In-person schooling and SARS-CoV-2 transmission across Italian regions

Abstract

BACKGROUND. The role of in-person schooling for community transmission of SARS-CoV 2 has immediate policy relevance for deciding how to operate schools safely as the pandemic unfolds, new variants of SARS-CoV-2 are circulating, and immunization coverage remains limited among children. OBJECTIVES. We compare trends in SARS-CoV-2 weekly incidence among school-aged children vis-à-vis other age groups, during Fall 2020 and Spring 2021, by analysing empirical evidence across all Italian regions. Looking at regions where intergenerational effects are more evident, Lombardy, Emilia Romagna and Piedmont regions, we detect impacts of secondary infections based on intergenerational dynamics between children and parents. METHODS. COVID-19 case data are analysed using a standard descriptive methodology to capture dynamics in weekly incidence of the disease among children, adolescents and young adults between September 2020 and April, 2021. Statistical analyses are then extended adopting an event cohort method to quantify the impacts of school closures on COVID-19 positive laboratory tested cases among parents, secondary infections, accounting for changes in SARS-CoV-2 infections among children, primary infections, over time. RESULTS. Increases in weekly incidence among school-aged children 14-18 have preceded increases in other age groups in several Italian regions during the second and third waves. In Lombardy, Emilia Romagna and Piedmont regions, we find that the decision to close schools has been associated with a medium-term significant decrease in infections of parents’ age groups. Whereas further investigations are needed to definitely assert causality, our findings highlight the potential of school closing effects as last resort to limit the resurgence of SARS COv-2 viral transmission.