A new ‘5 Tests’ to avoid an unsafe, unprepared, premature school opening

Einstein is supposed to have said that “insanity is repeating the same mistakes and expecting different results”.

While it probably wasn’t Einstein who said it, many current scientific experts are warning that the UK Government is about to ignore that adage and repeat the mistakes it has made previously over fully reopening schools. We must assess their advice, and the available evidence, and set our own clear demands over how and when more students can return to face-to-face teaching, without risking another repeat surge in infection rates.

If our demands are not met, then trade unions must use their collective strength to make sure Ministers are not able to put health, safety, and livelihoods at risk once again. As we did in January, we must resist any unsafe, unprepared, premature school opening plan.

Assess the evidence – and challenge unsafe conclusions from Government backers

In recent appearances on both BBC Breakfast and BBC Radio 5 Live,  epidemiologist Dr Deepti Gurdasani from the University of London has outlined the scientific evidence that the Government should be basing their actions upon. Her conclusion, supported by those also reached by both Independent SAGE (UK) and the Centers for Disease Control and Prevention (US), is that schools should not open further until infection rates are lower. All of them call for wider opening to be on a phased basis reflecting local community transmission rates, and, even then, only alongside appropriate additional mitigation measurements being put in place, particularly mask wearing, ventilation controls and reduced pupil numbers.

Of course, there will be other scientists arguing differently. On the Radio 5 Live recording, Dr Mike Tildesley, a member of one of the modelling subgroups of SAGE, claims that “the evidence suggests that really schools aren’t contributing significantly to community transmission, particularly primary schools”. His arguments were strongly challenged by Dr Gurdasani, who pointed out that his argument was contradicted by SAGE’s own data.

The Government will claim that their reopening plans have scientific backing. But we must question where that backing is coming from and on what evidence it is based.  For example, a January 2021 ONS Report made the much-publicised claim that  school staff were at no greater risk  than other occupations. It was shown by Dr Sarah Rasmussen to be erroneous. The Office for Statistics Regulation have since written to the ONS about the weaknesses in their conclusions and analysis. 

I am summarising below the evidence which I believe can be relied on for constructing a safe plan for a phased return to fully open schools.

Do schools and school-aged children contribute significantly to community transmission?

The fact that schools are “vectors for transmission, causing the virus to spread between households” should not really be a debate. After all, it was Boris Johnson himself who admitted this when changing his plans over school reopening at the start of January.

i)  SAGE evidence

In case there is any doubt, it’s worth starting with the evidence presented to the Prime Minister by his own SAGE advisers at the end of last year. They concluded that:

1)      “Accumulating evidence is consistent with increased transmission occurring amongst school children when schools are open”

2)      The ONS Infection Survey modelling for December, when schools were fully open, and new variants on the rise, showed that school aged children showed the highest positivity rates of all age groups.

3)      “Children and young people are more likely to bring the virus into the household than those aged 17+”

4)      “Young people (aged 2-16) are much more likely than those aged 17+ to be the first case in their household (see figures for ‘Relative External Exposure’)  

5)      “2-16 year olds are more than twice as likely to pass on the virus within their household compared to people aged 17+” (see figures for ‘Relative Transmissibility’)

ii)  Public Health England Data – and transmission amongst Primary Aged Children

The weekly PHE Influenza Surveillance graphs provide further evidence for the link between school opening and increased transmission. As pointed out by SAGE’s Task and Finish Group Report (above), there is a correlation between confirmed Covid-19 cases and school holidays, with rates dipping during the half-term school closure, for example.

The graphs also point out that, since January, clusters and outbreaks have continued to be reported in those settings where Headteachers have been under pressure to maintain high numbers in class – i.e. Nursery, Primary and Special Needs. Not only is this further evidence of a correlation between school opening and viral transmission, it is also evidence that nursery and primary settings are not protected from such risks either.

This risk of viral transmission in Primary and Early Years settings where pupil numbers are too high is also borne out in the latest positivity rates reported in the latest ONS Infection Survey. Thanks to the present lockdown measures, positivity rates have been falling across all age groups. However, the rate of fall has been slowest in the “Age 2 to School Year 6” age group.

It’s important to recognise from SAGE’s Task and Finish Group report that, while the estimated rates of test positivity and External Exposure are highest of all for secondary-aged children, the rates of Transmissibility are the same across the whole 2-16 age group. In addition, while primary-aged test positivity and External Exposure rates may have been lower than those of secondary-aged children, they were still found to be higher than those of adults aged 17+.

In short, unions and parents should not accept the argument that there are minimal risks associated with the full reopening of primary schools. This is not backed up by the UK data.

iii)  International Data – and the new variants

One argument that will be made by those arguing for a premature unsafe school reopening will be that “there is no firm evidence of school transmission”.  But the reason that UK conclusions are having to be based in good part on correlation, rather than clear cause, is because of the failure to have reliable working track and trace systems that could have provided that UK evidence!

However, there are many international studies that have provided such additional evidence, evidence which must not be ignored in the UK. I have posted links to some of these international studies in previous articles.

A recent British Medical Journal article reports on further international evidence from Israel and Italy. Both raise particular concerns about the greater transmissibility of the new variants of the virus amongst young children.

Israeli figures suggest that the spread of the “UK variant B1.1.7”  has been linked to a sharp rise in new daily cases accounted for by children aged under 10. Similar concerns have been raised by a study in northern Italy where 10% of a village’s population of 1400 were reported to have tested positive for the virus.  60% of those positive tests were from children of primary or infant school age. These young children are thought to have infected other family members.

This potential of greater transmissibility of the new variants amongst younger children is another reason to proceed with caution when it comes to reopening primary schools fully.

Vaccination must be considered separately to transmission

The UK Government must ensure that infection levels are much lower before moving to release lockdown, including starting to fully reopen schools, or we will just see a repeat of the surges seen when this was done previously.

Dr Gurdasani made these key points in her presentation to the BBC on 12 February:

1)      It’s clearly very welcome that lockdown measures have helped lower the Reproduction Number ( R ) beneath 1.0  but the latest ONS Infection Survey still estimates that 1 in 80 people in England are infected and the number of confirmed COVID-19 patients in hospital is still higher than the April 2020 peak.

2)      Vaccinated individuals may still transmit the virus, so measures to decrease and maintain low transmission rates must be in place. These must be considered separately, and in parallel, to extending the level of vaccination across the population. Remember that the vaccine is not yet licensed for use with children.

3)      High levels of transmission also provide more opportunities for mutation and replication of new variants, potentially undermining vaccination response.

4)      A good test, trace, isolate and support system must be in place to address outbreaks and maintain low levels of infections. (‘Support’ includes financial help for those isolating or stay at home to provide childcare).

5)      If the Government adopts such a careful ‘elimination’ strategy, we could return to more normal lives, as seen in e.g. Australia, but, if they don’t, then we may have to endure repeated lockdowns and restrictions for years to come.

6)      We cannot only focus on Covid deaths, again Office for National Statistics evidence confirms that around 10% of those infected are also suffering from “Long Covid” with a range of symptoms remaining after 12 weeks.

7)      Further ONS data on Long-Covid estimates around 300,000 individuals are presently suffering from “Long Covid” symptoms after 5 weeks and that includes a significant proportion (over 1 in 7) of school-aged children.

So when will it be safe to start reopening schools fully?

A range of different bodies have reached the same conclusions about what needs to be done. This should form the basis of a trade union position, with unions also using their collective strength to put these demands into practice, if necessary, to defend safety:

i)   Independent SAGE – “Data not Dates” – A Tiered Approach

I have previously reported on Independent SAGE’s proposals for a tiered reopening of schools, based on the case rates in a local authority area. In summary, their Traffic Light system proposes:

• Schools in a local authority area should begin to reopen when R is less than 1 and the incidence falls below 100 per 100,000 confirmed cases per week.

• When the rate is between 50 and 100 cases per 100k, schools should employ ‘red light’ safeguards, including:

-          Reduced class sizes either through prioritising the return of certain year groups and/or through a rota system within years whereby, at any point in time, half of pupils learn in-person and half online (with necessary provision of IT, broadband etc);

-          Wearing of masks in all classes for all school students, primary and secondary.

• When the rate is between 10 and 50 cases per 100k, schools should employ ‘amber light’ safeguards. These will allow all pupils to access full time in-person classes. However, mask wearing and banning of assemblies will be maintained.

• When the rate is below 10 cases per 100k per week, schools should employ ‘green light’ safeguards. These will remove all safeguards bar mask wearing in crowded spaces, basic social distancing and hygiene measures.

ii)   CDC Strategy for Phased Mitigation – Masks, Those At Higher Risk, Vaccination

In the US, the Centers for Disease Control and Prevention (CDC), part of the US Department of Health and Human Services, has just released a similar set of recommendations to those proposed by Independent SAGE.

Again, the CDC propose a phased approach based on the same “Traffic Light” levels of community transmission. They also stress the requirement for five key mitigation strategies to also be in place. These must be replicated in any serious plan for wider opening in the UK:

1)      Universal and correct use of masks

2)      Physical distancing

3)      Handwashing and respiratory etiquette

4)      Cleaning and maintaining healthy facilities

5)      Contact tracing in combination with isolation and quarantine

It’s important to note that the CDC are clear that “masks should be worn at all times, by all persons in school facilities, with exceptions for certain persons who, because of a disability, cannot wear a mask or wear a mask safely, or for certain settings such as while eating or drinking. Masks should be required in all classroom and non-classroom settings, including hallways, school offices, gyms, etc.”. This applies across ALL school sectors.

Staff should also remember that UK Legislation (The Personal Protective Equipment at Work Regulations 1992, Reg.4) states clearly that “Every employer SHALL ensure that suitable personal protective equipment is provided to his employees who may be exposed to a risk to their health or safety while at work except where and to the extent that such risk has been adequately controlled by other means which are equally or more effective”.

The CDC also make clear that “students, teachers, and staff who are at high risk of severe illness or who live with people at high risk should be provided virtual options”.

On Vaccination, they state that: “Teachers and school staff hold jobs critical to the continued functioning of society and are at potential occupational risk of exposure to SARS-CoV-2. In order to support safe school reopening, state, territorial, local, and tribal (STLT) officials should consider giving high priority to teachers in early phases of vaccine distribution”.

“Access to vaccination should nevertheless not be considered a condition for reopening schools for in-person instruction. Even after teachers and staff are vaccinated, schools need to continue mitigation measures for the foreseeable future, including requiring masks in schools and physical distancing”.

iii)  Parents United – Open Letter, Ventilation, Close the Digital Divide

The 'Parents United' campaign, with the backing of some of the scientists mentioned above, have issued an open letter that draws on much of the evidence outlined above and calls for a similar tiered approach to that recommended by Independent SAGE and the CDC in the US.

It also raises these important additional demands:

- mitigate risk in high infection rate areas with smaller class sizes to reduce contacts, and the risk of airborne transmission. This could be achieved by the use of rotas, or by hiring more spaces and more mental-health and education staff. 

- acknowledge airborne transmission as a significant route of transmission of Covid-19, and provide school-specific guidance and funding for mitigation, which must be drawn up in consultation with aerosol science specialists and building ventilation consultants.  Mitigations likely to be suggested include reduced class sizes, increased mask use, installation of ventilation systems or the use of portable HEPA filters, and C0₂ monitoring.

- continue to disapply section 444 of the Education Act (so that parents are not fined over a lack of school attendance owing to Coronavirus health concerns) and ensure that a comprehensive, fully resourced online learning program is available to every family who wish to continue supporting their child’s learning from home.

- close the digital divide by providing laptops and broadband to children who need them to support learning from home - whether or not this is by choice.

    iv)   Infection rates not yet low enough in most Local Authorities even for partial opening

While infection rates thankfully continue to fall, if the “10/50/100 cases per 100,000” tiered "Traffic Light" criteria are applied in the UK, then no Nation and no English Region is yet (on 15/02/21) even in the ‘red light’ zone of under 100 per 100,000 cases over a 7-day period.

The latest official data can be found from https://coronavirus.data.gov.uk/details/cases. It shows that it’s possible that by early March, the date that the UK Government may be looking at to reopen schools fully, some Upper Tier Local Authorities (UTLAs) could be in a position to safely open – but only at an initial phase of reduced numbers. Even that depends on other mitigation measures to reduce the risks of transmission also being in place.

As things stand with a month to go , as the map on the UK Government Coronavirus Data website shows, infection rates in over 3/4 of UTLAs are still too high even for the partial opening suggested by Independent SAGE, and others, once a rate of 100/100,000 is reached.

The NEU must demand no school or college reopens fully unless our demands are met

Earlier in the pandemic, the NEU clearly set out ‘5 tests’ for Government to meet before schools could safely reopen. These were not in place sufficiently in September and, thanks to Government failure, our schools and colleges DID “become hot spots for Covid-19”, just as the NEU had warned would happen in our "5 tests".

In January, to avoid our members facing a serious and imminent danger, we had to urge members to invoke their “Section 44” rights to a safe workplace. We now urgently need to put forward a new set of “5 tests” that must be met if we are to avoid those serious dangers being repeated once again.

A new set of ‘5 tests’, based on the analysis above, could be:

Test 1 : Lower numbers of Covid-19 cases

No wider opening until Covid-19 cases in a Local Authority are securely beneath the rate of 100 per 1000,000 population over a 7-day period. No more than 50% in-school attendance* until Covid-19 cases are securely beneath the rate of 50 per 1000,000 population over a 7-day period.

Test 2 : Mitigation Strategies must be in place: Social Distancing, Masks, Ventilation

We insist not only on secure distancing and bubble protocols, but also, given the greater knowledge that now exists on the significance of airborne transmission, adequate ventilation and C0₂ monitoring as well as mask wearing in classrooms in primary and secondary schools.

Test 3 : Test, Trace, Isolate, Support

Guarantees that a test, trace, isolate and support system will be in place in order to respond to outbreaks, maintain low levels of infections and support those who have to isolate or stay at home to provide childcare. We also demand additional financial support to ensure schools have the additional staffing and resources needed for a safe phased return and to put in place a recovery curriculum that meets the needs of all students.

Test 4 : Whole school strategy

In addition to the overarching demands in these new ‘5 tests’, we insist on clear agreed risk assessments that ensure acceptable measures are in place in every workplace.

Test 5 : Protection for the vulnerable

Students and staff who are at high risk of severe illness, or who live with people at high risk should be able to work from home, using the teaching and learning methods developed over the last year.

This time, for the sake of the health, safety and welfare of staff, students, and our wider school communities, we must insist these tests are fully met.

* I have amended the wording of "Test One" from the initial "No full opening until ..." in order to leave no room for misinterpretation. This is based on the Independent SAGE proposals detailed above.

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