NB Throughout this piece “younger children” refers to children aged 11 and under.
Schools in the UK are beginning to re-open their doors to all pupils. Having remained open throughout the pandemic for the children of key workers and vulnerable children, the return of all pupils will begin in England and Northern Ireland from 8 March 2021. Scotland and Wales are already welcoming younger pupils back with older pupils returning between now and Easter.
Both the closing and re-opening of schools is an emotive topic.
In May 2020 I wrote the piece “Back to school – should schools be reopening?” which looked at the risks of both opening and not re-opening schools.
In September 2020 I followed this up with the piece “COVID-19 – what are the risks for schools and universities?”
In both these pieces I wrote the following:
"The risks of not being in school may far exceed the risks from being back in school in terms of mental and physical health, emotional well-being and education. There is growing concern over the disadvantaged and vulnerable students who were being disproportionately affected by schools remaining shut."
During the UK’s second lockdown in November 2020 schools stayed open, and this blog piece here addressed the reasoning behind that.
Since then children have been through another prolonged closure of their schools that began with a chaotic start to the term in January 2021 when they were initially told they must return to school only for this to be overturned just 24 hours later. (1)
This time our children are returning to school as case numbers are again dropping and crucially against a backdrop of vaccination.
It continues to be the case that children and young people are highly unlikely to suffer serious illness from COVID-19 and the risks to their own health by returning to schools are minute.
However, do school children play a pivotal role in the transmission of the infection to others? And if so, what are the risks to school staff, each other and their families?
I have been asked many questions on this topic but all them tend to boil down to one over-riding question - is it safe to fully re-open our schools?
Here are some of the questions I have been asked over recent weeks.
The papers reported that Professor Whitty said it was not safe to re-open schools. So why are we?
Teachers and parents alike were understandably very concerned when UK newspaper headlines on 19 February 2021 reported that Professor Whitty, England’s Chief Medical Officer, had advised the government not to reopen schools as planned on 8 March. (2)
When asked about this at the Downing Street briefing on 22 February 2021 Professor Whitty said he too was surprised to hear he had said this as he had “....categorically denied it to the journalists involved. But they still printed it so fine.” (3)
Are our children safe at school?
It remains the case that children's risk of becoming seriously ill from COVID-19 is tiny. This did not change with the emergence in the UK of the more contagious variant in December 2020.
Crucially, hospital paediatric wards have not seen a rise in COVID-19 in children in hospital. Professor Russell Viner from the Royal College of Paediatrics and Child Health said in January 2021 that, "As cases in the community rise there will be a small increase in the number of children we see with Covid-19, but the overwhelming majority of children and young people have no symptoms or very mild illness only." (4)
During the UK’s November 2020 lockdown the schools and colleges remained open. Against a background of rising community infections there was no evidence that primary school children were drivers of infection with only limited spread in their age group.
At secondary school level infection rates were higher. We already know that this age group, 12-18 years, is akin to older adults in terms of transmitting the infection although again, it is rare for this age group to have serious COVID-19 illness. Higher rates in secondary school pupils appear to be driven by higher numbers of community cases and not outbreaks caused by the school. (5)
Globally COVID-19 infections are much lower in children than adults and other countries have noted than infections in schools seem to follow on from and reflect what is happening in the local community with COVID-19 rather than driving increases in infections. (6)
Are teachers safe at school?
The ONS (Office for National Statistics) collates COVID-19 death figures by sex, ethnicity, age and profession. (When doctors complete death certificates they include the occupation of the deceased person.)
In January 2021 the ONS released their analysis of deaths in different professions. In their press release of 25 January 2021 they gave more detailed information specifically about the rates in health and social care workers and teaching and educational professionals.
(Teaching and educational professionals refers to those qualified to teach in a wide range of settings from primary school through to university level education. It does not include other jobs in the teaching and educational sector such as administration.)
Between 9 March and 28 December 2020 there were 139 deaths from COVID-19 in teaching and educational professionals aged 20 to 64 years in England and Wales. For both men and women the rates of death from COVID-19 in this group were statistically significantly lower than the rates of death from COVID-19 among those of the same age and sex.
The death rate for men in the general population is 31.4 deaths per 100,000 men; for male teachers and educational professionals it is lower at 18.4 deaths per 100,000.
For women, the death rate in the general population is 16.8 deaths per 100,000 women; for female teachers and educational professionals it is lower at 9.8 deaths per 100,000.
The ONS also compared the teaching occupations with other professional occupations that have similar economic and educational backgrounds. Overall there were no differences in death rates with one exception. The death rate in male secondary school teachers was higher than in men in similar occupations of the same age. It was not higher when compared with all men of the same ages in the general population. (7)
Given the close proximity often needed when teaching younger children it is perhaps surprising that nursery and primary school staff don’t have higher rates of serious illness and deaths from COVID-19. However, we already know that young children are rarely seriously ill with COVID-19 and emerging evidence now indicates that they are also not spreaders of infection either. It was assumed, based on other known viral disease mechanisms, that young children were easily passing on COVID-19 whilst remaining well themselves but this does not appear to be the case. (This does not mean no young child ever passes COVID-19 onto others, clearly this sometimes happens. But young children are neither the cause nor the drivers of COVID-19 outbreaks.) (8)
Increasing age, being of BAME (Black, Asian and Minority Ethnic) ethnicity and being male are recognised risk factors for COVID-19. Given that women account for 75% of all teaching staff in UK schools and that 86% of all teachers are White British, this may be one reason why higher than average rates of serious illness are not seen within the educational establishment. It may also explain why one subgroup of teaching staff – male secondary school teachers – has a slightly higher mortality rate. Male teachers are more likely to work in the secondary school sector. A 2010 census found that of all male teachers, more than 75% worked in secondary schools and academies. The higher mortality rate in this subgroup may reflect being male rather than being a teacher per se. (9) (10)
What about teachers and pupils who are clinically vulnerable?
There will be teachers and pupils in the CEV (clinically extremely vulnerable) group.
The government’s advice is that all people in the CEV group are to continue shielding and stay at home as much as possible until further notice. Shielding is expected to continue until at least the end of March 2021. (11) (12)
What about families where the child is healthy but there is a vulnerable parent in the home?
In this situation the advice is that the child should still return to school on 8 March.
The COVID-19 precautions already in place in schools are being enhanced with secondary school pupils undergoing regular testing and the wearing of masks in the classroom when they go back.
In addition, all those in the CEV group are being called for vaccination at the time of writing and it is expected that all those in the most vulnerable groups in the UK will have received their first dose of vaccine before the schools go back. This will give a significant layer of added protection to CEV members of the family. (13) (14)
Shouldn’t all teachers be vaccinated before schools re-open?
At the time of writing there are no plans to immunise all teaching staff as a priority group. The only occupation that has been vaccinated as a priority are frontline health and social care staff who are in tiers 1 and 2 of the nine tiers for initial vaccination.
The clinically vulnerable are prioritised in tier 4 with tiers 5 to 9 based on five year age increments. (15)
Anybody with significant health problems would be in tier 4 irrespective of occupation and should have been offered a vaccine now.
Vaccinating by age bands is the quickest and easiest way to get the whole population vaccinated. Every single person in the UK has their date of birth on their NHS record. This allows rapid calling of people by date of birth. Trying to vaccinate certain occupations, be it teachers, the police, shop staff or transport workers would take more time as there is no single data base of occupations from which to call them.
Trying to identify and invite people for vaccination based on occupation would cause delays to the whole vaccination programme and the unwanted consequence of more vulnerable people remaining unvaccinated for longer.
It would require not only a lot of time and manpower to invite people based on occupation but would also mean the higher risk groups have to be moved down the priority list as occupational groups are moved up.
What are other countries doing?
Across western Europe most country’s schools are open or already in the process of opening. The one exception at the time of writing is Portugal whose schools are due to open from the beginning of March. There has not been any surge in cases in countries where schools have opened fully and thus far schools have not become drivers of new COVID-19 hot spots. (16)
In Conclusion
As parents and teachers nationwide ready themselves for the return of all pupils to school there is understandable anxiety. When pupils went back after the first national lockdown the only ways we had to combat the virus was through practical interventions such as social distancing, bubbles and lots of handwashing.
However, this time pupils are returning against a backdrop of the entire adult population being offered vaccination. Combined with the ongoing COVID-19 measures already in place in schools plus the addition of testing in secondary schools, this time they should hopefully be going back for good.
(4) https://schoolsweek.co.uk/covid-19-nine-things-we-learned-from-scientists-at-education-committee/
