TABLE 1. COVID-19 incidence* and rate ratios in 169 elementary schools,† by county COVID-19 incidence, school characteristics, and COVID-19 prevention strategies — Georgia, November 16–December 11, 2020.
| Characteristic | No. (%) of schools | No. of enrolled students | No. of cases§ | Cases per 500 students enrolled (95% CI) | RR¶ (95% CI) |
|---|---|---|---|---|---|
|
Total
|
169 (100)
|
91,893
|
566
|
3.08 (2.84–3.34)
|
—
|
|
County COVID-19 incidence** | |||||
| 0–150 |
25 (14.8) |
12,358 |
52 |
2.10 (1.61–2.76) |
Ref |
| 151–200 |
54 (32.0) |
32,399 |
169 |
2.61 (2.24–3.03) |
1.21 (0.75–1.96) |
| 201–250 |
45 (26.6) |
24,482 |
106 |
2.16 (1.79–2.62) |
1.00 (0.60–1.66) |
| 251–300 |
21 (12.4) |
11,556 |
122 |
5.28 (4.42–6.30) |
2.55 (1.47–4.47) |
| >300 |
24 (14.2) |
11,098 |
117 |
5.27 (4.40–6.31) |
2.26 (1.32–3.88) |
|
School type
| |||||
| Public |
154 (91.1) |
86,878 |
536 |
3.08 (2.84–3.36) |
Ref |
| Public charter/Magnet/Alternative |
8 (4.7) |
4,645 |
27 |
2.91 (2.00–4.22) |
0.97 (0.50–1.97) |
| Private/Parochial/Independent |
7 (4.1) |
370 |
3 |
4.05 (1.38–11.78) |
1.46 (0.31–5.33) |
|
Urban–rural setting
††
| |||||
| Metropolitan |
120 (71.0) |
65,501 |
386 |
2.95 (2.67–3.25) |
Ref |
| Nonmetropolitan |
49 (29.0) |
26,392 |
180 |
3.41 (2.95–3.94) |
1.14 (0.83–1.58) |
|
Instructional model
§§
| |||||
| 100% in-person |
30 (17.8) |
14,538 |
106 |
3.65 (3.02–4.41) |
Ref |
| Hybrid |
139 (82.2) |
77,355 |
460 |
2.97 (2.71–3.26) |
0.91 (0.60–1.36) |
|
Mask requirements for teachers and staff members
¶¶
| |||||
| Optional |
57 (33.7) |
29,881 |
264 |
4.42 (3.92–4.98) |
Ref |
| Required |
110 (65.1) |
61,190 |
298 |
2.44 (2.17–2.73) |
0.63 (0.47–0.85) |
|
Mask requirements for students
| |||||
| Optional |
82 (48.5) |
42,761 |
326 |
3.81 (3.42–4.25) |
Ref |
| Required |
87 (51.5) |
49,132 |
240 |
2.44 (2.15–2.77) |
0.79 (0.50–1.08) |
|
Flexible medical leave policies for teachers
| |||||
| Not offered |
31 (18.3) |
17,194 |
137 |
3.98 (3.37–4.71) |
Ref |
| Offered |
138 (81.7) |
74,699 |
429 |
2.87 (2.61–3.16) |
0.81 (0.56–1.17) |
|
Ventilation improvements
| |||||
| No*** |
37 (21.9) |
21,844 |
183 |
4.19 (3.63–4.84) |
Ref |
| Yes |
87 (51.5) |
44,771 |
234 |
2.61 (2.30–2.97) |
0.61 (0.43–0.87) |
| Don’t know |
45 (26.6) |
25,278 |
149 |
2.95 (2.51–3.46) |
0.63 (0.42–0.95) |
|
Desks or tables separated ≥6 ft
| |||||
| Some/No classrooms |
137 (81.1) |
76,348 |
472 |
3.09 (2.83–3.38) |
Ref |
| All classrooms |
32 (18.9) |
15,545 |
94 |
3.02 (2.47–3.70) |
0.97 (0.66–1.45) |
|
Desks or tables with barriers
| |||||
| Some/No classrooms |
131 (77.5) |
71,163 |
445 |
3.13 (2.85–3.43) |
Ref |
| All classrooms |
38 (22.5) |
20,730 |
121 |
2.92 (2.44–3.48) |
0.98 (0.69–1.41) |
|
Students per classroom, median (IQR)
|
19 (15–21) |
— |
— |
— |
1.02 (0.98–1.06) |
|
Cohort size,††† median (IQR)
|
20 (15–21) |
— |
— |
— |
1.00 (1.00–1.00) |
| Handwashing stations, median (IQR) | 9 (8–9) | — | — | — | 0.88 (0.76–1.01) |
Abbreviations: CI = confidence interval; IQR = interquartile range; GDPH = Georgia Department of Public Health; K–5 = kindergarten through grade 5; RR = rate ratio; Ref = referent.
* Case incidence in schools was calculated as the sum of cases reported to GDPH during November 16–December 11, 2020, divided by the number of students enrolled multiplied by 500.
† GDPH and Georgia Department of Education contacted all public Georgia K–5 superintendents (1,321 schools) and private school leaders (140 schools); 169 schools with available case data completed the survey (response rate 11.6%).
§ Number includes both students and staff members with a case of COVID-19 during the study period.
¶ All RR estimates except for county COVID-19 incidence were adjusted for county-level 7-day case incidence per 100,000 population on December 1, 2020. RRs that exclude 1 are statistically significant.
** Per 100,000 population. County incidence was calculated as the 7-day cumulative sum of COVID-19 cases reported to GDPH on December 1, 2020, divided by the county population multiplied by 100,000. Population estimates for 2019 were provided by the Annual Estimates of the Resident Population for Counties in Georgia from April 1, 2010, to July 1, 2019.
†† Based on the 2013 National Center for Health Statistics classification. Metro counties include large metro (county population ≥1,000,000), medium metro (250,000–999,999), and small metro (<250,000); nonmetro counties include: micropolitan (10,000–49,999) and noncore (nonmetropolitan counties that did not qualify as micropolitan).
§§ For schools that are 100% in-person, students attend in-person for the full school week; for hybrid models, a combination of in-person and remote learning occurs on an alternating schedule.
¶¶ Two schools had discordant mask requirements for teachers and other staff members (i.e., one school required mask use among teachers, but not other staff members, and one school required mask use among other staff members, but not teachers). These were excluded from the calculation of the RR for mask requirements for teachers and staff members. All other schools either required masks for both teachers and staff members or allowed for optional mask use among both groups.
*** Includes schools that reported “No” to improving ventilation and six schools that reported decreasing room occupancy as the only ventilation improvement.
††† Small groups of students who stay together throughout the day during in-person learning.