SARS-CoV-2 infection, risk perception, behaviour, and preventive measures at schools in Berlin, Germany, during the early post-lockdown phase: A cross-sectional study

Abstract Background Briefly before the first peak of the COVID-19 pandemic in Berlin, Germany, schools closed in mid-March 2020 for six weeks. Following re-opening, schools gradually resumed operation at a reduced level for nine weeks preceding the summer holidays. Aim During this phase, we conducted a situational assessment in schools among students and teachers as to infection status, symptoms, affective, behavioural, educational issues, and preventive measures. Methods At twenty-four randomly selected primary and secondary schools, one class each was examined. Oro-nasopharyngeal swabs and capillary blood samples were collected to assess SARS-CoV-2 infection (PCR) and specific IgG (ELISA), respectively. Medical history, household and schooling characteristics, leisure time activities, fear of infection, risk perception, hand hygiene, physical distancing, and facemask wearing were assessed. Results Among 535 participants (385 students, 150 staff), one teenager was SARS-CoV-2 infected (0.2%), and seven individuals exhibited specific IgG (1.3%); 16% reported symptoms upon examination, and 48% in the preceding 14 days. Compared to before the pandemic, the proportion of leisure time spent as screen-time increased, and the majority of primary school students reported reduced physical activity. Fear of infection and risk perception were relatively low, but acceptance of adapted health behaviours was high. Governmental preventive measures were adequately implemented, with primary schools performing better than secondary schools. Conclusion In this phase of rare infection and low seroreactivity, individual and school-level infection prevention and control measures were largely adhered to. Nevertheless, vigilance, continued and proactive preventive measures, and well-rehearsed reaction options are essential to cope with increasing pandemic activity.