Search

Objectives: When the COVID-19 pandemic was declared, Governments responded with lockdown and isolation measures to combat viral spread, including the closure of many schools. More than a year later, widespread screening for SARS-CoV-2 is critical to allow schools and other institutions to remain open. Here, we describe the acceptability of a minimally invasive COVID-19 screening protocol trialled by the Western Australian Government to mitigate the risks of and boost public confidence in schools remaining open. To minimise discomfort, and optimise recruitment and tolerability in unaccompanied children, a combined throat and nasal (OP/Na) swab was chosen over the nasopharyngeal swab commonly used, despite slightly reduced test performance. Design, setting and participants: Trialling of OP/Na swabbing took place as part of a prospective observational cohort surveillance study in 79 schools across Western Australia. Swabs were collected from 5903 asymptomatic students and 1036 asymptomatic staff in 40 schools monthly between June and September 2020. Outcome measures: PCR testing was performed with a two-step diagnostic and independent confirmatory PCR for any diagnostic PCR positives. Concurrent surveys, collected online through the REDCap platform, evaluated participant experiences of in-school swabbing. Results: 13 988 swabs were collected from students and staff. There were zero positive test results for SARS-CoV-2, including no false positives. Participants reported high acceptability: 71% of students reported no or minimal discomfort and most were willing to be reswabbed (4% refusal rate). Conclusions: OP/Na swabbing is acceptable and repeatable in schoolchildren as young as 4 years old and may combat noncompliance rates by significantly increasing the acceptability of testing. This kind of minimally-invasive testing will be key to the success of ongoing, voluntary mass screening as society adjusts to a new ‘normal’ in the face of COVID-19. Trial registration numb

Introduction: Amidst the evolving COVID-19 pandemic, understanding the transmission dynamics of the SARS-CoV-2 virus is key to providing peace of mind for the community and informing policy-making decisions. While available data suggest that school-aged children are not significant spreaders of SARS-CoV-2, the possibility of transmission in schools remains an ongoing concern, especially among an aging teaching workforce. Even in low-prevalence settings, communities must balance the potential risk of transmission with the need for students' ongoing education. Through the roll out of high-throughput school-based SARS-CoV-2 testing, enhanced follow-up for individuals exposed to COVID-19 and wellbeing surveys, this study investigates the dynamics of SARS-CoV-2 transmission and the current psychosocial wellbeing impacts of the pandemic in school communities. Methods: The DETECT Schools Study is a prospective observational cohort surveillance study in 79 schools across Western Australia (WA), Australia. To investigate the incidence, transmission and impact of SARS-CoV-2 in schools, the study comprises three “modules”: Module 1) Spot-testing in schools to screen for asymptomatic SARS-CoV-2; Module 2) Enhanced surveillance of close contacts following the identification of any COVID-19 case to determine the secondary attack rate of SARS-CoV-2 in a school setting; and Module 3) Survey monitoring of school staff, students and their parents to assess psycho-social wellbeing following the first wave of the COVID-19 pandemic in WA. Clinical Trial Registration: Trial registration number: ACTRN12620000922976

Introduction & Aims: Preterm birth rates have risen to over 8% in Australia. The lungs are one of the last organs to develop and therefore, the preterm lung is immature at birth. As effects of premature birth on airway cell function are unknown, we investigated whether preterm nasal epithelial cells (NECs) are inherently different to cells of full-term born infants. Methods: The NECs were obtained via brushing nine preterm born infants (5 males, average gestational age at birth 26.6 ± 2.4 weeks) aged 1.7 years corrected age and nine full-term born infants (5 males) aged 2.3 ± 0.2 years. Submerged monolayer cultures were generated and RNA, protein, supernatant and cytospins were collected. Cell lineage markers were analysed at gene (qPCR) and protein (immunocytochemistry, Western blot) level. Cytokines were measured via ELISA. Two functional assays were performed; wound repair by monolayer culture and transepithelial permeability assay by differentiated, air-liquid interface culture. Results: Preterm NEC were morphologically similar to full-term NEC as monolayer and ALI cultures. Compared to full-term NEC, preterm NECs had significantly higher CK-19 gene expression at passage 1 (1.95 ± 0.51 vs 0.78 ± 0.17; p<0.05) but not CK-5 and vimentin expression. However, CK-19 protein was lower in preterm NECs. Cytokine differences were restricted to higher IL-8 by preterm NECs at passage 3 (31587 ± 3933 vs 15413 ± 5960 pg/mL; p<0.05). Interestingly, transepithelial permeability was significantly lower in preterm children for both particle sizes used (4 kDA: 59.75 vs 324; 20 kDA: 43.26 vs 415.9, p<0.05). Wound repair of preterm NEC was also lower (72 hours: 62.10 vs 100%, p<0.05). Conclusion: Preterm and full-term NECs morphology, gene, protein and cytokine expression were predominantly comparable at baseline. However, interestingly functional differences also existed. Preterm NECs could be used to model mechanisms of preterm respiratory disease.

Mullane, M. J., Thomas, H. M., Epstein, M., Mandzufas, J., Mullan, N., Whelan, A., ... Gething, P. (2021). DETECT schools study protocol: A prospective observational cohort surveillance study investigating the impact of COVID-19 in Western Australian schools. Frontiers in Public Health, 9, article 636921. https://doi.org/10.3389/fpubh.2021.636921

Thomas, H. M., Mullane, M. J., Ang, S., Barrow, T., Leahy, A., Whelan, A., ... & Bowen, A. C. (2022). Acceptability of OP/Na swabbing for SARS-CoV-2: a prospective observational cohort surveillance study in Western Australian schools. BMJ open, 12(1), e055217. https://doi.org/10.1136/bmjopen-2021-055217

Thomas, H. M., Mullane, M. J., Ang, S., Barrow, T., Leahy, A., Whelan, A., ... & Bowen, A. C. (2022). Acceptability of OP/Na swabbing for SARS-CoV-2: a prospective observational cohort surveillance study in Western Australian schools. BMJ open, 12(1), e055217. https://doi.org/10.1136/bmjopen-2021-055217