Treating ‘every blocked nose as though it’s Covid’ will ‘paralyse’ our education system, says public health expert

School Covid cases are linked to increasing infection rates in communities rather than pupil transmission, experts say.

With close to 300 Greater Manchester schools reporting confirmed cases since pupils returned at the beginning of the month, concerns have been raised over children transmitting the virus in classrooms.

But experts say that evidence so far shows that schools are seeing outbreaks when there’s an increase in infection rates in wider communities – and the cases that have appeared in some schools aren’t typically linked.

Dr Heather Catt, a clinical lecturer in public health at The University of Manchester, said: “I can’t talk for all areas, but what I’ve seen happening generally is that as there has been an increase in the community, there has been increase in school cases. I’m not aware of any major outbreaks that have been in schools.

“Most of the ones I’ve heard about are just related to an increase of cases in the community.”

Back in August, as the Prime Minister insisted he wanted all schools to reopen in September, government medical officers said that although transmission does occur in schools, it’s ‘probably not a common route’ for it to spread – and ‘it may be lower in primary age children than secondary age children’.

Recent events have backed that up, says Dr Catt.

“It does seem that children under 11 do not transmit the virus particularly well,” she said. “Whereas the secondary age group – at some point but we don’t know at what age this starts – but they start to transmit just as an adult does.”

Public Health England (PHE) collects data on infection rates and overall cases of Covid, including those in schools.

Dr Matthieu Pegorie, consultant in health protection at PHE, reiterated that community infection rates are behind the rise in school cases.

He said: “Our records suggest that the number of outbreaks in schools tends to reflect the rate of infection in the wider community. The more cases there are in an area, the more likely it is we will see cases in schools as well.

“Reducing the spread of COVID-19 in the community will help prevent cases in schools. That means it is more important than ever that people continue to follow the government’s advice on social distancing, hand hygiene and other infection control measures.”

Dr Catt, an epidemiologist and public health registrar, says she can understand why parents and teachers are concerned about the number of cases in schools, but feels both have ‘perhaps been too risk averse’ – particularly when it comes to sending whole year groups home following one positive case.

“There is so much confusion, it’s all so new and so complicated,” she said. “Even those of us who work in public health are scratching our heads every day as it is so complicated and it’s not just schools finding it difficult.

“I can completely understand the anxiety about it, but the key message is that Covid is vanishingly rare in this age group.

“Children, as a general rule, do not get severely ill – it’s very rare for anybody young, under 25, to get severely ill with this.

“From a parent’s point of view they are understandably concerned about their children but the risks are very small.

“All the restrictions and guidelines that are in place are to stop it spreading among the groups where there is a greater risk and people are more vulnerable.”

Stressing that pupils should only be sent home with one or more of the three main symptoms – a fever, loss of taste or smell and a persistent dry cough – she’s aware of children being sent home with the usual back to school ‘sniffles’. 

“Schools are definitely finding their way with this,” she said. “When you hear about bubbles with 100 plus children going home, if schools are going to use that every single time there’s a positive case then children are hardly going to be in school.

“There’s been a element of schools being risk averse. I know it’s easy for me to say from a distance they should only send home children with any of the three symptoms and they shouldn’t send them all for tests – if it’s your kids and it’s your school I can completely understand why they are risk averse – but they should be doing individual risk assessments in every situation to decide whether it’s necessary to send home an entire bubble. 

“I understand it’s harder work to do that investigation and identify the close contacts, but we’ve got to balance the pandemic and the kids’ education – making sure they get that education is going to be difficult if they’re sent home.”

Over recent weeks the Manchester Evening News has been keeping an up-to-date account of school bubble closures across the region.

In some instances, a positive case in one high school year group has meant hundreds of children being sent home to self-isolate.

And in primaries, where some have made bubbles from multiple year groups, one confirmed test has seen numerous classes sent home.

It’s something that Dr Catt thinks we’ll see less of in the coming weeks. 

“I think we’ll see that less and less over next month as schools get used to dealing with positive cases and balancing the risks,” she said.

“I think their risk perception is going to shift. We’ve started out with not taking any risk at all – send the children home then work it out. But as we’re going along they’re becoming a bit more nuanced about how they’re doing it and working out the close contacts rather than sending everyone home.