Coronavirus (COVID 19): Advisory Sub-Group on Education and Children’s Issues minutes: 14 December 2021

Attendees and apologies

Advisory Group Members

• Linda Bauld (Chair)
• Catherine Agnew
• Prof Chris Chapman
• Prof Julie Fitzpatrick
• Prof Paul Flowers
• Gayle Gorman
• Gaenor Hardy
• Dona Milne
• Prof Ian Rivers
• Prof Devi Sridhar
• Diane Stockton

Apologies

• Catherine Agnew
• Prof Marion Bain
• Iona Colvin
• Prof Brigid Daniel
• Dr Eileen Scott

SG (observing)

• Victoria Ayre
• Victoria Bruce
• Michael Chalmers
• Chris Gosling
• Daniel Kleinberg
• Joanna MacDonald
• Audrey MacDougall
• Eleanor Passmore
• Dr Arlene Reynolds
• Christopher Roberts
• Gary Sutton

Secretariat

• Sam Anson
• Judith Tracey
• Judith Clark

Items and actions

Welcome

The Chair welcomed members to the meeting and provided a brief update on actions from the previous meeting.

Minute of meeting on 30 November

The minute was confirmed as an accurate record of the meeting.

Review of evidence

The sub-group considered the latest data on the state of the epidemic. The overall 7-day rate of positive cases was increasing in all age groups under 60, including increases in all children and young people age groups, but with less of an increase recorded in under 5s. The R rate was between 0.9 and 1.1 as of 23 November and 91% of the population aged 12 and over had received a first dose, with 83% fully vaccinated. It was noted that there has been good uptake of the booster vaccination in the education workforce, with higher uptake in this group compared to the population as a whole.

Early data suggesting quite high vaccine effectiveness against the Omicron variant at 2 weeks after a booster dose was welcomed. The sub-group highlighted its concern around the delay in a decision on vaccination for 5-11 year olds, with further advice from JCVI and MHRA approval awaited. They also recognised the potential supply issues while the clinical priority is for the more vulnerable age groups to get vaccination boosters.

Hospital occupancy, admissions and ICU occupancy had decreased overall in the week to 10 December. There was a slight overall increase in average hospital admissions in child age groups over the past 3 weeks. There were 88 registered COVID related deaths among the population as a whole in the week to 5 December, a decrease of 10% on the previous week. Early data on secondary attack rates and airborne transmission continued to be of some concern to sub-group members.

There was continued variation in the child case rates by local authority area, with relatively high rates observed in Falkirk, East Ayrshire, East Lothian, West Lothian, Midlothian, East Dunbartonshire, East Renfrewshire, Dumfries and Galloway,  Perth and Kinross, North Ayrshire and South Ayrshire.

Sub-group members discussed recent school absence data, which showed both an increase in the number of pupil absences due to self-isolation, and an increase in pupils who are absent as a result of precautionary decision-making by parents/carers. There was a similar pattern in these voluntary absences last year in the run-up to the school holidays, which may be linked to attempts to protect holiday visits to more vulnerable family members.

Impact of measures on younger children

The sub-group received a brief update on the impact of COVID-19 measures on younger children. It was noted that emerging data is now evidencing some of the predicted wider harms as a result of the pandemic. This included increases in developmental concerns around communication, social, and emotional needs in very young children, with key developmental milestones being missed. An increase in perinatal mental health concerns was also noted.

While more prominent among those in the most disadvantaged, these longer term harms reached across deprivation quintiles. Concern was also expressed over the significant increase in 5 year olds who were reported to be overweight or obese. The importance of holistic, in person contact for health visitors and family nurse partnerships was particularly highlighted, as virtual interactions can make it more difficult to recognise risks, including child protection issues and signs of domestic abuse.

It was noted that some 3rd sector services which support children, young people and families, but particularly young children have not restarted after lockdown. These include parent and baby groups, breastfeeding groups and services providing support in the home, which play an important role in relation to perinatal health concerns, amongst other factors.

Sub-group members emphasised that these issues continue to feature prominently in their considerations, and highlighted the importance of encouraging uptake of vaccination and lateral flow testing among those providing these services, to reduce transmission while ensuring the continuing support which these services provide to the most vulnerable.

Action – Sub-group members to consider the evidence on this in greater detail at a future meeting.

A ‘maximum mitigations’ approach in education settings

The sub-group welcomed recent statements from the First Minister and others that school and ELC closures on a national level should only be a last resort, particularly given the risk of ongoing harms to education, but also to the safety and wellbeing of more vulnerable children. The sub-group emphasised the need to consider the rights of children and young people when making any decisions on schools and ELC settings, and ensure that the approach to restrictions for children and young people is not disproportionate to restrictions for wider society.

The subgroup also said that risk of transmission outside of educational settings should be noted while households and groups mix in wider society, and additional measures applied to ELC or schools cannot address this. It remains critical to stem infection rates in local communities if we are to achieve the aim of maintaining face to face learning.

The sub-group reiterated their previous advice regarding the wider accumulated harms that children and young people had suffered as a result of the pandemic, which should continue to be taken into consideration in any decisions about further protection measures in schools and ELC settings. Evidence is growing that the pandemic has had severe social, educational and wellbeing impacts on children and young people, including on their mental health. There is also growing evidence of the impact on the very youngest children in terms of developmental delay, with potential long-term consequences.

Some of the impact of disruption to education on learning, including literacy, numeracy, and widening the attainment gap, was clearly demonstrated in the ACEL data published on the day of the meeting. It was also highlighted that the greater knowledge base regarding the impact of some mitigations on R means more informed decisions can be made when advising on proposed measures.

The options for a ‘maximum mitigations’ approach in schools and ELC settings in light of ongoing concerns around the Omicron variant were discussed, with the sub-group noting their appreciation for the existing efforts by staff and learners in terms of current protections. It was emphasised that this was not a return to the approach earlier in the pandemic given the extensive evidence on wider harms resulting from some measures.

In relation to schools, the potential benefits of a return to groupings in order to minimise the number of contacts amongst pupils were discussed in detail. While reducing the number of contacts contributes to reducing the R rate, it was noted that the main reason for introducing these previously was to reduce the number of isolations required in the event of a positive case and avoid whole class isolations. However, as the current self-isolation policy does not require this, it would no longer be proportionate where implementing groupings would cause significant disruption to learning and wellbeing.

It was highlighted that the ease of groupings varies depending on the education setting, with class groupings being relatively easy to implement in primary settings, but year group or whole senior phase groupings being potentially more appropriate in secondary settings. Given the reduced risks associated with outdoor transmission, groupings would not be proportionate in outdoor settings. There was broad agreement that, groupings should not be required on school transport given the significant resulting operational difficulties, particularly given that there were no plans to reintroduce physical distancing requirements or other similar protections on public transport.

The importance of the subsidiarity principle was also reiterated with regard to schools in particular. Headteachers and local authorities should have some flexibility to make decisions about the best approach for their individual school or setting.

The following points were also raised in discussion:

• it is important to consider the very different operational context of ELC compared to schools, though many of the same considerations apply
• given the very limited evidence for limiting specialist visitors, it was suggested that no further restrictions should be put in place, and there was particular emphasis placed on the need for visits from professionals such as social workers, youth workers, child psychologists, and speech and language therapists to continue in order to avoid wider harms. The need for tutors to visit student teachers on placement was also noted.
• due to the potential impact on national qualifications, the impact on mental health and wellbeing, and the breadth of the curriculum, there was not sufficient justification for reinstating previous restrictions on expressive arts and physical education in schools
• recent changes to the position on self-isolation in wider society were highlighted, noting that education staff will be eligible for critical national infrastructure exemptions. Separate arrangements are under consideration for ELC staff
• continuing work to increase uptake of asymptomatic testing in schools and ELC settings was welcomed, including the collaboration on communications with parental and other stakeholders, and efforts to simplify the distribution of test kits

More generally for schools, sub-group members agreed that ensuring maximum compliance with current measures, such as one-way systems, staggered start and stop times, asymptomatic testing, and the correct use of face-coverings, would help to reduce transmission, while also having a low impact on learner outcomes. The sub-group agreed that: i) minimising contacts, and ii) making any contacts safer, were the main ways to avoid the transmission of COVID between children and young people in schools, and that these needed to be combined with a pragmatic approach in order to ensure that learning and teaching could continue unhindered. 

In conclusion, sub-group members recommended that:

• learner groupings are employed as far as is practical and proportionate according to individual school or ELC contexts, in order to reduce mixing and the accompanying transmission risks
• groupings when outdoors or on public transport were not considered proportionate and should not be reinstated
• in ELC, movement of staff between rooms or settings is kept to a minimum wherever possible to reduce transmission risk
• guidance on ventilation is updated to provide greater clarity around the ratio of CO2 monitoring devices to learning, teaching and play spaces and/or reference to recommendations for ongoing monitoring. This should include clarification regarding air cleaning devices, which do not replace the need for good ventilation.
• further effort should be made to encourage greater uptake and reporting of asymptomatic testing among all staff and secondary-aged learners. All school and ELC visitors, including peripatetic staff, should be encouraged to take a lateral flow test before their visit.
• primary-aged learners who are identified as low risk contacts should be more strongly encouraged to take a lateral flow test prior to returning to school, although sub-group members recognised that this is invasive and difficult for the youngest children
• visits from professionals such as social workers, child psychologists, and speech and language therapists to continue. In person parental visits in the best interests of the child, should be considered on a case by case basis.
• in line with wider society, spectators at outdoor school sport events can continue
• as broader society shifts, associated changes may be required in education settings. Further robust data on increased paediatric admissions to hospital with SARS-CoV-2 infection from the Omicron variant should be carefully monitored by the sub-group.
• parent councils and similar groups should not meet on school premises. These groups should instead return to virtual meetings where possible
• previous restrictions on expressive arts and physical education should not be reinstated

Potential for a differentiated approach to ELC in the event of significant numbers of temporary school closures

The sub-group discussed whether there might be a need for a differentiated approach to ELC settings. It was emphasised that mass temporary closures of school and ELC settings continues to be a measure of last resort – everything possible will be done to keep schools open. Keeping ELC settings open is particularly important to avoid the wider harms of developmental and speech delays, which are a key concern for this age group.

There are particular financial challenges for the ELC sector in the event of closures, given that many providers are part of private, voluntary or independent (PVI) provision rather than being funded by a local authority. In the event that previous additional financial support from the UK government was unavailable, this might result in permanent closures for some settings due to a lack of funding, with resulting potential long term impacts on early years education.

In discussion, the following points were made:

• available evidence for the Delta variant suggested that transmission risk was lower among under 5s, however uncertainty remains around the Omicron variant.
• as with school closures, any ELC closures would have resultant workforce impacts.

The sub-group agreed that even in the event of mass temporary school closures (which would be an absolute last resort – everything possible will be done to avoid this), the subsequent harms from parallel national closures for ELC settings would not be justified from a wider harms perspective.

Action – Sub-group to keep the harm 1 risks of the Omicron variant COVID-19 for the youngest age groups under close review.

Date of next meeting

The next meeting will be held on 11 January.