Clusters of SARS-CoV-2 Infection Among Elementary School Educators and Students in One School District — Georgia, December 2020–January 2021
Authors: Jeremy A. W. Gold, Jenna R. Gettings, Anne Kimball, Rachel Franklin, Grant Rivera, Elana Morris, Colleen Scott, Paula L. Marcet, Marisa Hast, Megan Swanson, Jazmyn McCloud, Lemlem Mehari, Ebony S. Thomas, Hannah L. Kirking, Jacqueline E. Tate, Janet Memark, Cherie Drenzek, Snigdha Vallabhaneni, Olivia Almendares, Abirami Balajee, Eleanor Burnett, Rebecca J. Chancey, Deanna Crosby, Morgane Donadel, Catherine Espinosa, Mary E. Evans, Katherine Fleming-Dutra, Catalina Forero, Kaitlin Forsberg, Esther Kukielka, Kiren Mitruka, Jasmine Y. Nakayama, Yoshinori Nakazawa, Michelle O’Hegarty, Emeka Oraka, Caroline Pratt, Marion E. Rice, Gurleen Roberts, Roxana Rodriguez Stewart, Raquel Sabogal, Emanny Sanchez, Andres Velasco-Villa, Mark K. Weng
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

In-person learning benefits children and communities (1).Understanding the context in which transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 , occurs in schools is critical to improving the safety of inperson learning.During December 1, 2020-January 22, 2021, Cobb and Douglas Public Health (CDPH), the Georgia Department of Public Health (GDPH), and CDC investigated SARS-CoV-2 transmission in eight public elementary schools in a single school district.COVID-19 cases* among educators and students were either self-reported or identified by local public health officials.Close contacts (contacts) † of persons with a COVID-19 case received testing.Among contacts who received positive test results, public health investigators assessed epidemiologic links, probable transmission directionality, and the likelihood of in-school transmission.§ Nine clusters of three or more epidemiologically linked COVID-19 cases were identified involving 13 educators and 32 students at six of the eight elementary schools.Two clusters involved probable educator-to-educator transmission that was followed by educator-to-student transmission and resulted in approximately one half (15 of 31) of school-associated cases.Sixty-nine household members of persons with schoolassociated cases were tested, and 18 (26%) received positive results.All nine transmission clusters involved less than ideal physical distancing, and five involved inadequate mask use * A COVID-19 case was defined as a positive SARS-CoV-2 reverse transcriptionpolymerase chain reaction or antigen test result in a person who attended school in person.† Close contacts were defined as persons exposed to an index patient at school within 6 ft for >15 minutes per day during a 24-hour period while the index patient was infectious (48 hours before to 10 days after symptom onset or, if asymptomatic, 48 hours before to 10 days after specimen collection).§ To be classified as having a school-associated COVID-19 case, a person had to meet three criteria: 1) the timing of symptom onset (if symptoms were present) and testing must have been consistent with acquisition of SARS-CoV-2 infection from the index patient or a person with a school-associated case in the school setting based on the known incubation period, 2) the person must have had close contact at school with the school index patient or another person with a school-associated case according to GDPH guidelines and during that patient's infectious period, and 3) the person must not have had known community or household contact with anyone with confirmed COVID-19 in the 2 weeks before receiving a positive test result, including with the index patient or another person with a school-associated case outside of school.