Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools

Thank you for your comment. As we described in the paper, adjudication of cases was left to each district's public health officials. Daily symptom monitoring was conducted in schools, and symptomatic students were asked to go to free testing sites identified by the school district. Upon identification of a case, contact tracing was conducted to adjudicate the infection as either primary (community acquired) or secondary (acquired within school setting). These data were then reported by district superintendents as aggregated data to ABC faculty. This was specifically to protect potentially identifiable information, as several schools had low numbers of infections. All close contacts were recommended to undergo testing and free testing sites were identified by the school district (see attached sample letter and schedule from one of the districts as an example). We do not have access to the number of close contacts who underwent testing, in part because mandated testing was not required by the study. As stated in the manuscript, non-mandated testing is a limitation of these data.

Well done. This informative paper concludes, "Our data indicate that schools can reopen safely if they develop and adhere to specific SARS-CoV-2 prevention policies." This seems right based on the data at hand for the period of investigation, but do the authors think that the findings will generalize to a situation where possibly more infectious variants like B.1.1.7 are spreading? Are there limits to this guidance?