Infectious Disease

COVID-19 outbreak in California school attributed to unvaccinated teachers

August 27, 2021

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A list of the authors’ relevant financial information can be found in the study.

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Half of elementary school students in a teacher’s unvaccinated classroom developed COVID-19 after the teacher – infected and symptomatic – worked for 2 days and read to students without wearing a mask, the researchers said.

The exposures resulted in a major California School outbreak linked to the Delta variant in May, with many cases occurring in ineligible children, reflecting the continued need for non-pharmaceutical prevention strategies throughout the year Illustrating pandemic, the researchers wrote in MMWR.

Source: CDC.gov.

An outbreak of COVID-19 among students at an elementary school in California has been attributed to their unvaccinated teacher. Source: CDC.gov.

The outbreak site was an elementary school in Marin County, California that serves 205 preschool through eighth grade students, with most students unable to get the vaccine due to age restrictions. The school was also reported to have 24 staff, with all but two of the teachers vaccinated.

One of the two unvaccinated teachers whom the study identified as an index patient reported that on Jan.

“The teacher continued working May 17-21 and then suffered from cough, subjective fever and headache,” the researchers wrote. “The school required teachers and students to mask themselves indoors. Interviews with parents of infected students indicated that student compliance with masking and distancing guidelines in line with CDC recommendations was high in class. According to reports, however, the teacher was occasionally exposed while reading aloud in class. “

On May 23, the teacher informed the school that he tested positive for COVID-19 on May 21 and had self-isolated by May 30. According to the study, the teacher did not receive a second COVID-19 test but reported that he made a full recovery while in isolation.

“The index patient’s students started experiencing symptoms on May 22nd,” the study says, and 22 of the teacher’s 24 students tested for COVID-19, with 12 testing positive, including eight those between 22nd and 22nd May 26th showed symptoms.

According to the researchers, the desks in the classroom were separated by 6 feet and arranged in five rows. The closer the students sat to the teacher’s desk, the higher the attack rate – eight out of ten students in the first two rows tested positive, compared with three out of 14 in the back three rows.

On May 26 and June 2, the Marin County Department of Health held outbreak control testing sessions at the school. During these 2 days, 231 people were tested, including 194 of the 205 students, 21 of 24 staff and teachers, and 16 parents and siblings of students. A total of 18 people tested positive for the Delta variant at the time, and five more positive later.

The study’s authors said that high levels of community vaccinations could have prevented further transmission – at the time of this outbreak, about 72% of eligible people in the city where the school is located were fully vaccinated.

“In addition to vaccinating suitable people, implementing and strictly adhering to multi-pronged non-pharmaceutical prevention strategies, including appropriate masking, routine testing, ventilation, and staying at home during symptoms, is important to ensure safe schooling,” the study says.

With school returning to many areas of the country in the coming weeks, the CDC encourages districts to follow guidelines to reduce transmission.

Rochelle Walensky

In a briefing on Friday, CDC Director Rochelle Walensky, MD, MPH cited a second MMWR study that showed that schools in Los Angeles County with security measures during the winter pandemic pandemic had COVID-19 rates roughly 3.5 times lower than rates in the surrounding community.

“While symptoms and severe cases in children are still rarer than in other age groups, we have seen an increase in pediatric cases and hospital admissions in recent weeks, likely due to the general increase in transmission in the community in general and in particular the delta variant is due to increased transferability, ”said Walensky.

Walensky said schools should do as many preventive measures as possible at the same time, such as

“This is to protect our children, even if there are inevitable violations in a single layer of protection,” said Walensky.

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Amesh A. Adalja, MD

Amesh A. Adalja

The report shows how the unvaccinated pose a threat to others. In this outbreak, instigated by an unvaccinated teacher, infected children who were too young to be vaccinated were infected by their teacher. Thus, by not being vaccinated and not careful with masking, the teacher triggered an avoidable outbreak. This incident underscores the importance of making teachers vaccinated as a prerequisite for employment. School attendance can be carried out safely if the appropriate instruments, such as B. Vaccines are used.

Amesh A. Adalja, MD

Senior Scholar

Johns Hopkins Center for Health Safety

Disclosure: Adalja does not report any relevant disclosures.

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