COVID-19 study confirms low transmission in NSW educational settings

The rate of COVID-19 transmission in New South Wales (NSW) educational settings was extremely limited during the first wave of COVID-19, research findings published today in The Lancet Journal of Child and Adolescent Health have shown.

Researchers from the National Centre for Immunisation Research and Surveillance (NCIRS) and the University of Sydney had earlier released their preliminary findings from this work from January to April 2020. 

The Lancet publication today contains detailed analysis on COVID-19 spread in 25 educational settings (15 schools and 10 early childhood education and care (ECEC) services) in Term 1. Additional data from Terms 2 and 3 are also available today.

Lead author Professor Kristine Macartney said the study showed transmission rates in NSW schools and ECEC services were minimal, particularly between children and from children to adults. 

“This is the first comprehensive population-based assessment of coronavirus transmission in educational settings worldwide,” Professor Macartney said.

“COVID-19 transmission in schools appears to be considerably less than that seen for other respiratory viruses, such as influenza. 

“This supports the previous findings that COVID-19 transmission in educational settings can be kept low and manageable in the context of an effective pandemic response that includes contact tracing and quarantine, and temporary school closures for cleaning if someone is found to be infected.

“It is also consistent with other data that show lower rates, and generally milder disease, in children than in adults.

“However, it is important to view these findings in the context of the NSW outbreak. Higher rates of transmission may occur in areas with higher levels of virus transmission in the community or with less rigorous public health and community response.”

In a linked commentary, Professor W John Edmunds, LSHTM, says, “Macartney and colleagues suggest that educational settings can remain open provided measures, such as contact tracing, quarantine, and even school closures, are in place to limit spread when cases occur.”

In Terms 1 and 2 there have been 33 initial cases of COVID-19 confirmed at 31 of NSW’s 7,700 schools and ECEC services, with 25 sites in Term 1 and six during Term 2 affected.

In Terms 1 and 2, a total of 16 children and 17 staff were the first cases who tested positive for the virus. 

Out of 1,333 close contacts in primary and high schools, just five (0.4%) possible secondary infections were recorded across Terms 1 and 2: one primary school student, two high school students, one primary school teacher and one high school teacher.

Initial cases were also seen in 11 ECEC services across Terms 1 and 2, with 13 possible secondary infections recorded out of 636 close contacts. 

All 13 secondary cases (seven children and six staff) were linked to an outbreak at a single ECEC service early in Term 1 that started initially in staff members. No secondary cases were identified in the other 10 ECEC services.

This observational study is continuing in Term 3 in NSW (July – September). Data for Term 3 are preliminary but as at 3 August, there have been 11 cases (eight children and 3 staff members) with two secondary infections being recorded in one primary school and one ECEC service. 

“We know anyone of any age can be infected and potentially spread the virus,” Prof Macartney said. 

“But understanding how the virus spreads in our context will assist modellers, policymakers, healthcare providers, and the public to understand the risk of COVID-19 in educational settings and help in decision making around school closures and re-openings.”

Access the Term 2 and updated Term 1 summary reports here

Related information:
A guide to NSW school students returning for Term 3
Australian Health Protection Principal Committee (AHPPC) advice on reducing the potential risk of COVID-19 transmission in schools (24 April 2020)

Declaration: Term 1 data are published in The Lancet Child & Adolescent Health. Additional data for Term 2 using the same methodology, have been released today and are available on the NCIRS website. These data have not yet been submitted for publication or peer-review.