Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study

• Main Authors: Aida Perramon, Antoni Soriano-Arandes, David Pino, Uxue Lazcano, Cristina Andrés, Martí Català, Anna Gatell, Mireia Carulla, Dolors Canadell, Gemma Ricós, M. Teresa Riera-Bosch, Silvia Burgaya, Olga Salvadó, Javier Cantero, Mònica Vilà, Miriam Poblet, Almudena Sánchez, Anna M. Ristol, Pepe Serrano, Andrés Antón, Clara Prats, Pere Soler-Palacin
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-09-01
• Series: Frontiers in Pediatrics
• Subjects: COVID-19; SARS-CoV-2; schools; epidemiology; child; tracing
• Online Access: https://www.frontiersin.org/articles/10.3389/fped.2021.754744/full

Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults.Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics.Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%).Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.