Covid-19: Close contact rules for children under 13 to be relaxed from Monday

Children under 13 who are close contacts of confirmed Covid-19 cases in primary schools or childcare settings will no longer be required to self-isolate from September 27th if they are symptom-free.

The move means thousands of children who have been forced to isolate at home will be able to return to class.

However, country's largest teachers' union has called for a delay on easing test and tracing rules until there is "reliable" data.

Public health advice remains unchanged for any child under 13 with Covid-19 symtoms. They are advised to self-isolate, not attend school and get tested.

The measures, announced on Wednesday by Minister for Health Stephen Donnelly, will not apply to children who are household close contacts of positive cases due to the higher risk of disease transmission in these settings.  Such children will still be required to restrict movements and get tested, regardless of symptomatic status. This includes children on a sleep-over, for example.

The changes will also mean automatic contact tracing of close contacts and testing of asymptomatic close contacts in childcare facilities and primary education will be discontinued, with the exception of special education settings.

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In a statement, Mr Donnelly said he had accepted National Public Health Emergency Team recommendations in relation to measures for contact tracing and testing for childcare and primary schools. He said the new measures will come into effect from Monday.

He said children aged 12 or under, “who are identified as close contacts in childcare, educational settings, special education settings or other non-household settings and who are asymptomatic will no longer be required to restrict movements, unless indicated by the local public health team”.

However “children aged 12 years or under who are identified as household close contacts in household settings will still be required to restrict movements and get tested, regardless of symptomatic status.

“ Public health advice remains that any child aged 12 years or under who displays symptoms consistent with Covid-19 should rapidly self-isolate and not attend school or to socialise until 48 hours after they are symptom free”.

Mr Donnelly said: “The latest data indicates that schools continue to be a low-risk environment for transmission of Covid-19. As such, I am happy to be in a position today to announce these significant updates to contact tracing in our school environments.”

Right Time

Chief Medical Officer Dr Tony Holohan said the National Public Health Emergency Team is reassured that the reopening of schools has not led to an increase in transmission of Covid-19 among school-going children or more widely across the population.

"This is good news for students, parents and all those involved in the education of our children," he said.

“As always, we will keep disease transmission in the population under review, but given the importance of education for our children we feel that now is the right time to evolve our approach to the public health management of Covid-19 in educational settings.”

Public health sources believe an increase in detected cases among primary school in recent weeks has been linked to a four-fold increase in testing and say case numbers have stabilised over the last 10 days or so.

However, some public health experts were criticial of the move which they said would lead to many more cases.

Prof Anthony Staines, professor in health systems at Dublin City University, said: "The plan is clearly to encourage infection in children, by not taking any effective measures. There are no masks in primary schools, no air filtration anywhere and limited monitoring of ventilation."

The relaxation of test and tracing rules at primary level comes as the Department of Health reported 1,432 new cases of Covid-19 with 30 deaths in past week. There were 272 Covid patients in hospital and 63 in ICU.

In a separate statement, the HSE confirmed the changes to the contact tracing and testing protocols will apply to hildren aged between three months and under 13 years. It said from Monday routine contact tracing “of asymptomatic close contacts among children in settings such as childcare facilities, primary education and social and sporting groups will no longer take place”.

Transmission uncommon

However it said children with symptoms should still self-isolate and get tested.

Dr John Cuddihy, National Clinical Director of Health Protection said, “Investigation of cases identified in school settings suggest that child to child transmission in schools is uncommon and not the primary cause of Sars-CoV-2 infection in children, particularly in preschool and primary schools. Children are rarely identified as the route of transmission of infection in to the household setting and children are not more likely than adults to spread infection to others”.

He said the change means children without symptoms will not have to restrict their movements or need to be tested,. He said if there are particular outbreaks children may still be designated as close contacts.

“Cases and outbreaks in Special Educational Needs (SEN) settings, respite care or residential settings and similar, will still require a Public Health Risk Assessment”.

Dr Abigail Collins, National Public Health Clinical Lead for Child Health said from Monday testing will focus on children with clinically relevant symptomatic disease.  “Parents who are concerned that their children may have symptoms of Covid-19 should immediately ensure their child self-isolates and they should phone their GP for advice and guidance, and COVID-19 testing if clinically appropriate”.

She said the HSE was “extremely conscious of the impact that periods of absence from school have on children’s educational, social and emotional well-being”

Unions

However, it has sparked concern among school staff unions who say it is too early to ease test and tracing protocols.

The increased number of cases among primary school students since schools reopened has been resulting in about 1,200 children being forced to restrict their movements every day.

However, latest data gathered by public health authorities indicates that Covid-19 cases in schools have stabilised over the past 10 days or so, according to well-placed sources.

While there was a significant increase in positive cases among children of primary school age in the first two weeks of the school year, latest public health data indicates that most of this was down to a four-fold expansion in testing which picked up additional cases.

Unions representing teachers and special needs assistants, however, are nervous about such a move.

Responding to the announcement on Wednesday, the Irish National Teachers’ Organisation (INTO) said the proposed changes to contact tracing should be deferred “until reliable data on outbreaks in primary schools is available”. It proposes that any change should be made from November 1st when the schools reopen after mid-term break. “This would allow time for better data to be obtained and sufficient time for considered analysis and to allow for the proposed changes to be implemented in an orderly fashion.”

By contrast, Fórsa, which represents about 14,000 school staff including special needs assistants (SNAs), welcomed the changes on the basis that students in special education settings are excluded.

It said the easing of measures in mainstream schools will reduce the large numbers of students without symptoms who are currently excluded from classes.

Separately, health authorities have sought to clarify advice on whether a runny nose is a symptom of Covid-19.

Department of Education advice lists a runny nose as an “uncommon” symtom of Covid-19, while HSE advice says it is “usually okay” to send a child with a runny nose or sneeze to school

Dr Colm Henry, the HSE’s chief clinical officer, said parents should be concerned if a child has a runny nose accompanied other symtoms by a fever, a new cough or shortness of breath.

However, if a child only has a runny nose, they can continue to attend “under observation”.