Cases and outbreaks of COVID-19 among students after returning to university in September 2020

In a recent study published in Emerging infectious diseasesresearchers assessed the increase in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among university students immediately after returning to their universities in September 2020. Students moved to their universities for the new term university during the coronavirus disease 2019 ( COVID-19) pandemic in England.

Background

In the United Kingdom (UK), university students are moving to their universities in September at the start of the new academic term, which has coincided with the increase in COVID-19 cases in the country during this period. While some universities in the United Kingdom (UK) preferred online teaching, some universities required students to attend in person. Unfortunately, immediately after the start of the new academic term, outbreaks of SARS-CoV-2 occurred in association with universities.

About the study

In the present study, researchers assessed the increase in COVID-19 cases and outbreaks as students returned to their universities for the new academic term beginning in September 2020 during the SARS-CoV-2 pandemic.

SARS-CoV-2 positive students (student-patients) were identified based on contact tracing records and their university attendance. Student patients residing in university student housing were identified by matching their residential addresses with national property databases. People positive for SARS-CoV-2 were asked about their activities and events in the week before the start of Covid-19 symptoms/ date of the test, which included data on their attendance at educational institutions.

To identify university students among case patients, those with positive reports for SARS-CoV-2 were linked to National Health Service (NHS) test and trace exposure data. Contact tracing and patient data were linked by SARS-CoV-2 positive sample number, date of birth and NHS number.

Accommodation types were identified by matching the patient’s address against the Ordnance Survey Address Base Premium database, in which each address is assigned a unique property reference number (UPRN) that allows patients to be mapped with a particular area of ​​residence. Age-specific case rates were compared between towns with universities and those without using mid-year 2019 estimates from the Office for National Statistics (ONS). The rates of COVID-19 cases among student patients and the rest of the population were compared, and the geographic regions with the highest number of cases were determined.

Results

Between September 1, 2020 and December 31, 2020, 1,999,180 cases of COVID-19 were reported in England, of which 53,430 (2.7%) were student cases. After the start of the new academic term (in September), a rapid increase in the number of student cases increased from 0.7% to 7.8% from September to October. The increase in COVID-19 cases was initially due to SARS-CoV-2 cases and outbreaks in university residences, more pronounced among people aged 18-23 (student population), and was twice as high in university towns.

In the student population, cases increased from 11 COVID-19 cases/100,000 individuals to 99 COVID-19 cases/100,000 individuals between September 1, 2020 and October 1, 2020. During the same period, the rate of COVID-19 cases among the remaining population of England has increased from three to 13 COVID-19 cases/100,000 people. At the start of the academic term, 60-70% of case students lived in student residences, with this percentage dropping to 20-30% after mid-November.

The mean age of student patients and all patients was 20 years and 37 years, respectively, and a higher proportion of women among student patients (57% female versus 53% male). Most student cases have been reported in Nottingham, Sheffield, Bristol, Manchester, Birmingham and Leeds. Most student patients residing in student accommodation have been reported in Nottingham, Sheffield, York, Newcastle and Coventry.

SARS-CoV-2 outbreaks in student residences continued for six days, compared to two days for other residences. Outbreaks involving students showed an upward trend, increasing from 0.7% to 7.3% in September 2020 but decreasing to 1% in December 2020. A significant reduction in COVID-19 cases was observed in November after the second period of national restrictions in university towns; however, rates rose in December after restrictions were lifted.

Conclusion

In summary, the unprecedented increase in COVID-19 cases among university students after the start of their terms, likely due to physical and social interactions of students in enclosed spaces during the cooler academic week, has been reduced in applying national COVID-19 restrictions. The study highlights the need for strict preventive measures to reduce the transmission of SARS-CoV-2.