Government guidelines for schools need to minimize transmission of Covid-19 in children

Home schooling
Photo by August de Richelieu from pexels

The hearing of the All Party Parliamentary Group (APPG) on coronavirus on 2 February heard public evidence on the transmission of Covid-19 in children, with a specific focus on schools.

We heard from two mothers – Caroline Lea a teacher and Sughra Nazir a social worker from the group Safe education for All. Both women are clinically vulnerable and shielding, due to the health risks of Covid-19 represented the group, Safe education for All, a combination of teachers and parents concerned about the lack of Covid-19 protection in schools.  

During the second national lock down in the UK, children were expected to attend primary and secondary schools. Caroline’s own children are young; she described a school where desks were close together and her children were unable to properly socially distance from each other resulting in her keeping children home and home-schooling them. The response of the school was not to help but to threaten her with fines. The school told her that her children would be reported as “absent”, thanks to this she was referred to an absentee legal panel. It was only after the intervention from the County Council that a new policy was introduced to allow her to keep her children at home.

Sughra Nazir’s children were older and she kept them home for periods of time, but she was not able to home-school her children as they were doing the A-Level Science resulting in her requesting the opportunity of remote learning. This request was denied. Her family tried living in such a way as to ensure she could shield herself from her children for most of the day. Her children were sent home three times, due to classmates being diagnosed with Covid-19, and they needed to isolate. Following this, in October, she kept her children at home. Even a letter from her Respiratory Consultant saying she needed to shield, did not help her situation.

The candid and deeply personal stories from these two mothers were followed by questions to an expert panel including:

  • Professor Anthony Costello – Professor of International Child Health and Director of the UCL Institute for Global Health. Also a member of Independent SAGE and a former Director of maternal and child health at the World Health Organisation (WHO).
  • Dr Sarah Rasmussen – EPSRC Fellow in the Department of Pure Mathematics and Mathematical Statistics (DPMMS) at the University of Cambridge. Sarah has been involved in post-publication criticism of a Lancet Child & Adolescent Health systematic review on school closures led by SAGE member and RCPCH President Russell Viner.
  • Dr Deepti Gurdasani – Epidemiologist and senior lecturer at Queen Mary University of London. Her research focuses on epidemiological and genetic factors that influence global health.

We heard from the experts that although children do not become as ill as adults with Covid-19, they are still Vectors for the virus. Data from various studies and from the Office of National statistics (ONS) on whether children transmitted the virus were presented, and whether or not there was any difference in transmission rates between primary and secondary school children. Dr Rasmussen questioned data suggesting that children transmitted the virus less than adults; Dr Gurdasani suggested some of the data the government were using was flawed and there were large misunderstandings about the evidence whether children transmitted the virus.  What is clear is that children are able to transmit Covid-19..

The issue of children being a vector for the virus is important, with a huge impact on education and schools re-opening. “Don’t forget the bubbles”, produced by a team globally recognized Paediatric Clinicians, suggests that transmission dynamics in children appear very different for Covid-19 to flu

Their information is updated regularly, recently recognising that:

“Children may be less infectious than adults, but there is little direct evidence.

“There is emerging evidence that asymptomatic individuals may be less infectious than those with symptoms, which given potentially high rates of asymptomatic infection in children may reduce their contribution to community transmission.

“It is unclear how environmental/modifiable factors will contribute to children transmitting Covid-19, and this will likely depend on international variations in social restrictions and infection prevention measures deployed in schools.

The experts discussed measures that should be implemented. Dr Rasmussen said that one measure should be to avoid the draconian measures that some schools have taken with parents. Also discussed by Dr Lisa-Maria Muller (Education Research Manager at the Chartered College of Teaching) was changing guidelines and U-turns from the Government, which together with insufficient time for teachers to implement the changes results in significant and ongoing disruption in schools.

Professor Costello said that we must focus on getting schools back, with a plan for this including on-line education and all children having access to required resources. The re-opening of schools needs to be based on solid quantification, based on the local community prevalence of Covid-19 and a proper plan to support education for all children.

Dr Gurdasani discussed the false dichotomy of schools being open versus closed, as well as the required mitigation measures in schools to minimize transmission possibly reflecting measures put into schools in other countries to make them safer. The Government talks about the importance of education not being disrupted yet, despite this, guidelines have not been changed to reflect this. The current guidelines provide for exceptions for children who need to isolate; there are no exceptions for the case the parent who needs to shield.

It can safely be said that the draconian behaviour towards parents remains very much in place.

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