Almost half of Irish households have school-age children, and there is no greater concern than keeping schools open and everyone safe. The pandemic disruption has affected all children, and some have suffered deprivation and neglect.
Governments shut down education in a pandemic because it works; it has been shown that closing schools and universities is the most worthwhile of all interventions, estimated to reduce the effective reproduction number (Rt) by 38 per cent. It follows, therefore, that opening schools increases the risk substantially, and that this requires additional precautions.
With more than a million children attending preschool, primary and secondary schools, preventing infection is also a very significant part of the Government’s suppression strategy. Just one extra infection in each of Ireland’s 4,000 schools would more than double the national case count this week. So, the progress of this pandemic will be significantly determined by what is done in schools.
While the data in Ireland is limited, UK government analysis shows a pattern of increasing spread of the virus among children when schools are open. More recently, concerns about increased transmissibility of variant B117 in children are supported by data from the UK, Germany, Italy and Israel. This variant, which is up to 70 per cent more transmissible, is now dominant, making up 90 per cent of cases in Ireland, up from 25 per cent in January.
In the Netherlands, when 40 per cent of children were infected in a school outbreak, it prompted community testing of thousands of people. Initial findings showed that 80 per cent of cases with the B117 variant in the region were linked back to the school.
This pattern of children bringing infection home is repeated elsewhere: a UK government survey found that 12-16 year-olds are seven times more likely to be the first case in their households compared with those over 17 years, and they are twice as likely to pass it on.
These international studies and research are useful for understanding risk, but they are not evidence that schools are either “safe” or “unsafe”. Flying is statistically safe, but the risk of being in a plane crash comes down to the aircraft, the weather and the actions of the crew.
Similarly, no two schools are the same and danger to a child is only a factor of their school building, who is in it and precautions taken. These are in our control and can be managed.
School safety is not a short-term challenge. Vaccines are not licensed for children and are not expected to be available for 12-17 year olds before late 2021. (Pfizer is currently licensed for 16- and 17- year olds, and trials are starting for 5-11 year olds). So at best, teenagers may be vaccinated in the course of the autumn and younger children in 2022.
Consequently, schools need a prevention plan for after Easter, and they need to prepare for autumn and winter. What is to be done?
Firstly, we must acknowledge that Covid-19 is predominantly spread by breathing infected air, and not from touching surfaces. This means a targeted focus on mask-wearing and clean indoor air. Activities that are high risk such as eating, drinking, exercise and singing need to be moved outside. For some children the greater danger is in buses and family cars, so specific advice and precautions are needed to avoid unsafe transport.
Secondly, each school needs to be assessed locally to catch places at risk of crowding and poor ventilation where the virus can linger in the air for hours and where super-spread conditions can develop. This means boots on the ground with inspections and technical support.
Thirdly, air-quality monitoring devices are needed so that the right balance can be struck between comfort, energy efficiency and ventilation for public health. Carbon-dioxide (CO2) monitors are low cost, easy to use and would ensure that classrooms are adequately ventilated without being too cold. In some cases, further measure such as operational or structural changes may be required. New York City, which has more schoolchildren than Ireland, has undertaken independent inspection of all schools and ventilation reports are available to parents. Out of the 64,000 classrooms surveyed, only 3,000 had issues requiring repair or maintenance.
Fourthly, some imagination must be brought to how and where the school day is arranged. During outbreaks of Spanish flu and tuberculosis many schools moved outdoors, and more recently timetable changes and the use of other buildings (churches, museums, sports halls and libraries) have enabled activities to spread out.
This is not a time for alarm, but neither is it a time for complacency. We must deal with the reality of the disease that we’ve got, not one that might be more convenient, and we must be transparent about outbreaks and case numbers, in order to learn more about the disease and how to prevent it.
If there’s a shared objective that everything must to be done to keep schools open, then everything must be done.