Reopening schools in the COVID-19 outbreak - Dr Alistair McMillan
Talk is turning to strategies for moving away from the current COVID-19 lockdown, and at the forefront of this should be the consideration of reopening schools. The Treasury is certainly concerned about those working from home being distracted by home-schooling duties and others, who cannot easily work from home, prevented totally from returning to work by child-care duties. However, in order to reopen schools, careful thought needs to be given to the implications of children from diverse localities being brought together on one site, and the impact on all who work there.
The softening process has already begun, with widespread publicity given to the UCL report, published in The Lancet: Child & Adolescent Health, School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review. This was given widespread coverage in the press, with the conclusion that ‘Policy makers need to aware of the equivocal evidence when considering school closures for COVID-19, and that combinations of social distancing measures should be considered’. This lead to headlines such as ‘Costs of school closures could outweigh benefits, study finds’ (Financial Times); ‘School closures likely to have little impact on spread of coronavirus, review finds’ (Guardian) and Coronavirus: Scientists question school closures impact’ (BBC).
When reading into the UCL report, the use of ‘rapid’ in the title may more accurately be described as ‘hasty’ given that it was based on a mere 16 related studies, one of which had not been peer-reviewed. Of the 15 studies which had been peer-reviewed, none were able to isolate the effect of school closures, as these were taken alongside other interventions, such as social distancing.
The non-peer-reviewed paper, Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand, concerned a modelling application to the UK, which concluded that ‘school closure as an isolated measure was predicted to reduce total deaths by around 2–4% during a COVID-19 outbreak in the UK, whereas single measures such as case isolation would be more effective, and a combination of measures would be the most effective’.
The authors of the UCL report discuss the lack of information on COVID-19 transmission, and so rely on flu transmission, noting that ‘although children appear to contract the infection at the same rate as adults, they largely have mild or asymptomatic forms of the disease and appear to be less likely to spread the virus through coughing or sneezing; however, a precise understanding is as yet lacking’. They also comment that the high reported transmission rate ‘is a particular concern for COVID-19, with its higher mortality among older people, as around 40% of the UK's grandparents provide regular childcare for their grandchildren’.
Predictably perhaps from an article in The Lancet: Child and Adolescent Health, not much attention is given to school staff and parents. For parents practicing social distancing, some in social isolation, whilst sending children off to school and exposing them to others who might live with/be in contact with other people who have COVID-19 is less than ideal. For school staff, similar issues prevail.
The Department of Education advice on social distancing for schools opens with the banal statement that ‘for the vast majority of children and staff, coronavirus (COVID-19) will not cause serious illness’. Amongst advice is that staff should ensure children are ‘keeping apart when in the playground’ (tell that to Donald Trump when leaving a press briefing) ‘are encouraged not to touch their faces’ (tell that to Dominic Raab when holding a press conference). And for staff, ‘The scientific advice indicates that educational staff do not require personal protective equipment’.
In circumstances where children and young people are unable to follow social distancing guidelines, such as due to special education needs, or where children require personal care and/or support, staff are advised to ‘increase their level of self-protection, such as minimising close contact (where appropriate), cleaning frequently touched surfaces, and carrying out more frequent handwashing.’ What objects and surfaces in a school are not touched regularly?
At present, schools are dealing with vulnerable children and those of key workers, both of which are high risk in terms of virus transmission. In light of this, why aren’t schools being considered for PPE? No wonder the National Education Union in its letter to the prime minister of 14 April, brings up the issue – and brings it up again in its recently launched petition, signatures on which now run into the hundreds of thousands.
We all understand that the move from lockdown to a more open economy will be difficult. Schools are an important part of that, for families, for jobs, and for society. But whilst sending children back to school whilst infection levels are still high might not kill them, it will – to put it in necessarily stark terms – make it more likely that the staff at school and parents at home may die.
Dr Alistair McMillan worked in the Department of Politics at the University of Sheffield. He is now retired.