Emergence of the Delta Variant and risk of SARS-CoV-2 infection in secondary school students and staff: prospective surveillance in 18 schools, England

  1. Shamez N. Ladhani
  2. Georgina Ireland
  3. Frances Baawuah
  4. Joanne Beckmann
  5. Ifeanyichukwu O Okike
  6. Shazaad Ahmad
  7. Joanna Garstang
  8. Andrew J Brent
  9. Bernadette Brent
  10. Felicity Aiano
  11. Zahin Amin-Chowdhury
  12. Meaghan Kall
  13. Ray Borrow
  14. Ezra Linley
  15. Maria Zambon
  16. John Poh
  17. Lenesha Warrener
  18. Angie Lackenby
  19. Joanna Ellis
  20. Gayatri Amirthalingam
  21. Kevin E Brown
  22. Mary E Ramsay
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Abstract

Background

The role of educational settings on SARS-CoV-2 infection and transmission remains controversial. We investigated SARS-CoV-2 infection, seroprevalence and seroconversions rates in secondary schools during the 2020/21 academic year, which included the emergence of the more transmissible Alpha and Delta variants, in England.

Methods

The UK Health Security Agency (UKHSA) initiated prospective surveillance in 18 urban English secondary schools. Participants had nasal swabs for SARS-CoV-2 RT-PCR and blood sampling for SARS-CoV-2 Nucleoprotein and Spike protein antibodies at the start (Round 1: September-October 2020) and end (Round 2: December 2021) of the autumn term, when schools reopened after national lockdown was imposed in January 2021 (Round 3: March-April) and end of the academic year (Round 4: May-July).

Findings

We enrolled 2,314 participants (1277 students, 1037 staff). In-school testing identified 31 PCR-positive participants (20 students, 11 staff). Another 247 confirmed cases (112 students, 135 staff) were identified after linkage with national surveillance data, giving an overall positivity rate of 12.0% (278/2313; staff [14.1%, 146/1037] vs students [10.3%, 132/1276; p=0.006). Nucleoprotein-antibody seroprevalence increased for students and staff between Rounds 1-3 but changed little in Round 4, when the Delta variant was the dominant circulating strain. Overall, Nucleoprotein-antibody seroconversion was 18.4% (137/744) in staff and 18.8% (146/778) in students, while Spike-antibody seroconversion was higher in staff (72.8% (525/721) than students (21.3%, 163/764) because of vaccination.

Interpretation

SARS-CoV-2 infection and transmission in secondary schools remained low when community infection rates were low because of national lockdown, even after the emergence of the Delta variant

Funding

DHSC

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