Was scrapping contact tracing in schools a mistake?

Rising coronavirus cases put spotlight on whether antigen tests would afford defence

The decision of a Wexford primary school to send pupils home because of high Covid-19 case numbers puts the new policy of not contact tracing infected classes under the spotlight.

Rising numbers of positive cases across all ages of the population has raised questions about the policy for schools, which the Health Service Executive has said are low-risk settings for transmission.

When does the rising number of cases in a classroom constitute a class outbreak that requires the testing of all pupils to determine if the virus is spreading in a classroom?

And if a whole class is deemed to be close contacts of an infected student, does that mean many children who are well must stay home and miss school for a prolonged period?

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One could hear the frustration in Vicky Barron’s voice, the principal of CBS primary school in Wexford, when she spoke about the challenge of managing a growing number of cases.

A first case was detected in a class on October 8th followed by a few more over subsequent days. It was not until October 12th until the HSE sent the entire class to be tested as close contacts.

On Sunday, the school’s board decided to send all pupils home for remote learning until next month. The school now has 34 cases.

"The HSE say this is not a school outbreak, but then what is it? It didn't come out of the walls. Somebody brought it into the room," Barron told RTÉ Radio.

Since September 27th, routine contact tracing has no longer been taking place for close contacts among children aged 12 years and younger in primary schools and creches.

This came about because large numbers of healthy children were forced to stay at home for up to 17 days when public health officials saw no risk of transmission from asymptomatic children.

But rising case numbers across all age groups means that inevitably more cases are emerging in schools.

"The more contact testing and tracing you do, the less likely you're going to have transmission," said Prof Kingston Mills, immunologist at Trinity College Dublin.

“But, on the other side, some people’s view is that there isn’t much transmission in schools. Obviously this argues against that if there is such a significant number of cases in one school.”

Home testing

HSE testing and tracing lead executive Niamh O’Beirne said the National Public Health Emergency Team would look at the data, but the policy had to balance the impact of excluding children from school.

At the Wexford school, parents had, like many others, resorted to their own defence by carrying out antigen tests at home and alerting the school to more detected cases.

School principals were puzzled by last month’s change when they went from managing dozens of close contacts and potential asymptomatic cases among students to none almost overnight.

"It just seemed like a very sudden measure without a further mitigation measure like antigen tests," said Simon Lewis, principal of the Educate Together primary school in Carlow Town.

“I know there always has to be balance but if you remove something there is a consequence and you are going to miss cases, however small they might be. It looks like this has backfired.”