Prevalence of SARS-CoV-2 Infections Among Students, Teachers, and Household Members During Lockdown and Split Classes in Berlin, Germany | Global Health | JN Learning | AMA Ed Hub [Skip to Content]
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Prevalence of SARS-CoV-2 Infections Among Students, Teachers, and Household Members During Lockdown and Split Classes in Berlin, Germany

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Children tend to bear a smaller proportion of the COVID-19 disease burden but are particularly affected by pandemic restrictions, including school closures.1 The occurrence of SARS-CoV-2 infection in school communities tends to be isolated and to produce few secondary cases.2,3 Between June 2020 and March 2021, we examined 24 school classes (12 primary and 12 secondary) across Berlin, Germany, on 4 occasions. In November 2020, there were 9 (2.7%), 2 (1.4%), and 14 (2.3%) SARS-CoV-2 infections among 338 students, 140 teachers, and 611 household members during the second pandemic peak, respectively (7-day incidence of 185 to 210 per 100,000). No secondary cases occurred among individuals in classes.3 After SARS-CoV-2 infections declined in early 2021, they increased again in mid-February and peaked by mid-April (Figure). In parallel, the SARS-CoV-2 B.1.1.7 variant gained predominance.4 Here, we present data observed with our cohort (1) at the end of February 2021, after a 2-month lockdown, and (2) at the end of March 2021, 2 to 3 weeks after schools resumed instruction with split classes half of the original size attending school on alternate weeks.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: July 27, 2021.

Published: September 28, 2021. doi:10.1001/jamanetworkopen.2021.27168

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 van Loon W et al. JAMA Network Open.

Corresponding Author: Welmoed van Loon, MSc, Institute of Tropical Medicine and International Health, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (welmoed.vanloon@charite.de).

Author Contributions: Ms van Loon had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: van Loon, Theuring, Hommes, Mall, Kurth, Mockenhaupt.

Acquisition, analysis, or interpretation of data: van Loon, Theuring, Hommes, Seybold, Kurth, Mockenhaupt.

Drafting of the manuscript: van Loon, Mockenhaupt.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: van Loon, Kurth, Mockenhaupt.

Obtained funding: Mockenhaupt.

Administrative, technical, or material support: Hommes, Mall, Seybold, Mockenhaupt.

Supervision: Seybold, Kurth, Mockenhaupt.

Conflict of Interest Disclosures: Dr Kurth reported receiving research funds from the German Joint Committee and the German Ministry of Health and having received personal compensation from Eli Lilly and Company, Teva, TotalEnergies SE, and BMJ. No other disclosures were reported.

Funding/Support: This study was supported by the Senate of Berlin.

Role of the Funder/Sponsor: The Senate of Berlin had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Ravens-Sieberer  U , Kaman  A , Erhart  M , Devine  J , Schlack  R , Otto  C .  Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany.   Eur Child Adolesc Psychiatry. Published online January 25, 2021. doi:10.1007/s00787-021-01726-5PubMedGoogle Scholar
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Ismail  SA , Saliba  V , Lopez Bernal  J , Ramsay  ME , Ladhani  SN .  SARS-CoV-2 infection and transmission in educational settings: a prospective, cross-sectional analysis of infection clusters and outbreaks in England.   Lancet Infect Dis. 2021;21(3):344-353. doi:10.1016/S1473-3099(20)30882-3PubMedGoogle ScholarCrossref
3.
Theuring  S , Thielecke  M , van Loon  W ,  et al SARS-CoV-2 infection and transmission in school settings during the second COVID-19 wave: a cross-sectional study, Berlin, Germany, November 2020. Eurosurveillance. Accessed August 26, 2021. https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2021.26.34.2100184
4.
van Loon  W , Rössig  H , Burock  S ,  et al  Emergence of SARS-CoV-2 B.1.1.7 lineage at outpatient testing site, Berlin, Germany, January-March 2021.   Emerg Infect Dis. 2021;27(7):1931-1934. doi:10.3201/eid2707.210845PubMedGoogle ScholarCrossref
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KIDSCREEN Group Europe. The KIDSCREEN Questionnaires—Quality of Life Questionnaires for Children and Adolescents. Handbook. Pabst Science Publishers; 2006. Accessed May 28, 2021. https://s2f1ad284f5ffc52e.jimcontent.com/download/version/1494315548/module/11487374212/name/KIDSCREEN_manual_English.pdf
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Berlin State Office for Health and Social Affairs. COVID-19 in Berlin, distribution by age group. Published April 5, 2020. Accessed May 20, 2021. https://www.berlin.de/lageso/gesundheit/infektionskrankheiten/corona/tabelle-altersgruppen-gesamtuebersicht/
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