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A cross sectional look at COVID-19 seroprevalence and mental health in school staff at different levels in Montreal, Quebec, Canada: An EnCORE cohort substudy

Abstract

Background: One of the first public health interventions implemented by the Quebec government during the COVID-19 pandemic was the closing of schools. Whilst research has indicated school reopening was not a major driver of transmission, it was of concern that school staff were at increased risk of contracting COVID-19 and that returning would be deleterious for their mental health. In addition, it was unclear if these effects differed by school level (daycare, elementary and high school).

Methods: A total of 454 staff from 4 neighborhoods in Montreal, Canada answered a questionnaire that assessed depression using previously established scales (PHQ-9, GAD-7, MBI-SS and BRS) and included sociodemographic questions. Seroprevalence was determined via presence of SARS-COV-2 antibodies in serum. Crude seroprevalence and mental health characteristics in each school level were reported. Adjusted seroprevalence measures were reported via multivariable regression. Determinants for SARS-COV-2 were determined via literature review.

Results: Overall crude seroprevalence of SARS-COV-2 was 8.3% (95% CI, 5.9 - 11.6). When analyzing seroprevalence by school level, the lowest crude seroprevalence was in high school staff (3.2%, 95% CI 0.9 - 8.3) followed by daycare workers (9.3%, 95% CI 4.9 – 16.4) and elementary school staff (12.4%, 95% CI 12.4 - 19.3). No statistically significant difference in the risk ratios of adjusted seroprevalence was found between levels, using daycare seroprevalence as the reference (elementary RR 2.1, 95% CI 0.68 – 6.58, high school RR 0.41, 95% CI 0.09 – 1.66). When analyzing mental health data by school level, severities of all analyzed characteristics were relatively evenly distributed except for burnout, with high school staff experiencing nearly double the burnout (high school: 42.7%, elementary: 23.0%, daycare: 23.1%).

Conclusion and future directions: Overall, the findings of lower seroprevalence and markedly higher prevalence of burnout in high school staff are of note. A potential reason is the volatile nature of teaching for high school staff during the pandemic, with classes switching between in person, online and hybrid learning potentially increasing burnout levels while decreasing the risk of infection. Future research should be conducted to inform policies to reduce the burden of burnout in high school staff.

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