratacós E
Understanding the role of children in SARS-CoV-2 transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools. During July 2020 we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through: (1) surveillance program in 22 summer schools' of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 RT-PCR during 2-5 weeks; (2)cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centres followed prevention protocols: bubble groups, hand washing, facemasks and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and effective reproduction number in summer schools(R*) were calculated. Among the over 2000 repeatedly screened participants, 30children and 9adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median 9 (IQR 5-10) for each primary case), among which twelve new cases (4.7%) were positive for SARS-CoV-2. The R* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9. The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission and supports current recommendations for school opening. © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: