Study suggests test-to-stay COVID-19 strategy in schools was effective
Using a test-to-stay (TTS) strategy in K-12 schools during the winter of 2021-22 resulted in substantial reduction in missed school days, according to a study yesterday in Pediatrics.
The study, led by researchers from Duke University, looked at the impact of TTS on North Carolina schools where masking was considered optional and the Omicron variant became the dominant strain in the United States.
The study enrolled 1,675 participants. Students and staff who were eligible for enrollment had a non-household exposure to SARS-CoV-2 within or outside of school from Nov 29, 2021, to Jan 28, 2022, as identified through the school contact-tracing program, and were not experiencing symptoms at the time of enrollment. Those enrolled were required to test using rapid antigen tests on the day they were notified of exposure, on day 3, and on day 5.
Researchers identified 201 positive cases and a tertiary attack rate of 10% (95% confidence interval, 6% to 19%). A total of 7,272 (89%) of potentially missed days were saved through the TTS strategy.
"We estimated one additional school-acquired case for every 21 TTS participants remaining in school buildings during the entire study period," the authors concluded. "Based on our data, a TTS approach allows more students and staff to remain in the classroom, with a modest increase in subsequent infections in optionally masked settings, even during the circulation of a highly transmissible variant."
Aug 16 Pediatrics study
Universal healthcare coverage tied to COVID-19 childhood vaccine uptake
Countries with more progress toward universal healthcare coverage (UHC) saw smaller decreases in childhood vaccination amid the health service delivery disruptions of the COVID-19 pandemic, suggests preliminary research published yesterday in PLOS Medicine.
Using a difference-in-difference design, New York University researchers quantified the relationship between UHC and childhood vaccination rates among 195 countries and their ability to provide 12 of 14 vaccines from 2010 to 2020.
A total of 20,230 country-year observations were included, 1,658 of which occurred after the emergence of SARS-CoV-2 in 2020. The data were derived from the World Health Organization/UNICEF Joint Estimates of National Immunization Coverage, and the 2019 UHC Service Coverage Index was used to classify countries' progress toward UHC.
The team found that, after adjustment, countries with a UHC index score of 80 or higher observed a 2.7% smaller drop in childhood vaccination in 2020 than those with lower scores. Before the pandemic, countries with a high UHC index had an average childhood vaccination uptake of 92.7%, compared with 86.2% in lower-UHC countries. In the first year of the pandemic, countries with a high UHC index realized a coverage rate of 91.9%, versus 81.7% in lower-UHC countries.
"Countries' health system resilience against public health emergencies has been studied almost exclusively under the framework of global health security (GHS), with no role of UHC discussed," the researchers wrote. "This clear separation of investigations has precluded the opportunity to examine the potential contribution of UHC in strengthening health system resilience against external shocks."
In a PLOS news release, senior author Yesim Tozan, PhD, noted that the COVID-19 pandemic has affected the delivery of essential health services worldwide. "This study provided the much-needed quantitative evidence of the protective effects of universal health coverage in times of public health crises, underpinning the policy recommendations for sustained political commitment and investments for universal health coverage to build resilient health systems," she said.
Aug 16 PLOS Med study
Aug 16 PLOS news release
Measles outbreak in Zimbabwe kills 157 children
A new measles outbreak in Zimbabwe has killed at least 157 children, virtually all of them unvaccinated, according to an Associated Press (AP) story today.
Officials have reported at least 2,056 infections. The outbreak was first reported in Manicaland province in the east in early April and has since spread nationwide. The government has initiated a mass immunization campaign targeting children from 6 months to 15 years of age. Authorities are also enlisting the help of traditional and faith leaders to encourage vaccination.
Zimbabwe continued vaccinating children against measles even during the height of COVID-19, but efforts have been hampered by Christian groups that preach against vaccines, the story said.
Church gatherings that have resumed following the easing of pandemic restrictions have led to measles spread to previously unaffected areas, the health ministry said.
Aug 17 AP story