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No doubt Munro and Faust intended to be provocative,1 but there is an unfortunate non-sequitur in the title of their Viewpoint paper: based on limited evidence, the authors suggest that since children may not be super-spreaders for COVID-19, it is safe to reopen schools. While acknowledging a lack of high-quality sero-surveillance data, the paper then reiterates: “Governments worldwide should allow all children back to school”. If only it were that simple. In fact, the question should not be ‘are children super-spreaders?’ but ‘what effect will re-opening schools to all pupils have on the local community in terms of spread of coronavirus?’ Schools vary with regard to feasibility of social distancing (still considered essential), and risk factors for severity of illness among staff and pupils, and simply do not operate in a social vacuum. What happens in schools will have ramifications for everyone within and outside of schools.
When the reproduction rate for the virus is above 1 in the North East of England, does it really make sense to open up the schools? The Independent SAGE (ISAGE) group report2 recommended that: “decisions on school opening be made at local level, involving all stakeholders, to ensure there is support available as schools progress to full function”. The UK government’s own criteria for easing lock-down included a requirement for measures to be in place to avoid a second wave of infection, contingent on an effective ‘test and track’ system.3 This was reiterated by the Children’s Commissioner, who called for a “phased return to school, accompanied by rigorous COVID-19 testing of teachers, children and families to ease safety fears among parents”.4
Government was fixated on schools opening their doors on 1 June without considering just how this could be facilitated, and at a time when new cases of infection and deaths occurring daily were estimated to be around 17 000 and 300, respectively. Testing even for those with classic symptoms of COVID-19 infection has proved problematic, while contact tracing systems at the start of June were just being launched and may not be fully working until the end of September (if by then). Lack of trust in government stemming from refusal to acknowledge mistakes and inconsistencies in advice regarding rules for social isolation have led many parents to keep their children out of schools, with only one in four of those eligible returning.
I concur with ISAGE2 that decisions on school opening must be guided by evidence of low levels of COVID-19 infections in the community and the ability to rapidly respond to new infections through a local test, track and isolate strategy. Meanwhile, a plan is needed for education as for business. This should include computers for disadvantaged children, on-line teaching, use of temporary accommodation such as sports halls so that social distancing can be maintained, and summer clubs to help make up for missed social opportunities. Transparency and honesty from those in power will also be needed to rebuild faith in official advice. Child super-spreading hardly comes into it.
Twitter @John Puntis
Competing interests I am co-chair of Keep Our NHS Public and fully support the 5 tests elaborated by the National Education Union for safe reopening of schools and its ten-point proposals for a National Education Recovery Plan.
Provenance and peer review Not commissioned; internally peer reviewed.