COVID-19 the use of face masks in schools: FOI release

Information requested

I would like a copy of all the scientific data showing the use of face masks in schools. This information must include the following:

1. The scientific peer reviewed paper/papers and/or studies which the Scottish Government base their use of face coverings to stop the spread of Covid-19.
2. The scientific data that proves that wearing any type of face covering reduces the spread of any and all respiratory viruses which specifically includes Covid-19 within a school setting.
3. As the Scottish government have continued the use of face coverings please supply the scientific reviewed analysis which the Scottish Government use versus any and all scientific evidence that the English Government have used when removing the use of face coverings.
4. The risk assessment for forcing school children of any age to wear a face covering during school hours.

Response

The answer to your request is as follows:

1.  Policy decisions on mitigation measures have always been informed by advice provided by the Scottish Government’s Covid-19 Advisory Group, the Covid-19 Advisory Sub-Group on Education and Children’s Issues, the Scientific Advisory Group for Emergencies (SAGE) and the World Health Organisation (WHO).

I have listed the advice which has served to inform the Scottish Government’s position on the use of face coverings in all age cohorts, including children and young people, throughout the pandemic:

On 21 April 2020, the SAGE meeting number 27 considered DELVE group paper on face masks for the general public. The paper highlighted that asymptomatic and pre-symptomatic individuals are infectious and that droplets from infected individuals are a major mode of
transmission. Therefore, they concluded that face masks can be a tool for managing community transmission of COVID-19 within the general population.

Based on the above, SAGE concluded in meeting number 27, held on 21 April 2020, that evidence for using face cloth coverings in the community for source control and protection is weak. However, they could be recommended as a precautionary measure in high-risk indoor settings where it is not possible to follow social distancing measures.

On 28 April 2020, SAGE Environmental and Modelling Group (EMG) published the paper environmental influence on transmission. This paper looked at transmission through airborne, droplet and contact routes and considered the evidence relating to different mitigating measures. They advised that face coverings could be another mitigation in place, especially when 2-metre distancing cannot be maintained.

On 4 June 2020, SAGE discussed mitigating measures which included the use of face coverings. You can find further information in the meeting minutes which are available on the UK Government website here.

On 5 June 2020, updated December 2020, the World Health Organisation (WHO) released updated advice on the use of face coverings. The guidance advised that, to prevent Covid-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear face coverings in specific situations and settings as part of comprehensive approach to suppress Covid-19 transmission. You can find a copy of this guidance on the WHO website here.

On 22 July, SAGE published a paper on aerosol transmission, which highlighted that “[Cloth] face coverings will reduce the dispersion of respiratory droplets and small aerosols that carry the virus into the air from an infected person”. The paper also highlights the importance of face coverings to reduce asymptomatic and pre-symptomatic transmission. The paper can be found on the SAGE website here.

On 24 July 2020, UK Parliament released a summary of the relevant SAGE reports on face coverings. This can be found on the UK Parliament website here.

On 15 September, SAGE NERVTAG-EMG provided updated advice on the use of face coverings. You can find further information in the meeting minutes which are available on the UK Government website here.

On 1 October 2020, SAGE concluded that to mitigate against aerosol transmission, enhanced use of face coverings should be considered alongside ventilation for reducing far-field aerosol transmission risks. You can find further information in the meeting minutes which are available on
the UK Government website here.

On 1 December 2020 WHO published updated advice on the use of face coverings in the community. You can access the most up to date guidance from WHO here.

On 22 December 2020, SAGE meeting number 74 discussed a paper on mitigations to reduce transmissibility. The publication reinforced the importance of strengthening all mitigation measures. For face coverings, they highlighted that this mitigation is important to reduce the emission rate of small aerosols, which provides a degree of protection for individuals around the wearer.

On 8 April 2021, SAGE highlighted that studies support the continued use of face coverings for staff working in hospitality, retail and leisure sectors, especially those working at restaurants, bars and pubs are at higher risk. You can find further information in the meeting minutes which are available on the UK Government website here.

On 5 July 2021 EMG, SPI-M and SPI-B published “considerations in implementing long-term ‘baseline’ NPIs.” The key messages are that ongoing baseline measures, such as face coverings, are required to decrease the risk of transmission from an infected person. The paper also highlights the importance of quality and fit of face coverings. You can find further information in the meeting minutes which are available on the UK Government website here.

Specific infomation for children, face coverings and schools:

On 25 August 2020 the Chief Medical Officer’s Advisory Sub-group on Education and Children’s Issues published an update on face coverings in schools which further supports our current position with regards to children wearing face coverings. The update can be found here. The Advisory Sub-Group on Education and Children’s Issues published advise on the return to school in August 2021. In their publication, they state that “face coverings should continue to be worn by adults and secondary-aged pupils in classrooms, as well as in communal areas and when moving around the school building. They should also continue to be worn by adults in communal areas and when moving around the building in ELC settings”.

Face coverings and children:

On the 21 August 2020, the WHO published evidence on the use of face coverings for children within the community. This evidence can be found on the WHO website here. On 1 December 2020 WHO published updated advice on the use of face coverings in the community, including children. It reiterated its advice of 20 August (as above) and 14 September that the decision to use masks for children between 6-11 should follow a risk-based approach.

On 21 June 2021, the Scottish Government published “Working Paper: Covid-19 Mitigation Measures Among Children and Young People”. This paper summarises the available evidence base around mitigation measures for children and young people, including the use of face coverings. This paper was undertaken in response to World Health Organisation (WHO) advice that countries should monitor the impact of face coverings on young people, looking at their physical and mental health and transmission of COVID-19. This paper is kept under regular review as new evidence and data emerges.

2. The information provided for question 1 also covers your second question. However, the two links below contain specific scientific advice around types of face coverings.

Sage paper from 13 January 2021, discussed in SAGE 76, focuses on the effectiveness of fabric face coverings (which includes face coverings of 1 to 3 layers) to mitigate COVID-19. The publication reinforced that the use of face coverings can be effective in reducing transmission in public and community settings. The paper also stressed that, when worn correctly, face coverings are likely to be most effective at reducing transmission in both indoor and outdoor settings when people are likely to be close together. The paper can be found here.

The WHO recommends that face coverings are made of cloth or other textiles and should be two, and preferably three, layers thick. The WHO does not advise using face coverings with exhalation valves. 

The Scottish Government COVID-19 Advisory Group members were supportive of the SAGE 87 paper “EMG, SPI-M and SPI-B: Considerations in implementing long-term ‘baseline’ NPIs”, which discusses that the potential effectiveness of face coverings fall between medium to high effectiveness,as these can be a source of protection to the wearer and have the potential to mitigates all transmission routes. All papers from Sage 87, can be found here.

On 14 June 2021, WHO published interim guidance on the approach that countries with advanced vaccination programmes should adopt to tackle Covid-19. WHO recommends the continued use of face coverings in areas of known community or cluster transmission. In summary:

“Decision makers should apply a risk-based approach when considering the use of masks for the general public regardless of vaccination or natural immunity status. In areas of known or suspected community or cluster SARS-CoV-2 transmission: WHO advises that the general public should wear a non-medical mask in indoor (e.g., shops, shared workplaces, schools)”.

These areas of known transmission tend to have the following characteristics: close proximity with people from other households, settings where individuals stay for prolonged periods of time, high frequency of contacts, confined shared environments, poor ventilation, among others. More information can be found in the publication on factors contributing to risk of transmission from Public Health England.

SAGE 86 highlighted that studies have consistently shown that staff working in hospitality, retail and leisure sectors, especially those working at restaurants, bars and pubs are at higher risk. A transmission paper focused on the hospitality, retail and leisure sectors, discussed at SAGE 86, indicates that staff in leisure settings such as gyms and swimming pools are at greater risk than customers. Public Health England have also identified nursing homes, homeless shelters, prisons and ships, meat-packing plants and some factories as settings with the largest outbreaks across the world. The Scottish Government does not have the information you have asked for regarding decisions made by the UK Government. As Health is a devolved matter, the decision to remove the requirement to wear face coverings was made by the UK Government. I would therefore like to refer you to the UK Government's FOI page to request this information: How to make a freedom of information (FOI) request - GOV.UK (www.gov.uk).

This is a formal notice under section 17(1) of FOISA that the Scottish Government does not have the information you have requested.

4. The following risks assessments have been produced and are available here:

• Children’s rights and wellbeing impact assessment on back to school arrangements – August 2021 - http://www.gov.scot/ISBN/9781802012422
• Impact assessment on back to school arrangements – August 2021 - http://www.gov.scot/ISBN/9781802012439

Anyone (whether child, young person or adult) wishing to wear a face covering in any part of the school should be permitted to do so. Some individuals are exempt from wearing face coverings. Further information on exemptions can be found in wider Scottish Government guidance. There are circumstances that may require particularly careful consideration, e.g. involving children with ASN or deaf children. Face coverings should be worn in the following circumstances (except where an adult or child/young
person is exempt from wearing a covering):

• at all times when adults in primary schools are moving around the school in corridors, office and admin areas, canteens (except when dining) and other indoor communal areas, (including staff rooms and toilets);
• at all times for all staff and learners in secondary schools (including special schools and independent and grant aided schools); and
• in line with the updated arrangements for public transport, where adults and children and young people aged 12 and over are travelling on dedicated school transport.

The Scottish Government published guidance on 3 August that states that it continues to be the employer’s responsibility to regularly carry out workplace risk assessments, including around face coverings, for their school and put in place measures to make the workplace as safe as is reasonably practicable to try and minimise the risk to staff including contracting COVID-19. This guidance can be found here: Coronavirus (COVID-19): guidance on reducing the risks in schools - gov.scot (www.gov.scot). In addition, the educational sub-group advice takes account of all the relevant evidence and seeks to balance risks when making recommendations.

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