COVID-19: KEEPING SCHOOLS OPEN IN SEPTEMBER (Updated 12/8/20)

PM Johnson has said that schools must go back in September.  Of course they should.  It is a top priority, both for the children’s education and letting parents back to work.   

Followed by Higher Education for young adults, for which there is a new 'adult' section below.

Indeed Johnson is right when he says "keeping [schools] open should be the absolute priority in the coming months".  But is that realistic, yet?

Three members of my family are or have been teachers, across three generations, teaching from 5 year olds to sixth formers.  My daughter teaches Key Stage 1, Infants, and her school has been open throughout for the children of key workers and others.

I fully understand how important education is for children and young adults, and also to let parents get back to work.

But I also understand about other factors that must be addressed before schools can open fully.  And then stay open.  If these are not addressed, schools won't stay open.  Disaster for education and the economy.  Hence this blogpost.

Discussion about schools, especially by Johnson and his Ministers, tends to focus on children and classrooms.  Children rarely show serious coronavirus symptoms, and even more rarely die.  But that overlooks four key risks:

• Schools are about adults too.  Teachers, other staff and parents, especially of the younger children they have to take to and from school.  Visitors too.

• Children can suffer from  MIS-C, Multisystem Inflammatory Syndrome for Children, which for adults is known as LongCOVID.  This is where organs other than the lungs are damaged

• That presumably means children can be carriers.  New studies are showing at least as much as adults, whatever Gavin Williamson the Education Minister says.  Children can spread COVID-19 amongst themselves and then take infection home.

• Areas of the school outside the classroom, including the children’s loos

Then there is what to do if there is a COVID-19 outbreak at a school.  Schools can't keep opening, closing and opening again in a repetitive manner without major disruption.  So opening schools is about keeping them open.

It has been found that in settings like meat processing factories, where COVID-19 outbreaks keep happening, the workplace itself may be a problem.  But the main issue is “bottlenecks in toilets and washrooms; the locker-rooms, where workers pile in before and after work; and the canteens, where they gather to eat.”

Similar problems in hospitals is thought to be why the virus spread from frontline worker to frontline worker there. Likely in schools too, unless steps are taken to reduce the risk.


TEACHERS AND OTHER STAFF

Problems with communal areas exist for teachers and other staff.  The staff rooms tend to be cramped, with staff in close proximity to each other.  Corridors can get rammed when pupils and staff need to move around.  Social distancing difficult if not impossible.

Door handles, stair rails and other commonly touched surfaces are a source of infection, if adults or kids then touch their mouth, nose or eyes.  These surfaces have to be washed or disinfected regularly.

Staggering class times can help reduce the number of people in one place at any one time.  But maintaining social distancing is still very difficult.  Masks are not necessarily practical.

Get one staff member on the premises with COVID-19 and it will spread rapidly to other adults before it is obvious that anyone has it.

Visitors are a risk too.


PARENTS

Parents of young children have to take their children to and from school.  Or grandparents or childminders do it.

Watch them at the school gates, with younger children running around with each other, and it’s clearly a high-contact social occasion.  Social distancing almost impossible.  Fortunately it is outdoors, which is inherently less risky, but nobody will wear masks outdoors, unless compelled to as is happening in Spain.

The 'school run' is especially difficult for those people who have been shielding and still need to protect themselves.

Some parents go indoors into the school and classroom, very common in the mornings to settle their youngster into school or to tell the teacher something.  Schools are trying to minimise this, but some is always needed.

Parents will also tend to meet up on the journey to and from school.  Sharing car lifts and walking together.  It is impossible to keep households apart, which is a primary objective in tackling an epidemic,

Schools are being encouraged to stagger start and finish times.  But that only reduces not eliminates the risk.

Again one parent who is infectious could infect many more before they realise.

With Scottish schools going back earlier than English, The Scotsman published this on their front page "Scots parents have been warned to stop gathering at school gates amid greater concerns they could be unwittingly spreading coronavirus"

Parents are just too sociable!


CAN CHILDREN CATCH AND SPREAD COVID-19?

Which brings us on to the children.  MIS-C Multisystem Inflammatory Syndrome for Children means you don’t want your child to be exposed to COVID-19 if you can avoid it.  Though the risk is small.

Gavin Williamson, the Schools Minister, announced this morning (Monday 10 August) that there is "little evidence of corona virus being transmitted in schools".  But as children can display MIS-C symptoms, they must on occasions be carriers. 

Indeed there are two new studies showing transmission by children is a problem:

1. From Chicago:  "...we report that replication of SARS-CoV-2 in older children leads to similar levels of viral nucleic acid as adults, but significantly greater amounts of viral nucleic acid are detected in children younger than 5 years."  If they've got it they will spread it, obvs.
2. From Trento, Italy: This study reports the analysis of contact tracing efforts during Phase I of the epidemic in March-April, 2020, mostly under lockdown. "The greatest risk of transmission to contacts was found for the 14 cases younger than 15 years of age (22.4%)"

Whilst the latter is yet to be peer-reviewed, my gut tells me that significant transmission by children is a reality, and further proof will surface shortly. 

Indeed, no sooner had I written that than news emerges from the American Academy of Paediatrics that "97,000 children test positive for coronavirus in just two weeks as US schools re-open."

Here's an analysis of the other two studies, New Evidence Suggests Young Children Spread Covid-19 More Efficiently Than Adults. "The conclusion is "If children from ages 5 to 17 are as or possibly even more contagious than adults, then opening schools in areas where daily rates of infection remain moderate to high is extremely risky and unwise."

Update 11/8/20:  Here is a note that  "Several studies and other reports published in recent weeks found coronavirus in children of all ages" and "Other research suggested that kids, especially older ones, can be a driving force behind transmission"

Gavin Williamson disagrees. He is planning to publish a report supporting his contention that there is "little evidence of coronavirus being transmitted in schools".  This is possibly one from Public Health England that recently reviewed 20,000 pupils from 100 schools.  This is apparently scheduled for September, which is clearly too late.  Nor is a single study enough.  It needs to take into account experience in countries worldwide, such as that set out above.

Given the uncertainty should we hope for the best, or err on the side of caution?  As COVID-19 can lead to both deaths and substantial incidence of LongCOVID and MIS-C I'm sure you can guess my answer!


THE CHILDREN IN SCHOOL

The Government is providing guidance to schools later this week, updating guidance previously issued.  This will cover a lot of the detail around children in school.  Let's just look at some of the key issues:

Classrooms

In private schools, small class sizes can mean it is easier to keep children distanced in the classroom, or in ‘bubbles’ of a few students.  State school classes of 30 often need to be split into two groups

Where are the extra classrooms and staff going to come from?  And what about pressure on staff rooms?

Or is the only way to have each group alternating one week in, one week off?  Very disruptive to parents and their employers.  It sounds like the Government is going to overrule schools and local authorities that attempt to do anything like this.

Indeed, not letting schools and their Governors control their own schools is likely to produce much friction!


Other areas

Kids have to use toilets, canteens and other communal areas.  With younger children in particular, hygiene standards are iffy at the best of times.

Does their supervision need to be increased? 


There are many practical issues like this which schools are having to grapple with. 


THE CHILDREN GOING HOME

Many households around the country are multi-generational.  Grandparents live with one or more of their offspring and their families.

If children can take infection home, as appears likely, this is asking for trouble.  How can those who have been shielding, of whatever age, be protected from COVID-19 brought home by children? Especially the older children and young adults


IN HIGHER EDUCATION

We must not forget Higher Education, and certainly not under-estimate the potential for widespread transmission of COVID-19.  There's then the resulting deaths and LongCOVID for the young adults and their tutors.

From a COVID-19 perspective, young adults are as susceptible to COVID-19 as adults generally, and much that is relevant to older children apply to students.

But there's then an additional issue.  Boys will be boys.  And as my cousin reminds me with a glint in her eye, girls will be girls.  Especially away from home.  Here are some tips from experts at the BBC. including "I certainly wouldn't advise having new sexual partners at the moment".

Here's some extra advice  from a sexual health charity, the Terence Higgins Trust, who say  "not realistic to ask people to avoid sex indefinitely" and "pick larger, more open, ventilated spaces".  I can recommend atop the Tennyson Down, but what about outdoors at university campuses?

Universities are having to restrict events such as Freshers' Week, and many sixth formers will no doubt be thinking about taking a year off.  Indeed Universities are now worried their student numbers will be down.


ON FINDING AN OUTBREAK

What happens if one or more adults or children go down with suspected or confirmed COVID-19?  Each school or college will have its own plan.

What has been happening for teachers in some schools, with the reduced numbers of children, is to have a 3-week rota system. 
Splitting teachers into three groups so each group works one week in three.

The idea being that if any one group contracts COVID-19, the other two groups can carry on for two weeks whilst the first group recovers.  That won't be possible if all pupils are back.

Gavin Williamson has announced that a whole school, or all pupils in a year group, may have to self-isolate at home if there are two or more confirmed coronavirus cases within a fortnight. Isn't one case enough?

That approach, however essential, is very disruptive to parents and their employers.  You can’t have schools closing and opening again willy nilly.

But that is exactly what is bound to happen if the general infection rate in the community is too high.  That is the real underlying issue.

THE SOLUTION

The only way schools and Higher Education can re-open for all pupils and stay open is for the infection rate in each local community to be very low. Far lower than it is currently on average across England, let alone in hotspots such as the North West.

A key reason why the Government needs to take action now if schools are to re-open sensibly in early September, and Higher Education shortly afterwards..