Longitudinal Testing of Respiratory and Gastrointestinal Shedding of SARS-CoV-2 in Day Care Centres in Hesse, Germany: Results of the SAFE KiDS-Study

Background: With the pandemic of SARS-CoV-2 ongoing in Europe in July of 2020, day care centres were reopened in the state of Hesse, Germany, after the lockdown. The role young children play in the dynamics of the transmission was unknown. Methods: We conducted a longitudinal study over a period of 12 weeks (18th of June 2020 to 10th of September, 2020) to screen attendees and staff from day care centres in the state of Hesse, Germany, for both respiratory and gastrointestinal shedding of SARS-CoV-2. 825 children (age range 3 months to 8 years) and 372 staff members from 50 day-care centres, which were chosen representatively from throughout the state, participated in the study. Parents were asked to perform both a buccal mucosa and an anal swab on their children once a week. Staff were asked to self-administer the swabs. RT-PCRs for SARS-CoV-2 were performed in a multiple-swab pooling protocol. Findings: 7,366 buccal mucosa swabs and 5,907 anal swabs were analysed. No respiratory or gastrointestinal shedding of SARS-CoV-2 was detected in any of the children. Shedding of SARS-CoV-2 could be detected in two staff members from distinct day care centres. Case 1 was a 37 year old female who was asymptomatic at the time of testing. The second case was a 63 year old female who was symptomatic. Interpretation: Respiratory or gastrointestinal shedding of SARS-CoV-2 in children or staff members in day-care centres was very rare in the context of low community activity. The data indicate day care centres do not pose a reservoir for SARS-CoV-2 in a low prevalence setting, no inapparent transmissions were observed. Funding Statement: The study was commissioned by the Hessian Ministry of Social Affairs and Integration and was supported by Roche, Basel, Switzerland. Declaration of Interests: None to declare. Ethics Approval Statement: This study protocol was approved by the ethics board of the University Hospital Frankfurt, Goethe University Frankfurt am Main, Germany.