· Temperature screening has not yet been demonstrated to reduce COVID-19 spread or accurately identify COVID-19 cases in schools. This did not prove to be a useful strategy when implemented in Singapore during the 2003 SARS epidemic.
· 14% to 19% of children with COVID-19 have an asymptomatic presentation and fever only develops in less than half of symptomatic pediatric cases. Fever is also a common presentation of childhood illnesses unrelated to COVID-19.
· Chemical and plastic-strip thermometers are considered unreliable in pediatric clinical settings and there is also an element of user error with any thermometer type.
Radu, L; Groot, G; Badea, A; Mueller, M; Young, C. Is the use of thermometers an effective screening strategy for students in schools during COVID-19? 2020 Sep 4; Document no.: EOC090201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 13 p. (CEST rapid review report)
A number of jurisdictions have re-opened schools successfully without a spike in COVID-19 cases, eg. Japan, Germany, France, Finland, Denmark, Austria, Norway
Most school plans indicate that staff/students/visitors who are sick or have had exposure to COVID-19 in the past 14 days should not attend school, and those that become symptomatic at school should be isolated and removed from the premises as soon as possible, with thorough cleaning thereafter
In Alberta, if two or more members of a cohort are found to be COVID-19 positive, schools should follow the outbreak procedures which are under review until September
In Nova Scotia, one confirmed case of COVID-19 in a school would be considered an outbreak
In Germany, classmates and teachers of an infected student are sent home for two weeks but other classes continue
Taiwan (based on the H1N1 response) suspends the class which had a confirmed case identified, for 14 days. With two or more cases the whole school must close. When 1/3 of the schools in a district are closed, all schools in the district must close.
In Israel, schools closed after a single case was identified , and following mass outbreaks in schools at least 355 schools had closed with over 2,026 students and staff testing positive and over 28,000 students in quarantine due to possible exposure
Badea, A; Muhajarine, N; Reeder, B; Miller, L; Mueller, M. What is the evidence and rationale describing the key public health principles to consider for school re-openings and precautions regarding school closures during COVID-19? 2020 Aug 17; Document no.: EOC070901 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 22 p. (CEST rapid review report)
· The CDC does not recommend universal symptom screening (all students in K-12 grades) to be done by schools prior to entry
· Schools/districts should individually work with public health officials to determine the necessity and details of implementing any testing strategies
· European CDC recommends that all symptomatic individuals and asymptomatic high-risk close contacts should be referred for testing – fast and effective contact tracing following testing is key
· Large scale universal testing in school settings has not been studied and it’s efficacy compared to implementation of other infection prevention control measures is unknown
· Large scale testing in school settings to date has largely been done in response to an outbreak, not as routine surveillance
Badea, A; Muhajarine, N; Howell-Spooner, B; Mueller, M. What laboratory surveillance testing strategies are effective for COVID-19 in school settings? 2020 Aug 27; Document no.: PH082501 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST rapid review report)