The meeting was chaired by Carol Tannahill. The Chair welcomed members to the meeting and provided a brief update on actions from the previous meeting.
The Chair noted that Sheila Rowan would be stepping down as Chief Scientific Advisor from 14 June, with everyone expressing their thanks in appreciation of Sheila’s valuable contributions to the work of the sub-group, and recognition of her wider work during her time in post.
It was confirmed that Catherine Agnew, Care Inspectorate Chief Inspector for Children, had agreed to join the sub-group to provide additional early years expertise.
Minute of meeting on 18 May
The minute was confirmed as an accurate record of the meeting.
Review of evidence
The sub-group considered the latest data on the state of the epidemic. The number of confirmed cases of COVID-19 had increased in the week to 26 May, with R between 1 and 1.3. The number of patients in hospital and admissions to ICU had increased over the last week, and registered COVID related deaths had decreased to 4 in the week to 23 May. The overall number of cases and test positivity across all child age groups increased. Relatively high pupil case rates were seen in Renfrewshire, Dundee City, East Renfrewshire, Glasgow City and East Ayrshire, with these generally reflecting areas of higher community prevalence.
Approximately 70% of reported cases were of the Delta variant. This was increasing daily and expected to become the dominant variant in Scotland. The proportion of cases reported in children will naturally be larger as the proportion of cases in adults decreases due to vaccination. There had been a decrease in the number of recorded lateral flow test (LFT) results for schools in the last week, but an increase in PCR test confirmed cases. It may be the case that negative LFT results are less likely to be reported. The importance of asymptomatic testing was highlighted, with questions being raised around how to increase the uptake and reporting of LFTs in schools.
The sub-group received an update from vaccination strategy colleagues. It was reported that 68% of teachers had already received their first dose of the vaccine, with all teachers expected to have received their first dose by the end of July. It is projected that 85% of teachers will have received both doses of the vaccine by 18 August, when most schools return.
Questions were asked about what learning there has been from the vaccination roll-out. It was noted that vaccine uptake has decreased with age, which may be in part due to the more mobile lifestyles of some younger age groups. Targeted approaches where vaccinations have been offered in the community have been successful with some groups, e.g. traveller communities.
The sub-group highlighted the importance of considering the wider harms of COVID-19, such as learning loss, when the JCVI and others are considering priority vaccination groups moving forward. The benefits of a consistent approach to accelerated vaccination in areas of high prevalence were also highlighted.
The sub-group also asked whether there was anything that could be done to reduce the numbers of healthy children who need to isolate as a result of being identified as a close contact, whilst continuing to maintain a proportionate response to infection prevention and control in the school environment. Members agreed that it would be helpful to convene a small group to consider this question .
ACTION – Sub-group secretariat to convene a group, including public health officials, to consider whether and how we can reduce the numbers of children and young people isolating, as well as the impact of isolation.
ACTION – Jamie MacDougall to update the sub-group regarding any discussion on school/childcare staff and child vaccination at the JCVI.
ACTION – Sub-group secretariat to invite an appropriate speaker to the next meeting to discuss infections and long COVID-19 in children.
Mitigations in Early Learning and Childcare (ELC)
The sub-group discussed an updated paper on proposed changes to mitigations in ELC settings. The sub-group agreed it reflected the previous discussion.
ACTION – Sub-group members to discuss proposed timing of relaxations of mitigations in ELC settings at the next meeting.
The sub-group discussed whether there should be any change to its advice on face coverings. It was agreed that current advice should remain in place until the end of this term, given case rates and the ongoing uncertainty around the Delta variant of concern. The sub-group remained open to reviewing any new evidence on this.
School Leavers’ Events
The sub-group discussed questions which have been raised about the possibility of holding school leavers’ events, such as proms and assemblies. The sub-group recognised the importance of holding end-of-year events, particularly for those young people for whom they were a symbolic rite of passage to mark the end of formal schooling. However sub-group members expressed concerns regarding the potential for transmission at large gatherings, particularly given the current uncertainty around the transmissibility and impact of the new Delta variant of concern. It was noted that, in primary schools, suitable activities during the school day can be more easily organised than for senior phase pupils.
The sub-group agreed that celebration events could still take place, although these should not involve large, indoor gatherings in schools, involving dancing or other high risk activities. The sub-group was aware that many schools and secondary pupils have already been creative about ways of celebrating, making plans within the boundaries of the schools guidance to hold sensible, risk-assessed approaches to end-of-year events. These may, for example, involve events during the daytime, outdoors, with appropriately small groupings and the usual mitigations in place, such as distancing, enhanced hygiene and hand washing, and face coverings as appropriate. The sub-group advised that, in line with the approach to transitions set out in the guidance, parental/carer attendance at such events should not generally be permitted.
Contingency Planning and Readiness
The sub-group discussed plans for the return to school in August, including what potential there may be for relaxing certain mitigations if circumstances allow.
The following points were raised in discussion:
- Mitigations that are necessary and proportionate to ensure the health, safety, and wellbeing of children and young people should be maintained in schools.
- Mitigations should be maintained where these are difficult to scale up or down (one-way systems, staggered breaks), and where ‘baseline’ measures have wider benefits (hand hygiene and ventilation).The organisational and operational challenges that schools face in implementing and removing mitigations should be taken into account. Requiring schools to remove mitigations too early, and to then reinstate them, would have a detrimental impact on their ability to focus on the delivery of education to children and young people.
- The expectation is that restrictions should be eased in line with those in wider society, unless there is a clear justification for not doing so. It is important to note that children and young people will become the largest unvaccinated population group as the vaccine roll-out moves forward, so a different approach to some mitigations in schools may be may be required for a period of time in order to ensure that schools remain as safe as possible and open.
- There may be a need to adapt mitigations to address any new variants of concern.
- It is also important to ensure that any restrictions in education settings align with the UN Convention on the Rights of the Child, and consider any equity issues which may arise in terms of curriculum provision.
- Some curriculum specific mitigations are already linked to levels, for example sport and expressive arts. Where circumstances allow, any measures which restrict the delivery of the curriculum should be relaxed as early as possible.
- It is helpful to keep messages as clear and simple as possible.
The chair noted that there would be no meeting of the data and surveillance task and finish group next week.
Attendees and apologies
Advisory Group Members: Prof Carol Tannahill (Chair), Prof Marion Bain, Dr Eileen Scott, Gaenor Hardy, Dona Milne, Prof Paul Flowers, Prof Devi Sridhar, Gayle Gorman, Prof Brigid Daniel, Prof Chris Chapman
Apologies: Prof Sheila Rowan, Prof Ian Rivers, Iona Colvin
Public Health Scotland: Diane Stockton, Claire Cameron
SG (observing): Liz Levy, Judith Ainsley, Daniel Kleinberg, Audrey MacDougall, Jamie MacDougall, Andrew Drought
Secretariat: Sam Anson, Judith Tracey, Judith Clark.
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