How safe are our primary schools amid latest Covid wave?

John Weir, the principal of St Mary's Parish Primary School in Bryanstown in Drogheda, Co Louth, is looking through the school's roll book. He can't remember a time when so many children and staff were out of school.

“We’ve seen a massive spike in Covid cases in recent times,” he says. “In some classes there has been close to 50 per cent attendance . . . There are Covid cases, precautionary absences, children waiting on tests, other illnesses. For others, we just don’t know until mum or dad tells us.”

Overall, the school has averaged an overall non-attendance rate of about 15 per cent for November, significantly higher than normal.

“We’re doing everything to minimise the spread within the school with the prevention measures, but the hard part is keeping it out of the school . . . Many parents are confused about when they can and can’t send their children into school. The guidance is being constantly updated.”

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The school, he says, has managed to limit transmission within pods to a few cases by acting swiftly when positive cases have been identified, but it feels like a constant battle. The mantra from Government that “schools are safe” doesn’t wash with him.

“These children are the only unvaccinated group left in society. Children are in rooms with 28 others for six or seven hours a day. You’re dealing with unmasked children. So, it’s very hard to see that they are ‘safe’.”

Highest infection

Latest figures released this week show that primary school-aged children now have the highest Covid-19 incidence of any age group, with some 10,000 positive cases in the past fortnight.

A report from the Health Protection Surveillance Centre (HPSC) notes that the infection rate for primary school-aged children has been rising since mid-October.

Many schools have been struggling to keep classes open due to staff shortages linked to high rates of sick leave or teachers being forced to self-isolate due to the virus. Tens of thousands of primary children nationally are estimated to be out of school as well.

The scale of the infection rate among young people has prompted urgent questions about how safe primary schools really are.

Are risk mitigation measures such as handwashing, opening windows and – potentially – face masks for the over-9s enough to combat the spread of the virus?

In primary school staff rooms this week, rumours once again swirled around circuit-breakers and potential school closures.

Remarks by Dr Ronan Glynn – the State's deputy chief medical officer – that "schools are not as safe now as they were" seemed to back up many teachers' long-standing concerns.

The country’s largest primary teachers’ union, the Irish National Teachers’ Organisation (INTO), earlier this week warned that the system that was “creaking at the seams” and that teachers had been “abandoned”.

However, public health experts are convinced schools remain a low risk for transmission of the disease.

They have briefed the Government that most of the infection among children is coming from parents, household contacts and the community, rather than within schools.

The latest HPSC report, for example, says increases in the virus among pre-school and primary-aged children have been broadly consistent with increases across other age groups since mid-October.

“The risk of onward transmission from undetected asymptomatic cases within the school setting remains low,” it states.

Risk

Dr Abigail Collins, consultant in public health medicine and the HSE's clinical lead on child health, endorses this. When asked if schools are "safe", she says public health experts tend to avoid such terms.

“We deal with risk assessment. With the right measures in place – such as keeping those with symptoms away from school and having infection controls in place – schools are low risk settings for onward spread of Covid-19,” says Dr Collins.

If schools really are such a low risk, why have the Covid-19 rates among five- to 12-year-olds trebled in the last two months?

Dr Collins points to a number of factors at play. If there is a high incidence of cases in the wider society, children will get it too via household or community transmission, she says.

Children are also the only remaining unvaccinated group in the population. In addition, she says, children tend to get tested more, because there is a strong motivation for parents to do so.

“Even now, the proportion of primary children testing positive is quite stable. The numbers are going up for all age groups . . . Are schools or classrooms amplification settings? It’s not what we’re seeing or experiencing.”

She points to trends in coronavirus data since schools reopened in September to illustrate the point.

Positive cases among children rose in early September when schools reopened, but stabilised and fell a few weeks later.

This rise, she says, was likely the result of a major spike in testing which detected asymptomatic cases that would not have been picked up otherwise.

Dr Collins says cases only began to rise significantly among primary school children into October when society began to fully reopen.

“You can see on the graphs that the adult cases went up, followed by children a little bit afterwards. That’s not a surprise. Children are part of the community. If there are high numbers in the community, there will be high numbers among children.”

Sceptical

Many principals and teachers, however, are sceptical about official coronavirus figures and have a nagging suspicion that school cases are not being properly recorded.

John Boyle of the INTO claims the removal of routine testing and tracing from schools in late September has concealed the escalation of positive case numbers among pupils and staff in primary schools.

“It simply cannot be a coincidence that the number of five- to 12-year-old children contracting the virus has trebled since crucial public health supports were removed from the primary sector less than two months ago, abandoning teachers and principals to protect themselves and their unmasked, unvaccinated pupils from the impact of the highest wave of infection in their schools since the pandemic began,” Mr Boyle says.

Some principals and teachers also point to official HPSC figures on outbreaks in schools to bolster their case: under the old testing and tracing regime, up to 90 outbreaks were being detected in a single week during in September.

Yet last week, without routine contact tracing in schools, just 24 outbreaks were detected.

Dr Collins accepts that public health authorities do not have the same level of oversight or visibility of outbreaks than they did under the old testing and tracing regime.

However, she says that in outbreaks where there is a public health response, the majority involve just a handful of cases.

Where there are high-profile examples of major outbreaks in schools, she says, they tend to have their origin in events outside school which a cluster of children or families have attended, such as a party or event.

“Society has opened up . . . That’s not anyone’s fault, but this is what drives transmission,” she says.

The other major risk is a Covid-positive child or staff member remaining in school, undetected, for a significant period of time.

Many principals and teachers say they want a return of contact tracing at primary level, which they believe will make schools safer by being able to hunt down the virus. They are convinced the system was relaxed too early because the system couldn’t cope with the volume of contact tracing required.

Dr Collins, however, argues that the system was unfairly leading to the exclusion of thousands of close contacts of positive cases in schools. Low transmission rates meant the vast majority – about 98 per cent – were testing negative.

She says authorities are “extremely conscious of the impact that periods of absence from school have on children’s educational, social and emotional well-being”.

In any case, she says the usefulness of contact tracing when there are large volumes of cases in the community is “blunted” and public health messaging becomes more important.

“So, public health messages such as ensuring that any child with symptoms of Covid-19 – including a new cough, shortness of breath, high temperature, sore throat – self-isolates and gets a PCR test are so important. That is overwhelmingly the most important thing to do right now.”

School closures

As for rumours about schools closing, they are are just that.

“There are very clear international recommendations that schools should be the last places to close and the first to reopen. I think a lot would need to close first before that would ever be considered,” she says.

Matt Melvin, principal of St Etchen's National School in Kinnegad, Co Westmeath, meanwhile, is focused on getting through the next few weeks to Christmas. It has been a case of all hands on deck in recent times,

“I’ve been a teacher, an SNA, a bus escort, a cleaner this week – and a principal,” he says, with a smile.

His school has been battling with staff shortages and Covid cases, but he is optimistic for the future.

“We’ve had cases in school recently – but schools are only a reflection of society. This is one for wider society to get a grip on,” he says.

At St Etchen’s, he says, the risk mitigation measures seem to be working: keeping windows open, limiting pupils to pods and using carbon dioxide monitors.

“We’re not seeing transmission within school, but we’ve had cases. The children are very compliant. They wash their hands, they stay in their pods and they’ll wear face masks if required,”he says.

“They keep an eye on the carbon dioxide monitors and if they go orange, we go out for 10 minutes . . . As far as I’m concerned, the school is calm, secure and safe. The children through this have been great. If the rest of society was half as compliant, we’d be in a much better position.”