College of Medical, Veterinary & Life Sciences

Teachers were not at increased risk of hospital admission or severe COVID-19 during 2020-21 academic year, a new study has found.

Led by the University of Glasgow in collaboration with Public Health Scotland and published in The BMJ, the research found that neither teachers nor their household members were at increased risk of hospital admission with COVID-19, or severe COVID-19, at any time during the 2020-21 academic year, when compared with similar working age adults.

The findings, based on Scottish data from March 2020 to July 2021, covered periods when schools were fully open, and also when they were fully or partially closed. In the latter period of time covered by the study, the delta variant was already circulating in the population.

Existing studies already indicate that teachers have not been at increased risk of hospital admission with COVID-19, although some variation was found by type of teacher, and previous research predated the widespread circulation of the alpha and delta variants.

Now, for the first time, this new study compares the risk of COVID-19 among teachers, and their household members, with healthcare workers and adults of working age in the general population from March 2020 to July 2021, when delta was latterly circulating.

After adjusting for factors such as age, sex, ethnicity, underlying medical conditions and deprivation, the results show that in the initial period of school closure (spring/summer 2020), the risk of hospital admission with COVID-19 was around 50% lower in teachers and their household members than in the general population.
In contrast, during this same period, the risk was almost 4 times higher in patient facing healthcare workers and almost twice as high in their household members.
During the later period of school closure (winter 2020/21), teachers and their household members again showed around a 50% lower risk of hospital admission than the general population.

In the first period of full school opening (autumn term 2020), the risk of hospital admission in teachers increased by around 2.4-fold, reaching a similar level to that in the general population. In the summer term of 2021, when schools were also open and vaccination of the Scottish population was underway, a smaller increase of around 1.7-fold was seen.
The study also found that both teachers and their household members were not at higher risk of severe COVID-19 (admission to ICU or death) at any time in the 2020-2021 study period.
Professor David McAllister, Professor of Clinical Epidemiology and Medical Informatics at the University of Glasgow and lead author of the study, said: “It is not possible from our study to say why when schools were mostly closed teachers had a lower risk of hospitalisation with COVID-19. It could be something particular about teachers themselves, or it could simply be that they had fewer contacts, on average, than other working-age adults at this time.

“What we can say, is that while schools were open, teacher’s risk of hospitalisation with COVID-19 was about average when compared to that of other working-age people in Scotland who were similar in terms of age, sex, and known underlying medical conditions. This was also true during the recent spike of infections due to the delta variant which occurred when schools were fully open. Together with the finding that teachers were at lower risk of severe COVID-19, and that people who shared a household with teachers were not at increased risk, this is likely to be broadly reassuring for people involved in face-to-face teaching.

“It is important to note that during the period where the delta variant was circulating, uptake of vaccination among teachers was high, and we would continue to encourage everyone offered a vaccine to take this up.”

Most teachers were young (average age 42), 80% were women, and 84% had no existing conditions (comorbidities).

During the study period, the overall risk of hospital admission with COVID-19 remained less than 1% for teachers, healthcare workers, and adults of working age in the general population.

No accompanying increase in the relative risk of severe COVID-19 among teachers and their household members was observed during either period, and the risks of hospital admission were broadly similar across different teaching sectors.

The study, ‘Risk of hospital admission with COVID-19 among teachers compared with healthcare workers and other adults of working age in Scotland, March 2020 to July 2021: population based case-control study’ is published in The BMJ. David McAllister is funded via an intermediate clinical fellowship by Wellcome.

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First published: 1 September 2021