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COVID-19 School and Community Resource Library Resources for clinicians advising schools and community groups on strategies to prevent and manage COVID-19 June 30, 2021 update Authors Kiara Alvarez, PhD Jessica Becker, MD Roby Bhattacharyya, MD, PhD Alyssa Bilinski, MS Thea Brennan-Krohn, MD Duru Cosar Leela Davies, MD, PhD Scott Dryden-Peterson, MD Kieran Fitzmaurice T. Rajesh Gandhi, MD Kristen Hysell, MD Karen Jacobson, MD Jennifer Johnson, MD Doug Krakower, MD Jacob E Lazarus, MD, PhD Philip Lederer, MD Stephanie Lee Benjamin Linas, MD, MPH Safdar Medina, MD Ruvandhi Nathavitharana, MD, MPH Beverly Nazarian, MD Sandra Bliss Nelson, MD Phoebe Olhava, MD Giulia Park Gregory Robbins, MD, MPH Leah Rowland, MD Lindsey Sawyer MS, LCGC Virginia Triant, MD, MPH Sam Wainwright, MD Editor/Communicating Author Andrea Ciaranello, MD, MPH Division of Infectious Disease Massachusetts General Hospital Harvard Medical School Boston, MA 02114 [email protected] 1 COVID-19 School and Community Resource Library https://globalhealth.massgeneral.org/covidlibrary.pdf June 30, 2021 Table of Contents What’s new in the Resource Library Objective Other recommended resources Disclaimer Topic sections: 1. Susceptibility of children to SARS CoV-2 and COVID-19 disease 2. Clinical outcomes in children with and after COVID-19, including MIS-C 3. Transmission to and from children in the household and community setting 4. Transmission to and from children in the school setting, including outcomes of school openings 5. City, state, national, and society guidelines 6. Impact of school closure, isolation, and pandemic on mental and physical health in children 7. Narrative reviews, including medical literature and lay press (multiple topics) 8. PPE: efficacy and feasibility of masks, face shields, plexiglass barriers, etc. 9. Ventilation 10. Handwashing and hand sanitizing 11. Physical distancing 12. Cleaning and sanitizing (surfaces) 13. Bussing 14. Singing 15. Band and orchestra 16. Athletics 17. Monitoring and transitions to/from in-person and remote learning 18. Guidance on response to symptoms in students or staff 19. Testing: viral load, assay types, and implications for testing and screening in schools 20. Strategies to reduce transmission with in-person education 21. COVID-19 vaccines and implications for children and schools 22. Emerging variants and implications for children and schools 2 COVID-19 School and Community Resource Library https://globalhealth.massgeneral.org/covidlibrary.pdf June 30, 2021 What’s new in the Resource Library Update: June 30, 2021: This is the 16th published version of the Resource Library; it replaces the May 28th version at https://bit.ly/mghcovidlibrary (CTRL+F5 will load the latest version). We anticipate that this will be the final published edition of the Resource Library. All additions and revisions are highlighted in yellow in the text of each section. This version includes the following updates: ● Section 1: Updated CDC seroprevalence data and CDC/AAP reported rates of diagnosis and testing. ● Section 2: Updated CDC/AAP reported rates of hospitalization and death; new MMWR report on hospitalization rates among youth. ● Section 4: New modeling studies using cell phone mobility data to estimate transmission by age before and after school reopening; report of an outbreak in a summer camp in Illinois; new MMWR report of access to remote, hybrid, or full in-person learning by race/ethnicity. ● Section 5: MA DESE describes their last planned updates to COVID-19 protocols; new MIAA youth sports guidance; new MA EEC guidance eliminating COVID-19 restrictions for child care settings; new guidance from 16 health organizations on vaccines and myocarditis; WHO statement on importance of in-person learning; new UK guidance lifting mask requirements in schools. ● Section 6: New CDC data on ED visits for suicide attempts among youth. ● Section 7: New lay and medical press summaries of key issues for children and for K-12 schools. ● Section 9: New reviews of airborne transmission techniques to improve ventilation. ● Section 15: New fluid dynamic study suggesting that rearranging orchestra musicians on stage may decrease exposure to aerosols. ● Section 16: New AAP guidance on indoor and outdoor sports mitigation measures, and return to play after COVID-19. ● Section 19: Additional resources listing characteristics of available SARS-CoV-2 assays; new description of MA state programs for K-12 schools and child care programs; new calculator for projecting impact of school-based testing. ● Section 20: New model-based evaluation of the impact of school-based SARS-CoV-2 screening on testing and child care costs. ● Section 21: Links to FDA and CDC/ACIP meetings about vaccination in children and myocarditis after vaccination; peer-reviewed reports of myocarditis; review of data on vaccine impact on asymptomatic infection and onward transmission; state laws regarding access to vaccination for minors; strategies for improving global access to vaccines. ● Section 22: CDC, UK government (consolidated), and lay press resources to track variant patterns; reports of estimates of the impact of new variants on disease severity, transmissibility, and vaccine effectiveness. 3 COVID-19 School and Community Resource Library https://globalhealth.massgeneral.org/covidlibrary.pdf June 30, 2021 Objective The COVID-19 School and Community Resource Library is a volunteer effort by a group of physicians, including pediatricians, infectious disease physicians, and school district physicians from multiple institutions across Massachusetts and other states. Our objective is to offer a compiled source of published and publicly available data for clinicians who are advising K-12 schools and community organizations regarding best practices to prevent and manage COVID-19. This document is not intended to provide guidelines or specific recommendations. We welcome your feedback and participation; if there are additional topics or data that you would like the Resource Library to include, please email [email protected]. The Resource Library will be updated as new data emerge, with updates posted at https://globalhealth.massgeneral.org/covidlibrary.pdf. CTRL+F5 will clear your browser’s cache and load the most recent version. Disclaimer This COVID-19 School and Community Resource Library and the information contained therein (together, the “Information”) is provided for informational and educational purposes only. It is intended to offer a compiled source of published data for physicians who are advising schools and community organizations regarding best practices to reduce the risk of disease transmission, specifically novel coronavirus SARS-CoV-2 and the disease it causes, COVID-19. The Information has not been reviewed or approved by any government agency or health organization. The Information is provided “AS IS” and must not be used to make a clinical diagnosis, to provide clinical care, to replace or overrule a licensed health care professional’s judgment, or to override or supersede guidance from government and health organizations, including, without limitation, the Centers for Disease Control and Prevention or any other agency or representative of the United States government, the World Health Organization, and/or any state and local government entities. User acknowledges that each organization, facility, and situation are unique and the Information will not apply to all institutions and/or situations. Furthermore, the Information should not be deemed inclusive of all proper methods nor exclusive of other methods reasonably directed to obtaining the same results. The Information reflects what was available at the time the Resource Library was created (please see posting date). User recognizes that details and information are changing daily, and new information and/or the results of future studies may require revisions to the Information (and the general guidance contained therein) to reflect new data. The General Hospital Corporation (“MGH”), and any and all of its affiliated institutions, including but not limited to Mass General Brigham Incorporated (f/k/a Partners HealthCare System, Inc.), is not responsible for ensuring that use of the Information will be clinically sound, without error, or otherwise successful. By choosing to use the Information, User assumes all risk and bears all responsibility and liability. MGH, and any and all of its affiliated institutions, specifically disclaims all warranties, express, implied or statutory, including implied warranties of merchantability, fitness for a particular purpose, and noninfringement. 4 COVID-19 School and Community Resource Library https://globalhealth.massgeneral.org/covidlibrary.pdf June 30, 2021 Other Recommended Resources ● Don’t Forget the Bubbles ○ Curated review of medical literature by pediatricians ● American Academy of Pediatrics COVID-19 Planning Considerations: Guidance for School Re-entry ○ Brief sections offering guidance on distancing, bussing, hallways, playgrounds, meals/cafeteria, cleaning/disinfection, testing and screening, masks and PPE, on- site health services, student with disabilities, behavioral health, mental health of staff, food insecurity, immunizations, sports and PE. ○ Massachusetts Chapter, American Academy of Pediatrics: COVID-19 Resource Page. ■ Includes link to key articles, government and AAP guidance, and webinars ● Resources that summarize many aspects of school opening approaches taken globally: ○ Learning Policy Institute (summary of many
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