Schools should not take in more pupils on 1st June unless it is safe to do so

On the 7th May, Doctors in Unite expressed its full support for the National Education Union’s five tests before schools could take in more children and colleges re-open. In brief, these tests were:

  • Far lower numbers of COVID-19 cases
  • A national plan for social distancing
  • Testing, testing, testing
  • Whole school strategy for testing in the event of infection
  • Protection of the vulnerable

However, it is now expected that primary schools will accommodate many more pupils from the 1st June, although the prime minister has acknowledged that some will need more time for preparation. The government anticipates that England’s schools are likely to be fully reopened by September this year, while only year 10 and 12 – pupils in their first year of GCSE and A-level studies – will be able to meet their teachers from 15th June.

Although numbers of coronavirus patients are falling, on 28th May there were still 1,887 new cases recorded. One cause of considerable anxiety is that plans to reopen schools more widely have failed to address the increased risk to BAME pupils and staff. Early figures on COVID-19 showed that 35% of almost 2,000 patients in intensive care units were black or from another minority ethnic background, despite BAME people making up only 14% of the population.

On a positive note, there has been a huge and welcome rise in the number of teachers becoming union members, and many parents also remain concerned about safety and are skeptical of government reassurances. Two recent opinion polls showed that 60% of parents were not prepared to allow children back to school. Teachers have rightly been critical of the government for being fixated on a date rather than focusing on ‘how’ schools are to manage the return of pupils.

In fact, government thinking on schools is difficult to fathom not least because the scientific advice on which it is based is still not being made fully public. This issue prompted Sir David King, previously the Government’s Chief Scientific Advisor, to set up an independent Scientific Advisory Group on Emergencies. The Independent SAGE takes a refreshingly honest and open approach, welcoming critique and public discussion, and includes a broad range of scientific specialists. It’s second report is a model of clarity and deals with the question of schools.

The report begins by stating: “The issue of schools reopening during COVID-19 does not just have implications for pupils; it also has knock-on effects for adult staff, parents and the communities and locality from which pupils come from”. Schooling is absolutely essential for children, but must be balanced against the risk to themselves and others. The report also asserts: “We believe that decisions on school opening should be guided by evidence of low levels of COVID-19 infections in the community and the ability to rapidly respond to new infections through a local test, track and isolate strategy. There is no clear evidence that these conditions are met. Until they are it is not safe to open schools on June 1”.

Unfortunately ‘tracking and tracing’ systems are only just now becoming operational and there are likely to be many teething problems not least because of a very top down government approach and the involvement of the private sector. Local initiatives such as in Sheffield are providing both a model approach and important lessons, but have already demonstrated that simply asking contacts of cases if they would not mind self isolating for two weeks is unlikely to work unless the teams actually have the authority to insist. While the government is already thinking ahead to possible financial penalties for those who do not comply with a polite request, they would be better providing financial support at the level of wages rather than the derisory statutory sick pay that is a disincentive for people to stay at home.

There are many things that could be done to ensure children’s education is re-established by preparing school environments for social distancing, and providing better hand washing and toileting facilities. All schools are different and teachers have the necessary insights here. Local knowledge, including rates of infection is essential to inform decisions and some schools will be able to open to greater numbers of pupils more quickly than others. The role of local public health officials is also hugely important and is only now being acknowledged. The development of an effective ‘track and trace’ system is both essential for an easing of lockdown and clearly some weeks if not even months away.

The education unions have put out a joint statement to call for the Government to step back from the 1st June and to work with unions to create the conditions for a safe return to schools. The key elements are fully supported by Doctors in Unite and are as follows:

  • Safety and welfare of pupils and staff as the paramount principle
  • No increase in pupil numbers until full rollout of a national test and trace scheme
  • A national COVID-19 education taskforce with government, unions and education stakeholders to agree statutory guidance for safe reopening of schools
  • Consideration of the specific needs of vulnerable students and families facing economic disadvantage
  • Additional resources for enhanced school cleaning, PPE and risk assessments
  • Local autonomy to close schools where testing indicates clusters of new COVID-19 cases

Dr John Puntis is the co-chair of Keep Our NHS Public, and a member of Doctors in Unite

Schools must not reopen without clear evidence and widespread agreement that this is safe

As a paediatrician, I share the grave concerns of nurse Ian Wilson who has two children at school in Lewisham and experience of working with covid-19 infected patients. In an open letter to Health Secretary Matt Hancock last week, he pleaded that we were not enrolled against our will in a giant experiment that could go tragically wrong, pointing out that forcing hundreds of people into small rooms in small buildings was self evidently nonsense during a pandemic (1). Nothing has changed since this letter was first published on the 20th April, other than some additional worrying scientific evidence from Germany supportive of keeping schools closed (2). This work has shown that children with mild symptoms have just as high viral loads as sick adults, considerably undermining the suggestion sometimes made that somehow children would be less infectious. It is now clear that you need neither symptoms nor coughing in order to spread disease if you are an asymptomatic carrier, since droplets are produced simply by talking (3).  In close proximity, pupils would not only spread infection among themselves and teachers, but also carry the virus home to family members and vulnerable relatives.

Terrible though it is for children not to be able to go to school, and with all the attendant risk of negative impact on current health and wellbeing as well as long term prospects, there should be no reopening of school unless it is absolutely safe to do so. Not only that, teaching staff through their union representatives must also agree it is safe, and the decision cannot be left to education secretary Gavin Williamson alone. Social distancing is clearly a concept that would not be grasped by young children, and schools are usually busy and crowded places with narrow corridors and other bottle necks herding pupils together. It is absolutely right for vulnerable children to be at school at the present time, when relatively low numbers can be managed safely. More attention needs to be given to ensuring that these children are actually at school as many appear to be staying away. There are now covid free hospitals where elective surgery is being performed and perhaps this points the way forward for educational establishments. It would clearly require intensive testing and monitoring. In the meantime, more thought should be given to helping children particularly from poor backgrounds to `access study materials, for example through the loan of computers. On line learning to support home teaching has made huge strides but can also be further refined and developed. Psychological support for children should also be made available through the NHS and delivered via the internet.

  1. https://www.theguardian.com/education/2020/apr/20/thousands-urge-uk-government-to-keep-schools-closed
  2. https://www.theguardian.com/world/2020/apr/30/coronavirus-scientists-caution-against-reopening-schools
  3. https://www.nejm.org/doi/full/10.1056/NEJMc2007800?query=TOC

John Puntis is Co-chair Keep Our NHS Public