We know that schools are a vital environment for children and young people’s wellbeing and mental health, as well as their learning. Schools have remained open to children of key workers and vulnerable children throughout the pandemic, and this has played a major role in keeping essential services like hospitals running. Children and young people are very rarely seriously ill following COVID-19 infection – the move to home learning for most children was part of the drive to lower community transmission.
Throughout the pandemic, PHE has advised that ‘schools should be the last to close and the first to re-open’ and that all young people should return to schools as soon as it is safe to do so.
Transmission in schools
Concerns about COVID-19 transmission in schools are understandable, particularly during this third significant wave, when community cases have been worryingly high, and new variants have emerged.
But staff, parents and pupils can feel reassured by current evidence that shows transmission of COVID-19 in schools remains low. There is also no current evidence to suggest that new variants are more transmissible or cause more serious illness among children.
Gathering data on school safety
From June to December last year, PHE conducted the Surveillance in Schools study (SKIDS) that showed during a period of partial lockdown and a full re-opening of schools, infection rates among primary school staff and students was extremely low (less than 5%). Our surveillance also identified that only a small proportion of primary schools were affected by outbreaks and in most cases these were rapidly contained.
In November 2020 the Schools Infection Study (SIS) was conducted, jointly led by PHE, the London School of Hygiene & Tropical Medicine (LSHTM) and the Office for National Statistics (ONS) which looked at infection in schools during the peak of the second wave.
The study involved asymptomatic testing of 10,000 students and staff across England and despite a slight over-representation in areas with higher infection rates, the study showed that infection rates in schools were low. Higher rates among staff and students were reported in regions with higher community prevalence, while many schools in areas of low community prevalence did not have any infections during the testing period. These findings confirmed the importance of maintaining low community infection rates to reduce the likelihood of infection in local schools.
Additional studies and surveillance also support this picture. A recent analysis of school absences in England during the COVID-19 pandemic by the University of Warwick shows similar findings. A study conducted by the ONS on occupational death rates between March – December 2020 showed the mortality risk to teachers was overall lower than the working age average. ONS data from September to mid-October 2020 also found no significant difference between teachers testing positive and key workers in other professions.
Effective Safety Measures in Schools
PHE has worked closely with the Department for Education and local authorities to advise on the system of public health controls to effectively reduce risks in schools and create inherently safer environments.
The results of our scientific studies to date reflect the huge amount of work that schools have already carried out to implement these controls and reduce risks.
For reopening of schools, PHE has advised on the continuation of these existing controls, enhanced by additional precautionary measures. These include:
- Minimising contact with individuals who are required to self-isolate by ensuring they do not attend school
- Advising everyone to clean their hands thoroughly and more often than usual.
- Ensuring good respiratory hygiene by promoting the ‘catch it, bin it, kill it’ approach
- Maintaining enhanced cleaning on site
- Minimising contacts across the school and maintain social distancing where possible, including creating bubbles, avoiding public transport etc.
- Wearing appropriate PPE where necessary.
- Keeping occupied spaces well ventilated.
- Increasing the use of face coverings in secondary schools and colleges
- Rolling out mass testing programmes for all staff and secondary school-age students.
Enhanced safety measures
The introduction of additional safety measures this term can provide further reassurance to staff, parents and pupils that the risk of COVID-19 transmission is minimised.
Emerging evidence increasingly shows the importance of good ventilation in reducing the concentration of the virus in the air and reducing the risk from airborne transmission. Schools are encouraged to ensure all occupied and enclosed spaces are well ventilated whilst a comfortable teaching environment is maintained.
The Health and Safety Executive guidance on air conditioning and ventilation during the coronavirus outbreak and CIBSE Coronavirus (COVID-19) Advice provides more information.
As an additional precautionary measure, adults and students in secondary schools are asked to wear face coverings indoors, in classrooms and where social distancing is not possible. Students do not need to wear face coverings when they are outdoors on the school grounds or during PE lessons. Some individuals are exempt from wearing a face covering.
This advice is in place whist community prevalence of the virus is still very high and school testing programmes are getting started. The advice will be reviewed at the end of this term.
In primary schools face coverings should be worn by staff and adult visitors where social distancing between adults is not possible. The measure is not advised for primary school children due to lower infection rates and limited evidence of transmission in these settings.
Testing School Children
Rapid mass testing of secondary school age pupils presents benefits for limiting transmission and preventing outbreaks. The testing programme will mean that pupils in secondary schools with asymptomatic infection can be quickly detected to self-isolate and stop onward transmission.
On returning to school or college, students will be tested three times at the school’s or college’s asymptomatic testing site (ATS). Conducting tests in supervised settings will support students to learn how to use the tests accurately. Students will be asked to take a fourth test at home. Thereafter students will be asked to continue using home testing kits twice a week. School staff will also be required to take twice-weekly tests using home testing kits.
Twice weekly testing has already been in place for primary school teachers and used effectively in other settings such as health and social care. Getting used to a twice weekly self-testing routine will be an important part of the process for opening up schools and wider society as we move out of lockdown.
The testing programme includes:
Testing secondary school students
- 3 initial tests in school or college. All tests will be provided by the school or college. Schools and colleges will have discretion on how to phase the return of their students over this period.
- Thereafter, 2 rapid home tests each week provided by schools. Schools should offer test kits 3-5 five days apart to students to manage the number of students passing through the test site at any one time.
- Asymptomatic testing sites will remain at schools and colleges for students unable to test at home.
Testing for primary, secondary and college staff
- Staff will be supplied with test kits to test themselves twice a week at home.
Primary school children won’t be part of the schools testing programme, however staff will continue to be tested twice weekly. This advice is based on the following factors:
- Infection rates in primary school age children have been consistently lower than in secondary school age children. Current evidence shows that transmission is low in primary schools and lower than in secondary schools. Studies also show transmission from pupils to staff is uncommon.
- It isn’t currently possible to accurately model the benefits of the roll out of a mass testing programme for primary age children, but it is clear there would be less benefit than testing secondary age pupils.
- The overall benefits of requiring young children to be swab tested, which some could find unpleasant, for protecting pupils, staff or the wider community from COVID-19 infection cannot be confirmed or quantified.
Keeping our eye on the science
Returning children to schools and colleges is a very high priority for government and PHE will continue to closely monitor the data as students return. In early March the Schools Infection Study jointly led by Public Health England, the Office for National Statistics and the London School of Hygiene & Tropical Medicine will be published and provide an important picture using recent data.
The return to face-to-face teaching is being done carefully and parents can feel reassured by the public health measures in place to maximise safety in school environments.
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Contributor: Viv Bennett