COVID-19 and education settings: last week’s scientific briefing

By Eddie Playfair on

AoC was represented at the independent scientific & technical panel briefing last Friday, together with other education stakeholders This was the day after the publication of the guidance on maintaining education and skills training provision.

We heard from the Chief Medical Officer, the Chief Scientific Adviser and the President of the Royal College of Pediatrics & Child Health and they shared what is and isn’t known about the potential risk levels in educational settings.

What is known

In the UK, the number of new cases, hospital admissions and deaths are all on a downward trajectory. At the moment, the Reproduction factor (R) is between 0.7 and 1.0. An R of less than 1 means the number of new cases is reducing.

There is currently a 0.27% prevalence of the disease in the population (between 2 and 3 per thousand). The ‘halving time’ is roughly 2 weeks at the moment. This means that in 2 weeks’ time there should be half as many cases as now.

Age and co-morbidities (underlying conditions) are the most important risk factors. The increased risk for BAME people is at least partly a result of the socio-economic gradient of infection with the more disadvantaged at more risk, as with so many other health indicators. BAME groups also start with a higher incidence of co-morbidities such as diabetes and Cardiovascular Disease (CVD).

Children and young people are the least clinically affected. Far fewer children get the disease, and those who do are at far less risk; so far in the UK, 300-400 under-18’s have been hospitalised and there have been less than 10 deaths. So, it’s clear that the risk to children is much lower than for adults and this rises steeply with age.

What is less clear

Although scientists around the world are working to better understand COVID-19 and its spread, there is much we still don’t know. Things which still need to be better understood include:

How infectious children and young people can be. Their infection rate and transmission rate are not higher than those of adults. They may be lower, but the evidence is not definitive.

We need to know a lot more about children and young people’s response to COVID-19, their ability to contract it asymptomatically and transmit it to others.

Studies in Holland, Iceland and New South Wales suggest low transmission from children to adults, these are mostly small scale and from early in the pandemic.

It seems that the current very low level of attendance in schools and colleges hasn’t had a significant impact on the R value, but there isn’t yet enough modelling of the impact of larger numbers returning. There is a suggestion that the return of younger children might have less impact than the return of older children.

More interaction and more mixing between people clearly increases the risk of transmission and this is why it is included in the hierarchy of protective measures to manage the risk of transmission. This also includes minimising contact with individuals who are unwell and increased cleaning and good hand and respiratory hygiene.

Reducing interaction and mixing in college settings is going to be a real challenge and the creation of small consistent grouping or ‘bubbles’ is very difficult. In colleges, students generally need to move between different groupings and spaces., They also exercise more discretion in their use of time outside timetabled sessions, with significant use of social and independent learning spaces. Colleges also often include adult students as well as young people.

Colleges planning for increased attendance on site

As they plan for any increased attendance on site, whether before or after the summer break, colleges will want to prioritise the safety of their students and staff, as well as that of their wider communities. The guidance gives colleges the flexibility they need to find the right balance between on-line and on-site learning and to establish new arrangements to be able to operate safely. All of this will need to be communicated clearly to students, staff, and parents/carers in a way which builds confidence and trust at a time of uncertainty and fear.

While there is clearly a lot still to be learnt about the prevalence of infectiousness, particularly among asymptomatic younger people, colleges need to understand the various levels of risk of different settings and activities. Even with adequate social distancing, are there issues associated with large numbers of people sharing spaces such as canteens, libraries, learning centres, gyms, changing rooms, circulation and social spaces, entrances, buses and bus stops? Are there issues associated with spending extended periods of time with the same people in one classroom or exam room and how do these compare to moving between spaces shared with different combinations of people?

Looking ahead, colleges will also need to know what kind of testing regime would ensure that a college campus can continue to be safe for all those who attend on site.

Given the incremental way our understanding grows, there is unlikely to be a single breakthrough moment when everything becomes clear. So, it’s important to have a continuing dialogue on these key questions with the experts and with students and staff as this will help to inform college decisions over the next weeks and months.

Eddie Playfair – Senior Policy Manager