Covid, for now no “open schools effect” but the reported outbreaks invite you to keep your guard up. Gimbe report

Covid, for now no “open schools effect” but the reported outbreaks invite you to keep your guard up. Gimbe report
Covid, for now no “open schools effect” but the reported outbreaks invite you to keep your guard up. Gimbe report

The GIMBE Foundation has published a report that provides a summary of the scientific evidence on the effectiveness of interventions aimed at improving COVID-19 safety in schools and detects regulatory, structural and organizational criticalities to implement such evidence in national school contexts.

The scientific evidence – declares Nino Cartabellotta, President of the GIMBE Foundation – on the one hand they demonstrate that there is no zero risk of contagion in schools, on the other they suggest that it is possible to minimize it through a multifactorial approach by integrating different individual and environmental prevention interventions “.

According to the data of the weekly report of the National Institute of Health (ISS), in the period 4-17 October 2021, 8,857 cases were diagnosed in the 0-19 age group, of which 99 hospitalized, 3 hospitalizations in intensive care and no deaths, with a progressive reduction – in the last 4 weeks considered by the ISS report – in the incidence of COVID cases -19 and hospitalizations.

These data – he claims Renata Gili, GIMBE Head of Research on Health Services – show that so far the feared “school effect” has not occurred, both thanks to the vaccination of students and school staff, and to the progressive vaccination coverage of the general population: the consequent reduction in viral circulation is reflected in the school environment, even in pupils under 12 for which there are still no authorized vaccines. One more reason to reach as many unvaccinated people as possible and speed up the administration of third doses “.

So what are the points analyzed by the Gimbe Foundation?

Vaccination for students.

As of October 25, 2021, the report reports, 67.2% of the 12-19 year old population (3,064,055) had completed the vaccination course and 5.5% (249,401) had received the first dose (Figure 1). The children who have not received even a dose of vaccine are 1,243,466 (27.3%), with percentages of not vaccinated ranging from 19.6% in the Sardinia Region to 43.8% in the Autonomous Province of Bolzano (Figure 2 ). Moreover, the trend of vaccination coverage with at least one dose in the 12-19 year range, after the sharp increase at the beginning of June, gradually slowed down starting from September, when the value was still below 70% (figure 3).

Personal vaccination.

91.2% of the school staff completed the vaccination course and 3% (45,745) received the first dose of the vaccine; 90,002 (5.8%) have not yet received even a dose (figure 4), with significant regional differences: from 3% in Veneto to 21.1% in the Autonomous Province of Bolzano. (figure 5). It should be noted that the data has not been updated since 1 October 2021.

Use of masks.

A rigorous simulation study of Centers for Disease Control and Prevention has shown that at school, even in conditions of high immunity, theuse of the surgical mask reduces the risk of transmissionand (figure 6). “Until the vaccination coverage rate among students, school staff and the general population has reached higher percentages – explains Cartabellotta – even considering that in the last two weeks, 60% of cases diagnosed in the age group 0-19 years occurred in the under 12s, the hypothesis of abandoning the masks in the classrooms with all the immunized students is too risky, as well as posing privacy problems on the control of vaccination status and potentially generating the risk of discrimination “.

Screening periodico.

The SARS-CoV-2 circulation monitoring plan in the schools of the Istituto Superiore di Sanità does not provide for a periodic and systematic screening, but only a sample testing campaign involving about 110 thousand students of the so-called primary and secondary “sentinel schools” first degree, using molecular tests on a salivary sample. An easy-to-use and non-invasive test, but – as noted by the report dell’European Centre for Disease Control and Prevention – with a low sensitivity (53-73%) in pediatric age, however conditioned by the method of sample collection, depending on whether it is carried out by health workers or by self-collection. “In order to monitor and evaluate the effectiveness of the strategies implemented – underlines Gili – it is essential that the data from these screening tests be made public, as well as the number of students and classes progressively quarantined”.

Social distancing.

The Memorandum of Understanding of the Ministry of Education provides for an “interpersonal distance of at least one meter, both in a static and dynamic position, if logistically possible”, or defines a flexible obligation, which can be waived in the presence of structural limits. This occurs, in particular, in the very numerous classes (so-called “chicken coop classes”) where maintaining social distancing can be substantially impossible.

Aeration and ventilation of closed rooms.

Although evidence shows that SARS-CoV-2 transmission occurs mainly by aerosols, too many resources continue to be invested in surface disinfection procedures and very few in aeration and ventilation systems. The Division Decree which assigned 350 million euros to schools provided for the purchase of “tools for ventilation”, but this intended use is not specified in the Legislative Decree 73/2021 which refers only to minor maintenance interventions. Consequentially, ventilation and ventilation are entrusted to keeping the windows open, whose effectiveness depends on the sensitization of the school staff and on the continuous ventilation of the rooms during the activities, which cannot fail to be conditioned by the weather conditions.

Public transport.

The management of public transport was not included in the analysis either because it is not the responsibility of the schools, and because it almost exclusively affects upper secondary school students.

There is also another aspect that the GIMBE report reiterates, namely that the various interventions to minimize the circulation of the virus cannot be applied in all school grades, each of which requires a tailor-made prevention plan, especially considering the greater contagiousness of the delta variant.

With the winter season upon us and the clear rise of new cases in the last week – concludes the President – It is essential to keep a close eye on schools where, due to the numerous criticalities detected, the reported outbreaks show that the equilibrium is unstable. In addition to aiming for maximum vaccination coverage for both school staff and students aged> 12 years, and the general population, it is necessary to simultaneously strengthen systematic periodic screening and implement system interventions that guarantee adequate aeration and ventilation of school premises: in particular in the under 12 age group where vaccines are not available and in the under 6 age group where even masks are not usable and the spacing is essentially inapplicable “.

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