- 30 Jun 2021
This advice note is to support Higher and Further Education bodies to plan for the approach to COVID risk-reduction in the next academic year drawing on the experience and evidence of the current 2020/21 academic year. It highlights the interventions and advice that are essential for communication with senior phase school pupils attending college and with FE and HE students during the summer, and for the resumption of in-person research and learning and wider student activities, given current understanding of the likely progression of the pandemic. It must, however, be recognised that the COVID situation remains inherently uncertain, and there may be a need for interventions and advice to be updated in the event of any significant unexpected developments during the summer holiday period. This advice is to assist the stakeholder COVID Recovery Group and the Scottish Government in developing operational guidance for use by the sectors. It is advice for consideration and does not constitute direct guidance to the sectors.
Scotland’s Coronavirus Strategic Framework sets out the interventions available to suppress the virus to the lowest possible levels. These are:
- the vaccination programme
- testing, contact tracing and self-isolation
- proportionate protective measures
- measures to manage the risks of importation of the virus
- supporting adherence
- providing care and support to mitigate the harms of the crisis
The advice that follows considers each of these interventions relative to the scenario that Scotland has moved beyond its current levels system into a ‘new normal’ [beyond level 0]. As restrictions are eased in wider society, the expectation is that comparable restrictions may be eased in university and college settings, unless there is a clear justification for not doing so. However it is emphasised that this is only one possible scenario, and plans should recognise that the alternative scenarios of (i) restricted/blended learning in current levels 3-4, and (ii) blended learning in current levels 0-2 (both deployed during 2020/21) may need to be reintroduced should the assumptions underpinning this advice not be realised.
Recognising the diverse nature of the Higher and Further Education sector in terms of the size and compositions of student and staff bodies, the physical fabric of facilities, and the activities undertaken, this advice seeks to summarise evidence and provide clear formal interventions and informal principles to be tailored in their implementation locally as befits the particular contexts of different organisations. The advice also seeks to bridge across the secondary sector where there is a shared age cohort age 16-18.
The advice recognises that there are lessons to be learnt from 2020/21 across the sector where institutes, students and unions working together for effective policy development, communication and guidance implementation helped to maintain COVID positive rates in FE and HE amongst students at similar levels to the general population. These development and implementation issues require as much attention as the particular mitigations and interventions themselves. As we move forward, the emphasis will shift towards one based less on national ‘rules’ and more on risk reduction including targeting and tailoring of shared/collective responsibility. This advice seeks to reflect that different dynamic, focussing on those issues that will be key to reducing Covid-related risks and fostering approaches/interventions that will continue to enhance awareness, understanding and sustained adherence.
State of the epidemic
The advisory sub-group has considered the current state of the epidemic, together with models of likely future trends. At the time of writing, cases are growing exponentially, with the currently dominant variant (Delta) and the case rate accelerating in many parts of the country. It is highly likely that Delta variant is more transmissible than Alpha/VOC-20DEC-01, and it is a realistic possibility that it is as much as 50% more transmissible (Eighty-ninth SAGE meeting on COVID-19, 13 May 2021 & 18 June 2021 Risk assessment for SARS-CoV-2 variant: Delta (VOC-21APR-02, B.1.617.2)). The secondary attack rates for contacts of cases with Delta/VOC-21APR-02 and no travel history are higher than those for contacts of non-travel cases with Alpha/VOC-20DEC-01 (SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 17). There remains uncertainty regarding the impact of the Delta variant on severity of illness, treatment or reinfections. Early evidence suggests there may be an increased risk of hospitalisation for Delta compared to Alpha although more data is needed to have more confidence in that finding (Confirmed cases of COVID-19 variants identified in UK - gov.uk & Risk assessment for SARS-CoV-2 variant: VOC-21APR-02 (B.1.617.2) (publishing.service.gov.uk)).
As the vaccination programme progresses and protects older age groups as well as those who are clinically most vulnerable, relative and absolute case rates are increasing among those who are not yet vaccinated such as children, young people and young adults. Locations where groups of younger people gather are thus likely increasingly to become the focus of outbreaks. Case rates have risen across all age bands this week, with the highest case rates being reported in those aged 20-39 followed by 0-19 year olds. Over the last week there was a further increase in the total number of COVID-19 cases in young people (aged 0-19 year) which has gone up from 1,179 cases in the week to 30 May to 1,534 cases in the week ending 6 June.
There has been a recent rise in interactions with those aged between 18-29 with all other age groups. The biggest increase in interactions has been between those aged 18-29 with each other.
Figure 1: seven day case rate in Scotland by age group by specimen date (refers to PCR testing only)
Hospital bed and ICU occupancy are projected to rise over the next few weeks Modelling of both ‘better case’ and ‘worst case’ scenarios highlight the risk of a rise in infections over coming months. More information is needed on the new Delta variant to understand the impact of this rise in infections on the NHS. This is particularly important against the backdrop of vaccination continuing to be rolled out. These scenarios highlight the importance of high vaccination take up in all age groups, as well as the importance of continuing with baseline measures, good compliance and other non-pharmaceutical interventions.
The vaccination programme
All efforts should be made to maximise vaccination rates among students and staff, including through vaccinating international students, operating vaccination centres that are located in or near university and college settings, and implementing communication methods to promote registration, provide information, address concerns and enhance uptake.
- on current programme projections and subject to supply, all those 30 years of age and over in Scotland will have had the opportunity to have completed two vaccination doses by w/c 9 August; and those age 18-29 by w/c 13 September. Assumptions about uptake vary but there is evidence that take-up is lower in younger age groups, with only 30% of the eligible population in Scotland currently signed up to receive a vaccination appointment and this also varies by cultural and other beliefs (30% of this age group have already received their vaccination as part of the other JCVI priority groups). Partners should continue to do everything possible to accelerate the vaccination programme, facilitate access, and maximise uptake across population groups
- ensuring that international students are invited for vaccination, either in their home countries or on arrival in Scotland, will be a priority. As announced by the Health Secretary on 11 June, international students arriving in Scotland will be included in Scotland’s vaccine rollout, in line with JCVI guidelines. Scottish Government is currently working with the Universities and Colleges Scotland as well as local health boards to firm up plans for these students. Measures may also be put in place for international students to provide proof of their vaccination status. Maximising and confirming vaccination rates among international students will be an essential component of any strategy to reduce risks for the next academic year
- university and college premises should be investigated as potential locations for vaccination centres and/or mobile vaccination facilities deployed close to student accommodation
- universities and colleges should develop pro-active plans in partnership with Scottish Government (SG) and Public Health Scotland (PHS) to maximise student and staff registration for/uptake of vaccination. Plans should also be made to facilitate access to vaccination centres and develop or signpost information to address staff and student concerns and questions. Involvement of student bodies in the development of these plans will increase their impact
- universities and colleges should work with each other and tap into existing expertise (eg in marketing, computer science, health, and behavioural sciences) to develop peer-led locally targeted and tailored mass and social media interventions to educate, persuade and enable student and staff to access vaccination
In addition to the key components of the vaccination programme as set out above, there are several factors to be taken into account for the start of the academic year:
- timescales: most Colleges restart before the end of August, and several Higher Education institutions restart before mid-September. These start dates do not include Freshers’ weeks/pre-term activities. Therefore there will be a proportion of cohort 12 (18-29 year olds) who will be returning to campus with at best only one vaccine dose (approx. 33-50% effective against Delta at preventing symptomatic disease, compared with up to 90% after two doses). Note too, that the projected completion of two doses for those age 18 and over by w/c 13 September does not allow for the 2-3 week period post-vaccination to maximise effectiveness of the vaccine. Plans should therefore recognise that on current projected timescales, maximum protection among this cohort won’t be realised until early October, unless there are also one shot vaccines available. Additional precautions - such as hosting virtual Freshers’ weeks and maintaining online learning - may therefore be required for the first few weeks of term
- age groups: 15% of university students and 21% of college students are under 18 years old, and many of these may be completely unvaccinated at the start of the academic year. The current planning assumption is that 16-17 year olds are likely to become the next cohort (cohort 13) in the adult vaccination programme, but timescales are yet to be confirmed and the approach will be subject to JCVI advice and risk-benefit assessments. Therefore, particular attention will be required to consider how these younger students – together with any staff in this age group – may best continue to be protected, including through consideration of their accommodation arrangements, and the application of other NPIs
Early data suggest that vaccines may be weakening the link between case numbers and hospitalisation, intensive care and deaths. Further data in coming weeks will enable us to understand whether this is the case. Advice will then be required as to the infection prevention and control approaches that are proportionate to the risks to individuals and communities in that context.
Testing, contact tracing and self-isolation
Effective implementation of testing (including asymptomatic testing), contact tracing and self-isolation will enable some other aspects of university and college life to return to a more familiar ‘normal’. As for vaccination, the development of clear communications to support these behaviours as accepted – and expected – norms should be a priority. Additionally, colleges and universities should ensure that there is a well-developed approach to support students and staff who require to self-isolate. This should include accommodation support, and also wider wellbeing and learning issues. Health and Wellbeing support will be particularly important for 1st year students who will not have established peer support networks and may be a considerable distance away from their families.
- general approach: universities and colleges should work with each other using all available national guidance and local expertise (staff and students) to develop targeted and tailored mass and social media interventions that educate staff and all UK and international students about the value of regular self-testing and detail exactly how to access it and report results. In April 2021, twice weekly LFD testing was introduced for all eligible students and all staff on campus or working in institutional accommodation, with PCR confirmation for positives. Testing for university students is available at the established Asymptomatic Testing Sites (ATS) on campus or through partnership arrangements. Testing for college students is through self-use tests, available for collection on campus. If positive, in common with anyone who tests positive, students and their contacts will have to isolate. Scottish Government has published guidance and FAQ documents which give detailed information on the testing programme and how to access it
- the development of further peer-led interventions to promote regular weekly testing as one way of reducing COVID risks (e.g. as the socially responsible thing to do before a party, before returning home to see friends and family) is also advised. The wider importance of contact tracing – including use of contact tracing apps – should be built into these interventions. The importance of self-isolation as an intervention to prevent the cycle of increased transmission and as an act of social responsibility should be emphasised. In 2020-21, the university sector provided assurance that practical and welfare support is in place. Institutions and providers made arrangements to support students self-isolating because of COVID-19, including practically and emotionally. Students can also access Local Authority services supporting self-isolating individuals who are otherwise unable to access food and other essentials. This can be arranged through the National Assistance Helpline which is a service for those who cannot leave their home and cannot get the help they need in any other way. Universities will have accessible well-being services, with details on their web sites. The Student Information Scotland website has the student support pages of every institution, so can signpost students to support that is available. Scottish Government has committed funding to introduce additional counsellors in colleges and universities. Some of these counsellors are already in place
- UK students returning to campus or accommodation, including senior phase school pupils attending college, should receive communication on current guidance to reduce social contacts for 10 days and have a negative lateral flow test 24 hrs prior to return (note: this advice will be kept under review and updated should the guidance change in coming weeks)
- international students will need to follow the required current guidance for green, amber and red listed countries before departure and on arrival in Scotland. For overseas students, arriving in a new country, tailored guidelines for practical and emotional support should be developed, alongside communications about the mitigations that are in place and approaches to risk assessment and personal responsibility
In contact tracing interventions across varied infectious diseases insufficient attention has been paid to health inequities and the need to target and tailor contact tracing interventions to particular communities and their life circumstances. A COVID-19-driven recent rapid review (Megnin-Viggars et al., 2020) highlights major barriers and facilitators to engaging in contact tracing across a range of infectious diseases. It suggests key barriers relate to: mistrust and apprehension, fear of stigmatisation, specific challenges relating to mode of delivery (i.e., digital vs otherwise), and privacy concerns. In contrast, key facilitators of effective contact tracing interventions relate to the co-production of contact tracing systems, perceptions of collective responsibility, perceived personal benefit, and perceptions of the contact tracing intervention as efficient, rigorous and reliable.
Proportionate protective measures
Behavioural and non-pharmaceutical protective measures will continue to be required beyond level 0, and these should relate to the risks associated with different settings and activities. Wider guidance is currently being prepared by Scottish Government, in addition to a specific review of physical distancing. The approach taken in the higher and further education sector should reflect the guidance in place more widely for Scotland. The advice once again is that the processes of communication and support for adherence will be critical to maximise the impact of protective measures, and that attention should be paid to those groups for whom adherence will be most difficult.
- in advance of the next academic year, coordinated, sustained communication should take place over the summer, involving student representatives, taking every opportunity to welcome learners and to emphasise the priority given to their and the communities’ safety and well-being. This could be tailored by institutions to suit local circumstances but would avoid a proliferation of differentiated and confusing messages which may not promote adherence. Colleges and universities will be in regular contact with students over the summer as they deal with bursaries, results, placements etc. These contacts all provide opportunities to connect with learners and convey agreed key messages
- it will be important to manage expectations and to be open and clear about what learners should expect in the early weeks. It will be much easier to reduce or eliminate measures as the term progresses than to reintroduce them. As noted above, it may be that a greater level of protective measures are required at the start of term – and for those not yet vaccinated – than will be required as the term progresses, even in the ‘Beyond Level 0’ scenario
- stakeholders will wish to consider whether a common template and shared approach would be helpful across institutions to set the tone in the introductory weeks of term, in which case a working group might be established to develop this approach, drawing on materials available for example from SPI-B with guidance on how to keep safe and assess risk
Controlled, learning and research environments (workshops, labs, lectures, tutorials, libraries, study spaces etc) are at the lower-risk end of the spectrum. HE/FE institutions are best-placed to plan how their estate should be used given current guidance. Given the established evidence about the importance of airborne (including aerosol) transmission of the virus, ventilation remains a key mitigation and face coverings are advised where there are larger numbers and the scope for distancing is limited. It is recognised that 2m distancing is not always possible in these environments: in the ‘beyond level 0’ scenario, a move to 1m+ is advised. Regular cleaning and support for hand hygiene practices should remain in place.
Student accommodation is a higher risk setting, with several significant outbreaks last academic year (student cases in University until end November 2020 accounted for 3.0% of cases in Scotland (Public Health Scotland: COVID-19 and self-isolation among students: Lessons learnt (September to November 2020)) since then they have sat at 0.3-0.4 % in the overall student and staff LF testing). Student accommodation should therefore be a priority focus for planning for the next academic year, and regular testing and contact tracing will be essential for early identification of cases.
- student residences are likely to accommodate a concentration of younger students, who may not to be protected by vaccination for some or all of the first term. They are also likely to have particularly dense patterns of contact. Universities should concentrate particularly on such sites, and consider whether other such ‘pockets’ exist. These sites may need particular work to establish norms of protective behaviours, apply environmental modifications, and support adherence to processes such as regular testing. FAQs and ‘What if?’ scenarios could be produced to reinforce those norms and expectations. In addition, the application of clear policies to avoid divisions and tensions, and to deal fairly with non-adherence, will be essential
- for any student requiring to self-isolate, approaches need to be in place to enable this to happen quickly and with attention to student wellbeing. A key role for student services is to ensure that students who are in isolation receive the supplies and support that they require. The sector should have clear outbreak procedures in place, that are understood by all students
Social and indoor recreational activities (sports, clubs, Student Unions, bars etc): These are also higher risk settings, where groups of people gather and interact in closer proximity. Protective measures should be in line with those specified for similar activities and settings in Scotland as a whole, and students should be encouraged to recognise their responsibilities to behave safely not only for their own sake but also to help protect their friends and community. Recognising the higher levels of risk associated with the start of the academic year (due to lower levels of vaccination, the likely state of the epidemic, the impacts of the travel, and the establishment of new student households) institutions will wish to pay due consideration to the nature of Freshers’ week and other mass activities at that stage. Advice would be to postpone these activities for a few weeks if possible, and to focus on activities involving smaller numbers where distancing can be applied and ventilation enhanced.
Measures to manage the risk of importation of the virus
Travel into Scotland is currently the most likely route for the introduction of new variants, and the associated potential for vaccine escape. Students will be subject to the travel requirements in place at the time of their arrival, including requirements for post-departure and post-arrival testing and quarantining. As noted above, access to vaccination as soon as possible on arrival, for those not vaccinated in their home country, will be another essential measure.
- universities and colleges should provide accommodation within designated halls for international students arriving from amber list countries to quarantine for the required period on arrival. Medical attention and food should be provided, and regular attention to wider wellbeing ensured
- the approach required for international students who have full vaccine protection may differ, and further advice will follow on that issue
- recognising the important responsibility not to spread the virus from Scotland to other countries, testing before departure at the end of term is also advised
The importance of approaches to support adherence has been emphasised throughout this advice. HE/FE institutions should have clear plans for communicating with staff and with students prior to their arrival on campus, and throughout the term. These plans should outline the approach taken to teaching and learning, the non-pharmaceutical interventions that are required across campus, where to go for vaccinations/testing etc, risk assessment advice, and the importance of collective responsibility. The involvement of staff, students and specialist expertise in developing these communications is advised, as is the value of tailoring communications to different groups, including those recognised as being at higher risk. The value of establishing a working group over the summer to develop evidence-informed templates and core messages should be considered.
Providing care and support to mitigate the harms of the crisis
Whichever of the three scenarios applies at the start of the academic year, HE/FE institutions will want to consider not only how they support staff and students in relation to COVID-19 harms (through effective outbreak management policies; provision of accommodation and support for quarantining and self-isolation; maximising access to and uptake of vaccination etc) but also how they help to address the wider harms that have arisen as a result of the crisis. It is beyond the remit of the expert advisory sub-group to cover all of these issues, but group members have highlighted the following as priorities: bereavement support, mental health and counselling services, learning and assessment support in light of the educational disruption experienced over the past year, and additional financial support for students whose circumstances or family circumstances have been affected as a result of the pandemic.
The advisory sub-group will continue to review and develop this advice, taking account of new evidence, vaccination and testing policy, and the Scottish Government’s forward plans for requirements beyond level 0. What has been set out above should be used meantime as the basis for agreeing guidance for the sector, for the ‘beyond level 0’ scenario, and to inform any update to guidance for the other scenarios.
COVID-19 Advisory Sub-group for Higher and Further Education14 June 2021