Extensive SARS-CoV-2 testing reveals BA.1/BA.2 asymptomatic rates and underreporting in school children
Bibliographic record
Abstract
Abstract Case underreporting during the COVID-19 pandemic has been a major challenge to the planning and evaluation of public health responses. Inconsistent underreporting can undermine effective risk assessment due to high uncertainty in predicted future scenarios. Underreporting rates have been particularly high among children and youth, given that asymptomatic school children were often considered a less vulnerable population. In January 2022, the Canadian province of Newfoundland and Labrador (NL) was experiencing an Omicron variant outbreak (BA.1/BA.2 subvariants) and public health officials recommended that all students returning to elementary, junior high, and high schools (∼59,452 students) complete two rapid antigen tests (RATs) to be performed three days apart. To estimate the prevalence of SARS-CoV-2, we asked parents and guardians to report the results of the RATs completed by K-12 students using an online survey, and to specify the students’ school level and if students with positive RAT results had symptoms. When comparing the survey responses with the number of cases and tests reported by the NL testing system, we found that 1 out of every 4.3 (3.1-5.3) positive households were captured by provincial case count, with 5.1% positivity estimated from the RAT results, and 1.2% positivity reported by the provincial testing system. The survey data indicate that a higher percentage of SARS-CoV-2 cases were found in elementary schools, with 62.9% of positive cases (95% CI: 44.3%, 83.0%) reported from elementary school students, and the remaining 37.1% (95% CI: 22.7%, 52.9%) reported from junior high and high school students. Asymptomatic infections were 59.8% of the positive cases, with no significant difference between asymptomatic rates in elementary schools (60.8%) or in junior high and high schools (58.1%). Given the low survey participation rate (3.5%), our results may suffer from sample selection biases, and should be interpreted with caution. Nonetheless, our estimate of the underreporting ratio is consistent with ratios calculated from serology data, and our study provides insights into infection prevalence and asymptomatic infections in school children, a currently understudied population. We declare that This manuscript is original and is not a violation or infringement of any existing copyright or license The manuscript is not under consideration elsewhere All authors meet the definition of authorship as set out by the International Committee of Medical Journal Editors (ICMJE) Permission has been obtained from the copyright holder(s) if indicated, for the use of any third-party textual, graphic, artistic or other material
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".