Teachers in Scotland Not at Increased Risk for COVID-19 Hospitalization, Severe Illness

Teachers in Scotland Not at Increased Risk for COVID-19 Hospitalization, Severe Illness

(Reuters Health) – Since the beginning of the pandemic, teachers in Scotland have not had higher rates of hospitalization for COVID-19 or severe disease compared with healthcare workers and other adults of working age, a new study suggests.

An analysis of data on all teachers in Scotland found that between March 2020 and July 2021, teachers were 23% less likely overall to be hospitalized and 44% less likely to develop severe COVID compared with the general population. Even when in-person schooling was taking place, teachers were no more likely than other adults to experience those outcomes, according to the report in The BMJ.

By comparison, patient-facing healthcare workers were about twice as likely as similar adults in the general population to experience COVID-19 hospitalization and severe disease.

The new study shows that “teachers are at ‘average’ risk of hospitalisation with COVID-19 when compared to other similar adults,” study coauthor Dr. David McAlister, a professor at the University of Glasgow, a Wellcome Trust Intermediate Fellow and an honorary consultant in public health medicine at National Health Services Scotland, said in an email.

“Face to face teaching meant that teachers were at about average risk when compared to other working age adults who were similar in terms of age, sex, underlying conditions etc.,” Dr. McAlister said. “‘Other working age adults’ was, of course, a very mixed group. It included people in very low-risk occupations where they could work entirely from home and those in very high-risk occupations, such as people who provided personal care to older people in care homes. Compared to this group as a whole, teachers are at about average risk. In contrast, before healthcare workers were prioritised for early vaccination, both they and members of their households were definitely in the higher risk category.”

To take a closer look at the impact of the pandemic on teachers, the researchers linked datasets of all Scotland teachers to an existing Public Health Scotland case-control dataset on 132,420 COVID-19 cases and a random sample of the population (n=1,306,566) matched on age, sex and general practice that included about 39,000 healthcare workers.

Linking to an existing case control study, the researchers note, allowed them to leverage the extensive data processing and cleaning (especially of covariate data) that they had already performed to produce results more rapidly.

Most of the teachers in the case-control dataset (n=25,687) were young, with a mean age of 42; 80% were women; and 84% had no comorbidities based on previous hospital admission and drug dispensing data.

During the study period, the overall risk of hospitalization with COVID-19 was less than 1% for all working-age adults in the general population.

After adjusting for factors such as age, gender, ethnicity and socioeconomic status, the researchers found that during the initial period of school closure – spring and summer of 2020 – teachers’ risk of hospital admission with COVID-19 was half (rate ratio 0.50) that of the general population. Their risk increased by two- to four-fold during the autumn term of 2020 when schools were open, bringing it to a level similar (RR 1.20) to that of the general population, while teachers remained less likely (RR 0.45) to have severe COVID-19.

In contrast, during the school closure period, patient-facing healthcare workers’ risk of hospitalization was four times higher (RR 3.86) than that of the general adult population.

The new study has some issues, said Dr. Aaron Milstone, an infectious disease epidemiologist and a professor of pediatrics at Johns Hopkins Medicine in Baltimore.

One big problem is that there can be many confounding factors, such as mask wearing, Dr. Mistone noted. “You could say that this might be reassuring to teachers, but it was done at a population level and that doesn’t really allow for generalizability to a place where teachers might have behaved differently.”

SOURCE: https://bit.ly/3mXGBSo The BMJ, online September 2, 2021.

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