Objective To determine the risk of hospital admission with covid-19 and severe covid-19 among teachers and their household members, overall and compared with healthcare workers and adults of working age in the general population. Design Population based nested case-control study. Setting Scotland, March 2020 to July 2021, during defined periods of school closures and full openings in response to covid-19. Participants All cases of covid-19 in adults aged 21 to 65 (n=132 420) and a random sample of controls matched on age, sex, and general practice (n=1 306 566). Adults were identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and their household members were identified through the unique property reference number. The comparator groups were adults identified as healthcare workers in Scotland, their household members, and the remaining general population of working age. Main outcome measures The primary outcome was hospital admission with covid-19, defined as having a positive test result for SARS-CoV-2 during hospital admission, being admitted to hospital within 28 days of a positive test result, or receiving a diagnosis of covid-19 on discharge from hospital. Severe covid-19 was defined as being admitted to intensive care or dying within 28 days of a positive test result or assigned covid-19 as a cause of death. Results Most teachers were young (mean age 42), were women (80%), and had no comorbidities (84%). The risk (cumulative incidence) of hospital admission with covid-19 was <1% for all adults of working age in the general population. Over the study period, in conditional logistic regression models adjusted for age, sex, general practice, race/ethnicity, deprivation, number of comorbidities, and number of adults in the household, teachers showed a lower risk of hospital admission with covid-19 (rate ratio 0.77, 95% confidence interval 0.64 to 0.92) and of severe covid-19 (0.56, 0.33 to 0.97) than the general population. In the first period when schools in Scotland reopened, in autumn 2020, the rate ratio for hospital admission in teachers was 1.20 (0.89 to 1.61) and for severe covid-19 was 0.45 (0.13 to 1.55). The corresponding findings for household members of teachers were 0.91 (0.67 to 1.23) and 0.73 (0.37 to 1.44), and for patient facing healthcare workers were 2.08 (1.73 to 2.50) and 2.26 (1.43 to 3.59). Similar risks were seen for teachers in the second period, when schools reopened in summer 2021. These values were higher than those seen in spring/summer 2020, when schools were mostly closed. Conclusion Compared with adults of working age who are otherwise similar, teachers and their household members were not found to be at increased risk of hospital admission with covid-19 and were found to be at lower risk of severe covid-19. These findings should reassure those who are engaged in face-to-face teaching. Access to data for third parties would require agreement of the organisations who provided data to Public Health Scotland (NHS Education Scotland and the General Teaching Council Scotland).

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2020 年 3 月至 2021 年 7 月，苏格兰教师与医护人员和其他工作年龄成年人相比，因 covid-19 入院的风险：基于人群的病例对照研究


目的 总体确定教师及其家庭成员因 covid-19 和重症 covid-19 入院的风险，并与一般人群中的医护人员和工作年龄成年人进行比较。设计基于人群的巢式病例对照研究。苏格兰 2020 年 3 月至 2021 年 7 月期间，为应对 covid-19，在规定的学校关闭和全面开放期间。参与者 21 至 65 岁成年人中的所有 covid-19 病例 (n=132 420) 以及年龄、性别和一般实践相匹配的随机对照样本 (n=1 306 566)。苏格兰普通教学委员会确定在苏格兰学校积极教学的成年人，并通过唯一的财产参考号来识别他们的家庭成员。比较组是苏格兰的成年人、他们的家庭成员以及其他处于工作年龄的一般人群。主要结局衡量指标 主要结局是因 covid-19 入院，定义为入院期间 SARS-CoV-2 检测结果呈阳性、检测结果呈阳性后 28 天内入院，或被诊断为 covid-19出院时-19。重症covid-19被定义为被送入重症监护室或在检测结果呈阳性后28天内死亡或将covid-19指定为死亡原因。结果 大多数教师都很年轻（平均年龄 42 岁）、女性（80%），并且没有合并症（84%）。对于一般人群中所有工作年龄的成年人来说，因 covid-19 入院的风险（累积发生率）为 <1%。 在研究期间，在根据年龄、性别、一般医疗、种族/民族、贫困、合并症数量和家庭成年人数量进行调整的条件逻辑回归模型中，教师表现出因 covid-19 入院的风险较低（率比为 0.77，95% 置信区间为 0.64 至 0.92），重症 covid-19 的比率为 0.56，0.33 至 0.97）。在苏格兰学校于 2020 年秋季重新开放的第一阶段，教师的入院率为 1.20（0.89 至 1.61），重症 covid-19 的入院率为 0.45（0.13 至 1.55）。教师家庭成员的相应结果为 0.91（0.67 至 1.23）和 0.73（0.37 至 1.44），面向患者的医护人员为 2.08（1.73 至 2.50）和 2.26（1.43 至 3.59）。在第二阶段，即学校于 2021 年夏季重新开放时，教师也面临着类似的风险。这些值高于 2020 年春/夏季，当时学校大多关闭。结论 与其他方面相似的工作年龄成年人相比，教师及其家庭成员因 covid-19 入院的风险并未增加，并且重症 covid-19 的风险较低。这些发现应该可以让那些从事面对面教学的人放心。第三方获取数据需要获得向苏格兰公共卫生部门（苏格兰国民保健服务教育局和苏格兰普通教学委员会）提供数据的组织的同意。