Feasibility and acceptability of SARS-CoV-2 testing and surveillance in primary school children in England: Prospective, cross-sectional study.

Felicity Aiano,Bernadette Brent,Andrew Brent,Shamez N Ladhani,Frances Baawuah,Ifeanyichukwu Okike,Joanne Beckmann,Jessica Flood,Joanna Garstang,Samuel E I Jones,Zahin Amin-Chowdhury,Shazaad Ahmad,Mary E Ramsay,Khin Thet Wai

doi:10.1371/journal.pone.0255517

Abstract

BackgroundThe reopening of schools during the COVID-19 pandemic has raised concerns about widespread infection and transmission of SARS-CoV-2 in educational settings. In June 2020, Public Health England (PHE) initiated prospective national surveillance of SARS-CoV-2 in primary schools across England (sKIDs). We used this opportunity to assess the feasibility and agreeability of large-scale surveillance and testing for SARS-CoV-2 infections in school among staff, parents and students.MethodsStaff and students in 131 primary schools were asked to complete a questionnaire at recruitment and provide weekly nasal swabs for SARS-CoV-2 RT-PCR testing (n = 86) or swabs with blood samples for antibody testing (n = 45) at the beginning and end the summer half-term. In six blood sampling schools, students were asked to complete a pictorial questionnaire before and after their investigations.ResultsIn total, 135 children aged 4–7 years (n = 40) or 8–11 years (n = 95) completed the pictorial questionnaire fully or partially. Prior to sampling, oral fluid sampling was the most acceptable test (107/132, 81%) followed by throat swabs (80/134, 59%), nose swabs (77/132, 58%), and blood tests (48/130, 37%). Younger students were more nervous about all tests than older students but, after completing their tests, most children reported a “better than expected” experience with all the investigations. Students were more likely to agree to additional testing for nose swabs (93/113, 82%) and oral fluid (93/114, 82%), followed by throat swabs (85/113, 75%) and blood tests (72/108, 67%). Parents (n = 3,994) and staff (n = 2,580) selected a preference for weekly testing with nose swabs, throat swabs or oral fluid sampling, although staff were more flexible about testing frequency.ConclusionsPrimary school staff and parents were supportive of regular tests for SARS-CoV-2 and selected a preference for weekly testing. Children preferred nose swabs and oral fluids over throat swabs or blood sampling.

Highlights

The emergence of SARS-CoV-2 and its rapid spread has led to mass disruption globally, with implementation of lockdown measures that have included school closures in most countries
Primary school staff and parents were supportive of regular tests for SARS-CoV-2 and selected a preference for weekly testing
The scale of the sKIDS surveillance was unprecedented, given that these were undertaken in the middle of a pandemic and involved multiple investigations including blood sampling in young children

Summary

Introduction

The emergence of SARS-CoV-2 and its rapid spread has led to mass disruption globally, with implementation of lockdown measures that have included school closures in most countries. On 01 June 2020, primary schools for pupils aged between 4 and 11 years reopened, starting with reception, school years 1 and 6, until the end of the summer half-term in mid-July 2020 [6]. In June 2020, Public Health England (PHE) initiated prospective national surveillance of SARS-CoV-2 in primary schools across England (sKIDs). We used this opportunity to assess the feasibility and agreeability of large-scale surveillance and testing for SARS-CoV-2 infections in school among staff, parents and students

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Results

Discussion

Conclusion