Value of integrated mandatory national surveillance data and literature reviews to inform public health policy in the child care sector

• Published in: European journal of public health 2021-10, Vol.31 (Supplement_3)
• Main Authors: Buchholz, U, Lehfeld, A-S, Lindahl, M, Otte im Kampe, E, Lewandowsky, M, Haas, W
• Format: Article
• Language: English
• Subjects: Adults; Child care; Children; Children & youth; COVID-19; Data; Epidemiology; Health care policy; Health policy; Health surveillance; Literature reviews; Outbreaks; Pandemics; Prevention; Property; Public health; Severe acute respiratory syndrome coronavirus 2; Surveillance; Viral diseases
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckab164.326

Background Epidemiological properties of children have been a matter of debate during the entire duration of the SARS-CoV-2-pandemic. To inform public health policy two instruments were used that stemmed from mandatory national surveillance data as well as continuous, up-to-date literature screening. We report how these two instruments complemented each other in the first/second (before the advent of the VOC Alpha (B.1.1.7)) and the 3rd wave (dominated by VOC Alpha (B.1.1.7)) in Germany. Methods We monitored and analysed continuously data reported from local health departments via state health departments to the Robert Koch Institute. In addition, we reviewed peer-reviewed, pre-prints and grey literature on key epidemiological parameters in children, such as susceptibility, infectiousness and viral load. Results After the 1st wave in March-May 2020 the 2nd wave started in early autumn and lasted until the first weeks in 2021. The proportion of cases among 0-5 year old children stayed mostly below the corresponding population proportion, and was always lower than that of older age groups. Reported outbreaks in child care centres were small (median 4 cases). Primary cases were mainly adults. Among the cases reported from child care centre outbreaks the proportion of 0-5 year old children was only 35%. Information from the literature indicated lower susceptibility of children, lower viral load, but provided equivocal information about infectiousness. In the 3rd, B.1.1.7-dominated wave the number of outbreaks increased rapidly and exceeded the highest number in the 2nd wave. In addition, the proportion of 0-5 year old children involved in the outbreaks increased to 45%. Conclusions During the 1st and 2nd wave susceptibility and likely also infectiousness of 0-5 year old children was limited allowing broad opening of child care centres. In contrast, in the 3rd wave affectedness of children increased leading to recommendations to scale-up prevention efforts in child care centres.