Back to school – Protecting children from COVID-19 and making schools and childcare safer

Back to school – Protecting children from COVID-19 and making schools and childcare safer

Children should be at school as much as possible.  For that to happen with minimal disruption, we need a focus on what a ‘safer school’ would look like, and OzSAGE provides a plan for schools and childcare. 

All children in Australia should have the same standard of safety at school, and no child should be left behind.

OzSAGE is concerned that children and teachers have unequal levels of protection against COVID-19, depending on what State they live in.  Leading the way in the provision of safe schools is Victoria, with their purchase of 51,000 HEPA filtration units to clean the air, CO2 monitors to monitor air safety, additional funding for extra shade spaces to allow for fresh air/ outside learning alternatives and the announcement on 8 October 2021 that masks will be required from Grades 3 – 12 and strongly recommended for Kindergarten – Grade 2.   NSW Schools are conducting an audit of school buildings to determine if the windows can be opened, and require masks from Grades 7 -12.  Masks are recommended for Kindergarten – Grade 6. NSW is also encouraging as much teaching as possible to be done outside. In Queensland, high school students are required to wear masks, and students in primary school who wish to wear a mask are supported to do so, but safe indoor air has not been addressed.

A pandemic of children

We know nearly all unvaccinated individuals will eventually be exposed to COVID-19.   Worldwide, COVID-19 is now a pandemic of the unvaccinated.  At this time, about half of unvaccinated Australians are children. As at 10 October 2021 about 49% of 12 – 15 year olds have had one dose of the vaccine and only 9.09% of them are fully vaccinated. Additionally, only 34.06% of 16 – 19 year olds are fully vaccinated and 66.24% of them have had one dose. Disadvantaged children such as Aboriginal and Torres Strait Islanders, children with special needs or children living in poverty already face barriers to equitable healthcare, have lower rates of vaccination.  It is also a pandemic of medically at-risk people (some of who have been recognised by the Department of Health as in need of boosters) but are largely missing from all State Education plans for children. In NSW, an altered, less cautionary roadmap with more rapid mixing and movement of people and dropping of many community mask mandates, will likely see epidemics in schools during the last term of 2021.

Further OzSAGE is concerned that the NSW roadmap which assumes equal access to vaccines for all people in NSW does not include children under 16 years of age.  The rates of vaccination across NSW are highly varied, with the highest rates in affluent parts of Sydney, and lower rates in regional areas and less affluent parts of Sydney. Many people face barriers to vaccination, and unvaccinated people may not have access because of ongoing restricted vaccine supply. Many younger people cannot get bookings until the end of the year.

COVID-19 matters for children

If children are not adequately protected 1 – 3% of unvaccinated, infected Australian children may become hospitalised with COVID-19, and more may suffer from ongoing long COVID symptoms potentially lasting for a year or more. The Doherty model predicts over a million infections and between 29-86 deaths in unvaccinated children in the first 6 months after re-opening. Long COVID was formally recognised by the WHO on 6 October 2021 and has a wide range of associated risks, and unknown long-term effects in children, which should also be considered in relation to children and inform our precautionary approach to their protection. 

The paediatric health system, which is substantially smaller than the adult system, can be more easily be overwhelmed. School closures and educational disruption are likely. For example in England, where a return to school occurred with inadequate mitigations in place, 7% of high school students and 3% of pre-primary and primary school children tested positive and many children are missing school for COVID-19 related reasons By contrast, San Francisco has a comprehensive school safety program in place and has had months of face-to-face learning with 7 instances of in-school transmission during the 2020-2021 school year.

Protecting children requires vaccinating children when possible, ensuring access to safer air indoor through ventilation, using high quality, well-fitting masks, providing families with flexible choices between home schooling, face-to-face learning, and protecting children’s mental health.

OzSAGE recommends:

• Vaccinating eligible children, their parents and teachers/school staff as soon as possible

• Ensuring standardised access nationally to safer indoor air using evidence-based protocols to ensure adequate ventilation, and filtration where required.

• Using high quality masks for children and teachers in schools

• Providing families flexible learning options so they can make their own decisions about their children attending face-to-face learning.

Quotes:

Children are fortunately at lower risk from COVID19 than adults but they can still catch it, transmit it to other kids and adults, get sick from it and even die. Because our paediatric health system is small, it could be more easily overwhelmed than our larger adult health system. Fortunately, international experience has shown that there are layers of sensible, cost-effective mitigations that we can put in place to protect children at school and early childhood centres – including masks for teachers and students, attention to safe indoor air, and supporting parents to decide when school is safe for their child and family.

DR GREG KELLY

With our kids going back to school, it’s important that we learn from international experience on what has worked well and what has not. We want our schools to open safely, and with this advice we aim to safely keep them open for a long time.

MS KATE COLE

With a disease as contagious as COVID-19, almost everyone is going to get infected at some point if they’re not vaccinated. Adolescents are eligible for vaccination now, but younger children will have to wait a little longer until vaccines have been approved for them. Until that happens, it’s vital that we take the right steps to protect children from infection.

DR ZOË HYDE

These actions will stand us in good stead for any future pandemics and are a worthy investment that protects children, our most precious asset.

DR KARINA POWERS

There are many things we can do to improve mental health of families, and the first step is acknowledging that distress due to an unprecedented public health emergency is normal and will further exacerbate existing inequalities in our communities.

DR KATY MCALPINE

The populations at most risk are those with a large proportion under the vaccination age (12 years); whose kids are in overcrowded circumstances such as multi-family shared housing, multi-story towers, social housing, and those in crisis accommodation.  Specific and urgent attention must be paid to those most vulnerable in the appreciable population of those most at risk – children.

PROFESSOR LISA JACKSON PULVER

Update

A previous version of this document stated that 8% of schoolchildren in England were infected shortly after the start of the autumn term in September. This was actually the proportion of children absent from school for all reasons. This document has been revised to now refer to data from the Office for National Statistics, which indicate that 3% of primary school students and 7% of high school students were estimated to have a current infection at the start of October