Sarah has worked as a teacher for decades and loves her job but this year something has shifted — she is anxious about returning to the classroom in 2022.
“I just can’t get a picture in my head of how schools can be safe,” says Sarah (not her real name), who teaches language to around 120 primary-aged children each day at a South Australian public school.
With a significant number of her students from disadvantaged backgrounds, Sarah — now in her 60s, healthy and triple vaccinated – knows that effective teaching relies on deep connection with these kids and that doesn’t happen from a distance.
“Being a primary school teacher is all about being a close contact, down on the ground with the little ones in a circle on the floor, being right there. It’s an essential part of the teaching process,” she says.
“It is about showing your face, making a child know ‘I’m looking at you, I’m talking to you, I am making you feel as if I am really engaging with your learning’.”
It’s not a scenario that responds well to masks and social distancing. Add in kids with language or other social and cultural differences and that close, empathetic contact just can’t be replaced.
With less than a month to go until millions of Australian children are due to head back to campus, Prime Minister Scott Morrison adamant there will be no wriggle room on dates.
Yet Queensland Premier Annastacia Palaszczuk took the leap yesterday, confirming students in her state would face a delayed start to the 2022 school year as the Omicron wave peaked.
In NSW, Premier Dominic Perrottet has said a delayed return will not be considered. But with health and education departments in NSW and other states still locked behind closed doors nailing down their COVID school strategies it remains difficult to know just what the new school year will look like and how students and teachers can learn and work safely.
Many families and educators like Sarah feel they have been left with an information vacuum. The level of anxiety over what lies ahead is palpable.
Even the vaccination rollout for five-to-11 year olds, which begins today, has done little to calm rising concern.
Hit up a few groups on social media and the chat among parents and teachers centres around fears that every classroom in the country will quickly become a mini COVID super-spreader event once children are back on campus at the end of the month.
“Does anyone know when it will be safe to go back to work?” one teacher posted. “Are you thinking a staggered return to reduce the sudden wave of COVID?”
“Is anybody else feeling exasperated that the government is not addressing the fact that our young kids will not have access to vaccines in time for school reopening?” wrote a mother, concerned her daughter will only have one dose.
The transmissibility of Omicron – which has seen official records of daily infections surge into the tens-of-thousands in several states — does make it feel inevitable that COVID spread in a school setting will define the start of 2022.
Can schools open safely?
Experts like Professor Catherine Bennett – Deakin University’s Chair in Epidemiology — believes returning to school this year will be a puzzle that should draw together lessons from overseas, the science of what we know about Omicron and advice from research compiled by OzSage, NCIRS and the Doherty Institute.
“It’s about trying to reduce the risk of kids being infected but not being overly anxious,” says Bennett. “It’s trying to get the balance, right.”
Yet finding that balance is far from easy. The OzSage report includes data from the UK suggesting one-in-100 children with COVID required hospitalisation during the second wave and notes UK data showing between one in 20,000 and one in 50,000 cases of COVID in children is fatal. Add to that small number of kids likely to suffer from so-called long COVID.
It must also be emphasised that a child’s risk of death from COVID in Australia, while always tragic, is very rare.
Statistics from the federal Department of Health show just three children aged under 19 have passed away from COVID-19 from an estimated 137,000 cases.
Nevertheless, it is prudent to consider what a picture of safe school life this year might look like. It is likely to be broken into three categories:
- Building defences with vaccination
- Understanding the source of risk with testing
- Blocking spread with ventilation and masking
The magic ingredient, Bennett believes, will be a nimble and flexible attitude to “dial up and dial down” precautions as the virus moves.
Karina Powers, an occupational and environmental physician who specialises in understanding safe work environments, agrees. She adds that maintaining hybrid education models that allow children to learn from school, or from home, are also important to allow for periods of infection as well as an individual family’s appetite for risk.
Bennett says that while COVID won’t be everywhere all the time “there’ll be certainly places where we’ve still got high infection rates with Omicron to manage”.
“It might move through different parts of the community. It might move to a regional town after it started to really ease off in Melbourne, for example,” she says. “You’re still going to have situations where your current risk situation, whichever state or regional town or big city you live in, will determine what’s required with a focus to keep kids in school. That’s what 2022 is about.”
This is the problem
The problem, believe Bennett and Powers, is that Australia is nowhere near close enough to being in control.
Vaccination for the 5-to-11 age cohort is only just underway, access to testing is in chaos, masking in schools remains controversial and ventilating classrooms is not even a conversation some states are having.
“For pandemic disease, your best chance at controlling the spread is to use every level of control you can which includes everything from vaccination and safe indoor air, right down to personal protective equipment,” says Powers, a member of OzSage, a network of experts on COVID-19.
A structure that can offer part of the answer lies in ensuring schools apply layers of protection designed to block infection and catch cases early, a concept known as the Hierarchy of Controls, Powers says, which underpins the ‘vaccine-plus’ strategy advocated by the UK and experts like Raina MacIntyre, also an OzSage member.
Here’s what a safe schools strategy might look like:
Bennett says right now is the time to focus on vaccination and argues that with children 5-to-11 eligible from today, getting vaccinated sooner rather than later means the safer schools will be.
“The data we’ve just got out of the UK shows that even the first dose can make a difference in reducing symptomatic infection,” she says. “But it will take a while to get the benefit of that.”
Bennett explains that research is showing that two weeks on from the first dose there is around 20 per cent protection against infection.
It might not seem much, she notes, but argues at a population level a 20 per cent risk reduction is significant. “That’s really helpful if you’re trying to manage risk in schools,” she says.
Building her argument for vaccination, Bennett urges not to underestimate the importance of a child’s parents being vaccinated and boosted as a bulwark against spread.
“If parents are boosted it will mean less children getting exposed at home and bringing it to school,” she says. “So if those things come together – boosters for adults, double vaccination for teenagers, first doses for young children – then hopefully we’ll see ourselves in a different position over January.”
While Bennett emphasises 2022 is going to be different, she remains steadfast: “I think there’ll be a bit of a reset and we’ll have to deal with schools in a different way but the aim should absolutely be to keep the to keep kids in school not to close school as your first response.”
Powers agrees that vaccination is crucial for school-aged children, and points to US research that shows “a lot of the children sitting in hospital were the ones who were not vaccinated. It’s really clear vaccination protects children.”
“Ideally children would not be physically going back [to school] and into a situation which could lead them to become infected,” she says. “Ideally, they would be double vaccinated.”
But vaccination aside, the 2021 scenario in which schools or classrooms are closed down the moment a child or teacher tests positive is impossible this year. With so much COVID circulating it would be unworkable.
Bennett supports a refocus on the UK system of “test-to-stay” – a strategy that encourages wide testing with a view to keeping as many children as possible at school. It was floated for NSW last year but not widely implemented, partly because of RAT supply. NSW Premier Dominic Perrottet has implied RAT tests will be part of the return-to-school plan when it is made public.
“If you have high infection in the community, then you do random screening in schools. If you have a known exposure in the classroom, you get those close contact kids tested to stay like they did in the UK,” Bennett says.
So how would that work in practice?
Imagine a 10-year-old boy, let’s call him James, has a big sister who has tested positive. Here is a scenario of what Bennett advises might happen next.
James, his sister and immediate family would go into quarantine and be tested. But back in the classroom, although the boy is absent, teaching could continue as usual.
The only exception to that is if it was feared James was in the classroom while potentially infectious – a likely situation.
But unlike 2021 when the whole class would be quarantined and PCR tests done, in 2022 a more likely structure would be to rapid test everyone in the class and assuming results were negative, lessons could continue as normal while James saw out his quarantine at home.
If the school wanted another layer of protection, then children who are likely to have been in close contact with James – maybe his good friends, or the kids who sat close to him in the classroom — could be asked to take a rapid test every morning before arriving at school.
“There won’t be so much focus on a big quarantine periods,” says Bennett. “It might be more retested the screening period but as I said, you’d only be managed I think, you know, in a much more focused way.”
However, Bennett adds that waiting for a known infection in an environment of high COVID prevalence is not going to be proactive enough.
The 2022 gold standard should be to implement a policy of random screening in schools, Bennett believes.
“You might do proactive screening, just sampling kids from classes across the school each week and and trying to catch it early,” Bennett says. “If you do catch it before someone’s infectious and passes it on to other kids in school then you don’t have an outbreak. You’re just managing exposure.”
The risk of teachers becoming exposed or infected of course delivers a deeper dilemma. While one or two children missing from class can be managed, perhaps with a hybrid home-learning model, if teachers are taken out of the equation the whole class suffers. Not to mention the workplace risk facing teaching staff.
Yet reliance on testing is an area where Australia is vulnerable, Powers says.
With rapid antigen tests hard to come by or pricey at the moment, it’s difficult to know how sufficient tests can be available to carry out the level of screening suggested.
“We do not want a situation where schools in affluent suburbs are better able to manage infection control than schools in suburbs where parents can’t afford to keep screening their kids,” says Bennett.
Scott Morrison has been adamant that RAT tests will not be supplied free and while concession card holders have been granted10 free tests every three months that won’t scoop up all families with school-aged kids. Even relatively affluent families may struggle to fit $65-70 into the weekly budget – the going price of a pack of five RAT tests – if regular testing becomes a requirement of school attendance.
“People are saying why haven’t [governments] planned for access to rapid antigen tests because there’s been plenty of time and plenty of warning,” says Powers. “It’s painful.”
Powers is sounding the alarm on another level of control that rarely gets a mention but which she believes is central to creating safe schools this year: ventilation.
“Vaccinate, vaccinate, vaccinate. Ventilate, ventilate, ventilate,” is Powers’ mantra. What she means is that along with access to vaccination children must return to school with access to safe air.
“At the beginning of this virus we focused on surfaces and sanitising etc but now our understanding of spread has switched to air but we’re not keeping up,” Powers believes.
There are two approaches to ensuring air quality and Powers advocates using both.
One is to monitor the levels of carbon dioxide in the classroom and the second is to use quality filtration devises to clean the air.
CO2 acts as a canary in the coalmine – warning when air is becoming stale and hence more likely to be harbouring a build up of virus particles if anyone in the room is unknowingly infected.
Science has shown that COVID-19 is airborne, underpinning the argument for fresh air.
Powers explains that CO2 levels in outside air sit at about 400 parts per million. “Ideally a room would sit about 600, but I would say your risk really starts to climb from about 800 parts per million on,” she says.
Monitors would identify when air was reaching a dangerous level and ventilation could be adjusted – whether that is by opening doors and windows or turning on an air filter.
Students could also benefit from these systems during bushfires or other periods when air quality dips, Powers adds.
Anyone who believes investment in infrastructure like this is a waste of time as COVID-19 is just a temporary problem fails to understand the virus, believes Powers.
“This is a marauding virus, an epidemic virus,” she says. “We keep seeing this misleading term ‘it’s endemic’ but SARS-CoV-2 is not an endemic virus and will not become an endemic virus.”
Powers says COVID will continue to attack in waves. “What we need to do is put in the controls so we do not have the next wave or if unfortunately we have a wave it will be limited,” she says. “The virus can’t spread in places where you’ve got safe indoor air or once you start an outbreak people put on a mask. It’s logical. It’s common sense.”
Also common sense is urging teachers and students to use “the best masks you can put on”, says Powers.
What can we learn from overseas?
In Australia’s favour, is the fact that we have a few weeks grace to watch on as school kids in Europe, the UK and US return to class after the new year holiday. The way the Omicron virus responds will offer new answers, unfolding in real time.
In San Francisco, strategies to contain previous COVID waves have made the city an exemplar. Yet with Omicron in the mix, return to school this week was chaotic. As well as transmission between students, hundreds of teachers were off school with infections and others are threatening to strike if working conditions are not improved.
Elsewhere in the US Omicron is “hitting kids hard”, but vaccination rates are also lower than in Australia apart from in the 5-11 age group which has been eligible for the vaccine since November.
With such a serious picture taking shape overseas, and notwithstanding vaccination rates that are lower than Australia’s, it’s growing apparent that vaccines will not be enough to quell serious spread in schools, a point that is of no surprise to experts who have consistently pushed a “vaccine plus” strategy.
In the UK, masks are required in an effort to subdue the virus. And in Denmark twice-weekly testing of students and staff is part of the plan to keep kids in classrooms when they returned from the winter holiday this week.
With just a few weeks to go until children are expecting to return to the classroom, the COVID safety message is loud and clear.
The question is, have our decision makers been listening?