COVID-19 School of Medicine

COVID-19 transmission at school rare for children with disabilities

A study led by Washington University School of Medicine in St. Louis, in collaboration with Special School District of St. Louis County, found that rapid saliva test screenings – aimed at early detection of COVID-19 – contributed to exceedingly low transmission of the virus among students, teachers and staff in the six schools overseen by the district. (Photo: Getty Images)

Studies have determined that in-school transmission of the virus that causes COVID-19 is rare when masking, social distancing and other safety protocols are followed. However, little has been known about COVID-19 risks at school for children with intellectual and developmental disabilities. These students often are unable to mask or maintain social distancing and may have underlying medical conditions that make them more susceptible to the virus and related complications.

New research shows that rapid saliva test screenings – aimed at early detection of the virus – contributed to exceedingly low transmission of the virus among students, teachers and staff in the six schools overseen by the Special School District of St. Louis County, the largest specialized education provider in Missouri. Precautions such as masking and social distancing also were implemented when appropriate. The study was led by Washington University School of Medicine in St. Louis, in collaboration with Special School District.

“Our research shows that safety protocols can work in high-risk school settings,” said the study’s senior author, Christina A. Gurnett, MD, PhD, the A. Ernest and Jane G. Stein Professor of Developmental Neurology and director of the Division of Pediatric and Developmental Neurology at Washington University. “In-person instruction during the pandemic has been shown to be beneficial to students. However, what was lacking was specific guidance on how to safely return to in-person learning at schools serving students with intellectual and developmental disabilities. We wanted our work to help provide clarity.”

Weekly saliva testing detected fewer than two cases of school-based transmission during a six-month period in the six dedicated Special School District of St Louis County schools from November 2020 through May 2021.

The research is published in the Journal of Neurodevelopmental Disorders.

While the findings are reassuring, the researchers note that the study was conducted before the delta variant’s surge in Missouri and across the globe.

“How the delta variant will impact school transmission rates is unknown,” added Gurnett, who also serves as neurologist-in-chief at St. Louis Children’s Hospital. “However, data show that vaccines – currently available to children ages 12 and older – are effective against the delta variant. While breakthrough infections do occur, they are rare, and the vaccine is effective against preventing severe infections, hospitalizations and deaths. Mitigation strategies such as masking and social distancing will provide protection to children who are too young to be vaccinated.”

The research team said saliva test screenings can help maintain low transmission rates as students return to school. The simple test — developed by the School of Medicine’s Department of Genetics and the McDonnell Genome Institute, in collaboration with a biotechnology company — provides same-day results.

Voluntary, weekly saliva tests were offered to Special School District teachers, staff and students beginning Nov. 20, 2020, and the research project will continue throughout the 2021-22 school year. The school district’s six campuses serve more than 700 families that have children in kindergarten through the 12th grade.

“Ample, fast testing was key to detecting COVID-19 infections and allowing in-person instruction to resume within the high-risk school community,” said co-author Jason Newland, MD, a professor of pediatrics who has advised multiple school districts in Missouri during the pandemic. “A return to campus was important because the pandemic has disproportionately impacted students with intellectual and developmental disabilities.”

Some students have conditions such as neuromuscular disorders, orthopedic disabilities and severe autism; and some require gastric-tube feedings or breathe through a tube inserted in the airway.

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