Chronic health consequences of the COVID-19 pandemic on school workers: a cross-sectional post-pandemic analysis.

IMPORTANCE

The COVID-19 pandemic dramatically affected schools. However, there are insufficient data on the chronic physical and mental health consequences of the pandemic in school workers.

OBJECTIVES

To determine the prevalence and the functional and mental health impact of pandemic-related chronic health symptoms among school workers towards the end of the COVID-19 pandemic.

DESIGN

Cross-sectional analysis of health questionnaires and serology testing data (nucleocapsid, N antibodies) collected between January and April 2023, within a cohort of school workers.

SETTING

Three large school districts (Vancouver, Richmond, Delta) in the Vancouver metropolitan area, Canada (representing 186 elementary and secondary schools in total).

PARTICIPANTS

Active school staff employed in these three school districts.

EXPOSURE

COVID-19 infection history by self-reported viral and/or nucleocapsid antibody testing.

MAIN OUTCOMES

Self-reported, new-onset pandemic-related chronic health symptoms that started within the past year, lasting at least 3 months, after a positive viral test among those with a known infection.

RESULTS

Of 1128 school staff enrolled from 185/186 (99.5%) schools, 1086 (96.3%) and 998 (88.5%) staff completed health questionnaires and serology testing, respectively. The N-seroprevalence adjusted for clustering by school and test sensitivity and specificity was 84.7% (95% Credible Interval (95% CrI): 79.2% to 91.8%) compared with 85.4% (95% CrI: 81.6% to 90.3%) in a community-matched sample of blood donors. Overall, 31.1% (95% CI: 28.4% to 34.0%) staff reported new-onset chronic symptoms. These symptoms were more frequently reported in staff with viral test-confirmed infections (38.0% (95% CI: 34.3% to 41.9%)) compared with those with positive serology who were unaware that they had COVID-19 (14.3% (95% CI: 7.6% to 23.6%); p<0.001) or those with a negative serology (18.1% (95% CI: 12.7% to 24.6%); p<0.001). New-onset chronic symptoms were also more common in women (OR=1.6 (95% CI: 1.1 to 2.4)) and staff with a pre-existing health condition (OR=1.9 (95% CI: 1.4 to 2.5)). After controlling for age, sex and comorbidities, symptoms were associated with more days absent from work during the acute SARS-CoV-2 infection (OR=1.1 (95% CI: 1.0 to 1.2)), poorer mental health (OR=2.5 (95% CI: 1.9 to 3.4)), anxiety (OR=2.1 (95% CI: 1.5 to 3.0)) and depressive symptoms (OR=2.8 (95% CI: 2.0 to 4.0)).

CONCLUSIONS

The pandemic had major health impacts on school workers. To our knowledge, this study is among the first to concurrently quantify a broad range of chronic physical and mental health impacts, highlighting the need for further research and targeted health programmes to address this significant burden.