Safe Reopening Research Articles

Academic activism on behalf of children during the COVID-19 pandemic in Israel; beyond public health advocacy

Among the challenges presented by the SARS-CoV2 pandemic are those related to balancing societal priorities with averting threats to population health. In this exceptional context a group of Israeli physicians and public health scholars (multidisciplinary academic group on children and coronavirus [MACC]) coalesced, examining the role of children in viral transmission and assessing the necessity and consequences of restricted in-class education. Combining critical appraisal and analytical skills with public health experience, MACC advocated for safe and monitored school re-opening, stressing the importance of education as a determinant of health, continuously weighing this stance against evolving COVID-19-risk data. MACC’s activities included offering research-based advice to government agencies including Ministries of Health, Finance, and Education. In a setting where government bodies were faced with providing practical solutions to both decreasing disease transmission and maintaining society’s vital activities, and various advisors presented decision-makers with disparate views, MACC contributed epidemiological, clinical and health policy expertise to the debate regarding school closure as a pandemic control measure, and adaptations required for safe re-opening. In this paper, we describe the evolution, activities, policy inputs and media profile of MACC, and discuss the role of academics in advocacy and activism in the midst of an unprecedented public health crisis. A general lesson learned is that academics, based on the rigor of their scientific work and their perceived objectivity, can and should be mobilized to pursue and promote policies based on shared societal values as well as empiric data, even when considerable uncertainty exists about the appropriate course of action. Mechanisms should be in place to open channels to multidisciplinary academic groups and bring their input to bear on decision-making.

Impacts of COVID-19 on Transport Modes and Mobility Behavior: Analysis of Public Discourse in Twitter.

This study proposes a framework to analyze public discourse in Twitter to understand the impacts of COVID-19 on transport modes and mobility behavior. It also identifies reopening challenges and potential reopening strategies that are discussed by the public. First, the study collects 15,776 tweets that relate to personal opinions on transportation services posted between May 15 and June 15, 2020. Next, it applies text mining and topic modeling techniques to the tweets to determine the prominent themes, terms, and topics in those discussions to understand public feelings, behavior, and broader sentiments about the changes brought about by COVID-19 on transportation systems. Results reveal that people are avoiding public transport and shifting to using private car, bicycle, or walking. Bicycle sales have increased remarkably but car sales have declined. Cycling and walking, telecommuting, and online schools are identified as possible solutions to COVID-19 mobility problems and to reduce car usage with an aim to tackle traffic congestion in the post-pandemic world. People appreciated government decisions for funding allocation to public transport, and asked for the reshaping, restoring, and safe reopening of transit systems. Protecting transit workers, riders, shop customers and staff, and office employees is identified as a crucial reopening challenge, whereas mask wearing, phased reopening, and social distancing are proposed as effective reopening strategies. This framework can be used as a tool by decision makers to enable a holistic understanding of public opinions on transportation services during COVID-19 and formulate policies for a safe reopening.

COVID-19 information seeking and utilization among library and information science professionals in Nigeria

Like many countries, Nigeria’s library services were affected by COVID-19. This study (conducted in 2020) examined the priorities and barriers for information seeking and use by library and information science professionals in Nigeria, including what type of information was sought, the sources used and how these were evaluated. An online survey, with questions informed by a literature survey, was sent to library and information science professionals in Nigeria with WhatsApp accounts (individual and library and information science group accounts). The responses were automatically collected and saved into Google Sheets for further analysis using descriptive statistics. There were 167 responses (61% response rate). The main information needs were causes of the virus, COVID-19 symptoms, providing library services during physical library closure, the timing of reopening, and staff and user safety measures required for library reopening. The respondents were also concerned about COVID-19 test procedures and transmission mechanisms, treatment (including herbal medicines), vaccines, government policy and restrictions on movement. The main information sources used were the Internet (including government and World Health Organization websites), social media, television and radio. The authority, reliability, currency and relevance of the information were considered when evaluating COVID-19 information consulted, and were using the information primarily to ‘keep safe’ in accordance with government regulations, to provide library services on time and to plan for safe reopening. The barriers to information seeking and use were technical (poor telecommunications), financial (lack of funds to purchase resources) and physical (library closures). One barrier was the volume of information (both reliable and unreliable). Verification was viewed as important but seemingly difficult to do. The respondents were concerned about the safe and effective operation of library services. Library and information science professionals in Nigeria may need advice from health professionals on the most reliable sources of information on COVID-19 and how to use them for themselves and their users.

Designing the Safe Reopening of US Towns Through High-Resolution Agent-Based Modeling.

As COVID‐19 vaccine is being rolled out in the US, public health authorities are gradually reopening the economy. To date, there is no consensus on a common approach among local authorities. Here, a high‐resolution agent‐based model is proposed to examine the interplay between the increased immunity afforded by the vaccine roll‐out and the transmission risks associated with reopening efforts. The model faithfully reproduces the demographics, spatial layout, and mobility patterns of the town of New Rochelle, NY — representative of the urban fabric of the US. Model predictions warrant caution in the reopening under the current rate at which people are being vaccinated, whereby increasing access to social gatherings in leisure locations and households at a 1% daily rate can lead to a 28% increase in the fatality rate within the next three months. The vaccine roll‐out plays a crucial role on the safety of reopening: doubling the current vaccination rate is predicted to be sufficient for safe, rapid reopening.

School closures were over-weighted against the mitigation of COVID-19 transmission: A literature review on the impact of school closures in the United States.

Background:The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread wildly across the world. In March of 2020, almost all kindergarten through 12th grade (K-12) schools were closed in the United States in an urgent attempt to curb the pandemic in the absence of effective therapeutics or vaccination. Thirteen months since then, schools remain partially closed. Accumulated evidence suggests that children and adolescents are not the primary facilitators of transmission, limiting the restrictive effects of school closures on disease transmission. The negative effects of school closures on K-12 students need to be systematically reviewed.Methods:Following the guideline of Preferred Reporting Items for Systematic Reviews and Meta-analyzes, a comprehensive literature search from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science regarding school closures and its impact on K-12 students was conducted. The primary outcomes included the impact of school closures on the mitigation of the pandemic and the resulting public health concerns of K-12 students.Results:Prolonged school closures possessed negative effects on K-12 students’ physical, mental, and social well-being and reduced the number of health and social workers, hindering the reopening of the country.Conclusions:School closures were over-weighted against the mitigation of coronavirus disease 2019 (COVID-19) transmission. A safe reopening of all K-12 schools in the United States should be of top priority.

Risk scorecard to minimize impact of COVID-19 when reopening.

BackgroundWe present a novel approach for exiting coronavirus disease 2019 (COVID-19) lockdowns using a ‘risk scorecard’ to prioritize activities to resume whilst allowing safe reopening.MethodsWe modelled cases generated in the community/week, incorporating parameters for social distancing, contact tracing and imported cases. We set thresholds for cases and analysed the effect of varying parameters. An online tool to facilitate country-specific use including the modification of parameters (https://sshsphdemos.shinyapps.io/covid_riskbudget/) enables visualization of effects of parameter changes and trade-offs. Local outbreak investigation data from Singapore illustrate this.ResultsSetting a threshold of 0.9 mean number of secondary cases arising from a case to keep R < 1, we showed that opening all activities excluding high-risk ones (e.g. nightclubs) allows cases to remain within threshold; while opening high-risk activities would exceed the threshold and result in escalating cases. An 80% reduction in imported cases per week (141 to 29) reduced steady-state cases by 30% (295 to 205). One-off surges in cases (due to superspreading) had no effect on the steady state if the R remains <1. Increasing the effectiveness of contact tracing (probability of a community case being isolated when infectious) by 33% (0.6 to 0.8) reduced cases by 22% (295 to 231). Cases grew exponentially if the product of the mean number of secondary cases arising from a case and (1—probability of case being isolated) was >1.ConclusionsCountries can utilize a ‘risk scorecard’ to balance relaxations for travel and domestic activity depending on factors that reduce disease impact, including hospital/ICU capacity, contact tracing, quarantine and vaccination. The tool enabled visualization of the combinations of imported cases and activity levels on the case numbers and the trade-offs required. For vaccination, a reduction factor should be applied both for likelihood of an infected case being present and a close contact getting infected.

A novel index-based decision support toolkit for safe reopening following a generalized lockdown in low and middle-income countries

While the effectiveness of lockdowns to reduce Coronavirus Disease-2019 (COVID-19) transmission is well established, uncertainties remain on the lifting principles of these restrictive interventions. World Health Organization recommends case positive rate of 5% or lower as a threshold for safe reopening. However, inadequate testing capacity limits the applicability of this recommendation, especially in the low-income and middle-income countries (LMICs). To develop a practical reopening strategy for LMICs, in this study, we first identify the optimal timing of safe reopening by exploring accessible epidemiological data of 24 countries during the initial COVID-19 surge. We find that a safe opening can occur two weeks after the crossover of daily infection and recovery rates while maintaining a negative trend in daily new cases. Epidemiologic SIRM model-based example simulation supports our findings. Finally, we develop an easily interpretable large-scale reopening (LSR) index, which is an evidence-based toolkit—to guide/inform reopening decision for LMICs.

CO2 concentration monitoring inside educational buildings as a strategic tool to reduce the risk of Sars-CoV-2 airborne transmission

In order to avoid SARS-CoV-2 transmission inside educational buildings and promote the safe reopening of schools, the Italian Government, in line with the other European countries and in accordance with the WHO recommendations, adopted a contingency plan including actions able to guarantee adequate air ventilation in classrooms. Therefore, in this pilot study, a surveillance activity based on the real-time monitoring of CO2 levels as a proxy of SARS-CoV-2 transmission risk, was conducted inside 9 schools (11 classrooms) located in Apulia Region (South of Italy) during the reopening of schools after the lockdown due to COVID-19 pandemic. More specifically, monitoring activities and data treatment were conducted to evaluate the initial scenario inside the classrooms (first stage of evaluation) and the potential improvements obtained by applying a detailed operating protocol of air ventilation based on specific actions and the simultaneous real time visualization of CO2 levels by non-dispersive infrared (NDIR) sensors (second stage of evaluation). Although, during the first evaluation stage, air ventilation through the opening of windows and doors was guaranteed, 6 (54%) classrooms showed mean values of CO2 higher than 1000 ppm and all classrooms exceeded the recommended CO2 concentration limit value of 700 ppm. The development and implementation of tailored ventilation protocol including the real time visualization of CO2 levels allowed to depict better scenariosAn overall improvement of CO2 levels was indeed registered for all classrooms where teachers were compliant and helpful in the management of the air ventilation strategy. Therefore, this study reports the first evidence-based measures demonstrating that, with the exception of few environments affected by structural limits, the real-time visualization and monitoring of CO2 concentrations allowes effective air exchanges to be implemented and contributes to prevent SARS-CoV-2 transmission. Moreover, on the basis of the monitoring outcomes and in order to ensure adequate air ventilation in educational buildings, a 4 level-risk classification including specific corrective actions for each level was provided.

Aerosol-generating Procedures and Decision Drivers for COVID Pre-procedure Testing

Introduction: SARS-CoV-2 is thought to spread between individuals in close contact, primarily through respiratory droplets, including asymptomatic individuals [1,2]. The virus has been shown to persist in aerosols for hours [3]. Aerosol-generating procedures may increase the risk of transmission to healthcare providers, potentially putting dentists and patients at greater risk of exposure [3]. Current CDC guidelines for dental professionals include: N95 or higher-level respirator use during aerosol-generating procedures; COVID screening and triaging of patients; hand and respiratory hygiene best practices; facility updates; and physical distancing. The CDC also recommends considering pre-procedure testing to identify pre- and asymptomatic patients [2]. Methods: In June 2020, New Jersey health centers Zufall Health and CHEMED implemented COVID-19 testing prior to aerosol-generating dental procedures, along with other protocols, as part of the safe reopening of their facilities. They utilized screening and testing to safeguard dental staff and patients, to calm anxious front-line employees, and to facilitate patient follow-through on dental care. In September 2020, the centers undertook additional process improvements to determine the continued viability of pre-procedure COVID testing in their dental facilities. Results: From September 2020 to March 2021, the centers found parity between their COVID testing methods. Testing results were similar, indicating very few asymptomatic dental patients tested positive. Staff treating patients later determined positive for COVID were not infected. Conclusions: In an area of low, moderate, and high transmission, providers can feel confident that stringent adherence to recommended COVID precautions can safeguard staff and patients, including during aerosol-generating dental procedures. While testing is an important public health tool and helpful in reassuring staff and patients, one center determined it was no longer necessary to the safe and effective delivery of dental services. By the completion of the project, the other center was evaluating halting pre-procedure testing, and has since stopped testing.

DRUL for school: Opening Pre-K with safe, simple, sensitive saliva testing for SARS-CoV-2.

To address the need for simple, safe, sensitive, and scalable SARS-CoV-2 tests, we validated and implemented a PCR test that uses a saliva collection kit use at home. Individuals self-collected 300 μl saliva in vials containing Darnell Rockefeller University Laboratory (DRUL) buffer and extracted RNA was assayed by RT-PCR (the DRUL saliva assay). The limit of detection was confirmed to be 1 viral copy/μl in 20 of 20 replicate extractions. Viral RNA was stable in DRUL buffer at room temperature up to seven days after sample collection, and safety studies demonstrated that DRUL buffer immediately inactivated virus at concentrations up to 2.75x106 PFU/ml. Results from SARS-CoV-2 positive nasopharyngeal (NP) swab samples collected in viral transport media and assayed with a standard FDA Emergency Use Authorization (EUA) test were highly correlated with samples placed in DRUL buffer. Direct comparison of results from 162 individuals tested by FDA EUA oropharyngeal (OP) or NP swabs with co-collected saliva samples identified four otherwise unidentified positive cases in DRUL buffer. Over six months, we collected 3,724 samples from individuals ranging from 3 months to 92 years of age. This included collecting weekly samples over 10 weeks from teachers, children, and parents from a pre-school program, which allowed its safe reopening while at-risk pods were quarantined. In sum, we validated a simple, sensitive, stable, and safe PCR-based test using a self-collected saliva sample as a valuable tool for clinical diagnosis and screening at workplaces and schools.

A pre-COVID-19 assessment of aspects of the school health programme in some selected Nigerian primary schools: implications for school re-opening during the COVID-19 pandemic in developing country contexts

BackgroundFollowing the COVID-19 pandemic, school closures were part of the global public health response to limit community spread of the virus. In recent times, there has been an emphasis on safe school re-opening. This concept is likely to differ between developed and developing country settings. There are however no published studies on barriers hindering safe school re-opening within developing country contexts. This study evaluates aspects of the school health program (SHP) in some selected Nigerian schools that might relate to the pandemic control during school re-opening.MethodsIn 2017, we conducted a cross-sectional survey of the SHP of 146 registered primary schools in Gwagwalada Area Council in Abuja, Nigeria. These schools provided services to about 54,562 students. We used direct observational methods and interviewer-administered questionnaires to assess the SHP of each school. We compare SHP characteristics that might relate to COVID-19 control in schools across government-owned (public) and privately-owned (private) schools using a pre-defined framework.ResultsPublic school to pupil ratios was more than six times that of private schools. Only 6.9% of all surveyed schools employed qualified health personnel. Although 8 in every 10 schools conducted health talks for communicable disease control, the use of temporary isolation and school-based immunization were low at 1.4 and 2.7% respectively. Pipe-borne water access was present in 4 of 10 schools, with public schools having more limited access than private schools (p = 0.009). Similarly, less proportion of public schools had access to soap for handwashing (p < 0.001). Adequate classroom ventilation was present in 63% of surveyed schools, with private schools having more limited ventilation (p < 0.001).ConclusionsOvercrowding and infrastructural deficits within developing country contexts represent barriers to safe school re-opening during the COVID-19 pandemic. In these settings, there needs to be tailored and innovative strategies which consider local practical realities when designing the COVID-19 control programs during school re-opening.

The Classroom Re-Imagined and Re-Designed: The Pandemic-Ready Teaching and Learning Station

Save for the most callous among us, all of humanity knows the chaos wreaked upon the world by the Covid 19 Virus. The losses are of unspeakable proportions. Those losses continue. Among those losses is lost educational opportunity for our children and young adults. The debate among world experts continues unabated: when should we re-open schools? At what levels? Under what conditions? What are the potential perils? How do we assess the effects of viral mutations and variants? There is so much that we have yet to learn that, at best, we are making educated guesses; at worst, we yield to denial and despair. This paper charts the efforts made by various countries to deal with the impact of education on schools, colleges and universities. Given the vast differences in resources; the availability of medical and other expertise; innovativeness; and political will and the humility of political leadership to follow the advice of scientists, the responses have been markedly different. Not unusually, the poorer the country, the greater is the suffering. In this paper, we use Guyana as representative of nations bereft of those things we have just mentioned.However, even in nations that are blessed with the wherewithal for managing and minimizing the impact of this deadly pandemic, education has suffered. In poor countries, this damage may be almost irreparable for decades to come. The overall international quest has been to find a way to re-open educational institutions safely. Outside schooling, social distancing, hand-washing, and the wearing of masks have been vital ameliorating tools. Some places have used plexiglass to separate students and prevent the exhalation and inhalation of droplets. Other countries have simply followed uncritically what richer and more resourceful countries have done. Many countries have simply denied the fact of the pandemic or have simply guessed their way along. Denial and guess-work have lead to catastrophic results. In this paper, we have attempted a solution that involves the re-imagining and re-designing of the traditional classroom space into being a Teaching and Learning Station. This innovation, in our opinion, almost guarantees the safe re-opening of schools. It ensures the safe return to in-person teaching and learning, and it prepares us for inevitable future pandemics. We have offered up the design with the hope that it may be taken up and acted upon.

COVID-19 and School: To Open or Not to Open, That Is the Question. The First Review on Current Knowledge.

The COVID-19 pandemic has led to an unprecedented closure of schools in terms of duration. The option of school closure, SARS-CoV-2 initially being poorly known, was influenced by the epidemiological aspects of the influenza virus. However, school closure is still under debate and seems unsupported by sure evidence of efficacy in the COVID-19 era. The aim of our narrative review is to discuss the available literature on SARS-CoV-2 spread among children and adolescents, in the school setting, trying to explain why children appear less susceptible to severe disease and less involved in viral spreading. We also tried to define the efficacy of school closure, through an overview of the effects of the choices made by the various countries, trying to identify which preventive measures could be effective for a safe reopening. Finally, we focused on the psychological aspects of such a prolonged closure for children and adolescents. SARS-CoV-2, children, COVID-19, influenza, and school were used as key words in our literature research, updated to 29 March 2021. To our knowledge, this is the first review summarizing the whole current knowledge on SARS-CoV-2 spreading among children and adolescents in the school setting, providing a worldwide overview in such a pandemic context.

Dental Practice after COVID-19 Pandemic: Analysis of Italian Guidelines and Current Literature to Propose Appropriate Protocols for Dental Practices.

On March 11th, 2020, WHO declared COVID-19 a pandemic. This disease is caused by SARS-CoV-2, a virus that can be spread by symptomatic or asymptomatic carriers through contact, droplets and airborne transmission. Because of the transmission routes of this virus, dental treatments are considered “high risk” procedures, both for patients and operators. Italy was one of the most affected European countries and experienced a long lockdown period. Guidelines were provided by the Italian Health Ministry for a safe reopening of dental practices. In this article those guidelines are reported and compared with the available literature. The Italian model for reopening dental practice appears to be coherent with the indications provided by WHO and is supported by several studies.

Evaluation of reopening strategies for educational institutions during COVID-19 through agent based simulation

Many educational institutions have partially or fully closed all operations to cope with the challenges of the ongoing COVID-19 pandemic. In this paper, we explore strategies that such institutions can adopt to conduct safe reopening and resume operations during the pandemic. The research is motivated by the University of Illinois at Urbana-Champaign’s (UIUC’s) SHIELD program, which is a set of policies and strategies, including rapid saliva-based COVID-19 screening, for ensuring safety of students, faculty and staff to conduct in-person operations, at least partially. Specifically, we study how rapid bulk testing, contact tracing and preventative measures such as mask wearing, sanitization, and enforcement of social distancing can allow institutions to manage the epidemic spread. This work combines the power of analytical epidemic modeling, data analysis and agent-based simulations to derive policy insights. We develop an analytical model that takes into account the asymptomatic transmission of COVID-19, the effect of isolation via testing (both in bulk and through contact tracing) and the rate of contacts among people within and outside the institution. Next, we use data from the UIUC SHIELD program and 85 other universities to estimate parameters that describe the analytical model. Using the estimated parameters, we finally conduct agent-based simulations with various model parameters to evaluate testing and reopening strategies. The parameter estimates from UIUC and other universities show similar trends. For example, infection rates at various institutions grow rapidly in certain months and this growth correlates positively with infection rates in counties where the universities are located. Infection rates are also shown to be negatively correlated with testing rates at the institutions. Through agent-based simulations, we demonstrate that the key to designing an effective reopening strategy is a combination of rapid bulk testing and effective preventative measures such as mask wearing and social distancing. Multiple other factors help to reduce infection load, such as efficient contact tracing, reduced delay between testing and result revelation, tests with less false negatives and targeted testing of high-risk class among others. This paper contributes to the nascent literature on combating the COVID-19 pandemic and is especially relevant for educational institutions and similarly large organizations. We contribute by providing an analytical model that can be used to estimate key parameters from data, which in turn can be used to simulate the effect of different strategies for reopening. We quantify the relative effect of different strategies such as bulk testing, contact tracing, reduced infectivity and contact rates in the context of educational institutions. Specifically, we show that for the estimated average base infectivity of 0.025 (R_0 = 1.82), a daily number of tests to population ratio T/N of 0.2, i.e., once a week testing for all individuals, is a good indicative threshold. However, this test to population ratio is sensitive to external infectivities, internal and external mobilities, delay in getting results after testing, and measures related to mask wearing and sanitization, which affect the base infection rate.

The Science Behind Safe School Re-opening: Leveraging the Pillars of Infection Control to Support Safe Elementary and Secondary Education During the COVID-19 Pandemic.

There are limited tools for adapting coronavirus disease 2019 (COVID-19) infection control plans to school settings. We present an infection prevention model for optimizing safe re-opening for elementary and secondary schools during the global COVID-19 pandemic and review the current evidence behind various infection prevention interventions in school settings. The model is adapted from the Centers for Disease Control and Prevention fundamental pillars for infection prevention and includes 4 categories of intervention: epidemiologic controls (town prevalence metrics, diagnostic testing, quarantine strategies), administrative controls (state vaccination policies, alternative school models, symptom screens, quarantine breaks), engineering/environmental controls (distancing, outdoor space, ventilation), and personal protective equipment (PPE)/hand hygiene (face coverings, hand sanitizing).The adapted infection control pillars model utilizes implementation science–informed considerations to maximize pragmatism and adherence by leveraging evidence-based strategies. It highlights the necessity of redundant infection prevention interventions, acknowledges the importance of community buy-in to achieve real-world effectiveness, and addresses tactics to overcome implementation barriers. Recommendations are grounded in the Dynamic Sustainability Framework and include suggestions to maintain infection prevention effectiveness over time to ensure ongoing safety.

How SARS-CoV-2 and Comparable Pathogens Can Be Defeated in a Single Day: Description and Mathematical Model of the Carrier Separation Plan (CSP).

A simple, common-sense, three-component procedure—the Carrier Separation Plan (CSP)—can immediately halt the transmission of SARS-CoV-2 or a comparable pathogen, allow the safe reopening of an entire economy without the need for social distancing, and quickly eradicate the pathogen from the population (assuming the pathogen can be killed by the immune systems of the carriers). The three components are (a) nearly simultaneous self-testing for the pathogen by an entire population, followed rapidly by (b) nearly simultaneous self-isolation of carriers, and (c) secondary screening at entrances to facilities where people congregate. After a period of preparation lasting roughly 5–10 weeks, these steps could and probably should be taken in a single day. The power of this methodology has already been demonstrated in varying degrees with groups ranging in size from 1,000 to 11 million. Although this plan might seem daunting, its costs are minimal compared to the losses we have incurred by relying on half measures, and the US and other countries have the technological, logistical, and industrial capacities to implement this plan in a matter of weeks. With proper messaging during the weeks leading up to the testing, compliance in such a program is likely to be high given the potential benefits, and because participation is voluntary and testing is noninvasive, the legal and ethical issues associated with such a program are minimal – trivial, in fact, compared to those associated with imposing a months-long lockdown on an entire population. A SIRD/CSP model suggests that the single-day testing and separation procedure will substantially lower the number of infections, even if compliance with the procedure is modest. Modeling also suggests that when long-term secondary screening is added to the 1-day procedure, over time, the pathogen is eradicated from the population. This can occur even when compliance with secondary screening is itself relatively low.

Safe Reopening of Schools during COVID-19: An Evaluation of Handwash Facilities and Students’ Hand Hygiene Knowledge and Practices

Children are energetic and filled with vigour, the high rate of person-to-person contact at schools could leave the students susceptible to hygiene-related illnesses if appropriate measures are not put in place. The absence of adequate handwash facilities, inadequate hand hygiene knowledge, and poor hand hygiene practices have been reported to be prevalent among schools in Nigeria. The emergence of COVID-19 even makes it more important to provide recent and quality data as schools plan to reopen safely. This study aimed to assess the accessibility of public-school students in Badagry, Lagos State to basic handwash services, as well as their hygiene-related knowledge and practices. A 4-stage sampling method was used to select 5 wards, 5 schools, the classes, and 351 students. A mixed-method which included a semi-structured questionnaire, observational checklist, and a key informant interview guide was used to collect data. Data were inputted into SPSS version 20 and analyzed using descriptive statistics, chi-square, and logistic regression at a 95% confidence interval. The respondents had a mean age of 15.88± 1.54 years. All the available wash-hand stations (WHS) were in the toilet blocks. All the male toilet facilities had WHS as opposed to just 60% of the female facilities. None of the WHS had soap present, while a quarter of the WHS did not have water available. Based on the Joint Monitoring Programme (JMP) classification; none of the WHS provided basic hygiene service, 60% provided limited service and 40% provided no service. The majority (83%) of the students possessed a good knowledge of hand hygiene, however, only less than half (47%) reported washing their hands with soap and water at school. Factors like age (p=0.010) and their parents’ educational status (mother- p=0.002; father- p=0.011) significantly affected the students’ knowledge. The absence of basic handwash facilities in all the schools clearly shows the need for rapid intervention, particularly to eliminate gender disparities and to ensure the sustainable availability of sufficient soap and water.

Seroprevalence Study and Cross-Sectional Survey on COVID-19 for a Plan to Reopen the University of Alicante (Spain).

The implementation of strategies to mitigate possible cases of COVID-19 were addressed at the University of Alicante for the safe reopening of the 2020/2021 academic year. To discover the prevalence of immunity against SARS-CoV-2, a study was designed using a rapid immunoassay test (carried out between 6 and 22 July 2020), and in addition a cross-sectional survey was conducted on risk factors, symptoms, predisposition for becoming vaccinated, and sources of information about COVID-19. A random sample, stratified by students, faculty, and administrative staff, was selected. The seroprevalence found was 2.64% (39/1479; 95% CI 1.8–3.4), and the adjusted seroprevalence was 2.89% (95% CI 2.1–3.7). The average age of the students was 23.2 years old, and 47.6 years old for staff. In relation to COVID-19, the following was found: 17.7% pauci-symptomatic, 1.3% symptomatic, 5.5% contact with cases, 4.9% confined, and 0.3% PCR positive. More than 90% complied with preventive measures. The proportion willing to receive the COVID-19 vaccine was 91%. Their sources of information were the Internet (74%) and television (70.1%). They requested that the university offer information (45.1%), training (27%), and provide Personal Protective Equipment (PPE) (26.3%). Lastly, 87.9% would repeat the test. A plan was established that included the follow-up of cases and contacts, random sample testing, training courses, bimodal teaching, a specific website, and the distribution of PPE.

School and Community Reopening During the COVID-19 Pandemic: A Mathematical Modeling Study

Background: The closure of communities, including schools, has been adopted to control the coronavirus disease 2019 (COVID-19) epidemic in most countries. Operating schools safely during the pandemic requires a balance between health risks and the need for in-person learning. We use compartmental models to explore school reopening scenarios.Methods: Using demographic and epidemiological data between July 31 and November 23, 2020 from the city of Toronto, we developed a Susceptible-Exposed-Asymptomatic-Infectious-Recovered-Hospitalized-Isolated model. Our model with age, household, and community transmission allow us to study the impact of schools open in September 2020. The model mimics the transmission in households, the community, and schools, accounting for differences in infectiousness between adults and children and youth and adults' working status. We assessed the extent to which school opening may have contributed to COVID-19 resurgence in the fall and simulated scenarios for the safe reopening of schools up to May 31, 2021. We further considered the impact of the introduction of the new variant of concern.Findings: Though a slight increase in infections among adults (2.8%) and children (5.4%) is anticipated by the end of the year, safe school opening is possible with stringent nonpharmaceutical interventions (NPIs) decreasing the risk of transmission in the community and the household. We found that while school reopening was not the key driver in virus resurgence, but rather it was community spread that determined the outbreak trajectory, brief school closures did reduce infections when transmission risk within the home was low. When considered possible cross-infection amongst households, communities, and schools, we found that home transmission was crucial for mitigating the epidemic and safely operating schools. Simulating the introduction of a new strain with higher infectiousness, we observed substantial increases in infections, even when both schools and communities are closed.Interpretatio: nSchools can open safely under strict maintenance of strict public health measures in the community. The gradual opening of schools and communities can only be achieved by maintaining NPIs and mitigating household transmission risk to avoid the broader escape of infections acquired in schools into the community via households. If the new COVID-19 strain is more infectious for children, public spaces, including schools, should be closed, and additional NPIs, including the use of masks, should be extended to toddlers.Funding: This research was supported by Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada and York University Research Chair program.Declaration of Interests: The authors declare no conflict of interest.