Attendees and apologies
Advisory group members
- Prof Linda Bauld (chair)
- Catherine Agnew
- Prof Marion Bain
- Prof Brigid Daniel
- Prof Julie Fitzpatrick
- Prof Paul Flowers
- Gaenor Hardy
- Dona Milne
- Prof Devi Sridhar
- Dr Diane Stockton
- Prof Chris Chapman
- Iona Colvin
- Gayle Gorman
- Dr Eileen Scott
- Prof Ian Rivers
- Gillian Hamilton
Scottish Futures Trust
- Stephen Long
- Victoria Ayre
- Victoria Bruce
- Andrew Drought
- Andrew Dailly
- Dr Edward Doyle
- Daniel Kleinberg
- Joanna MacDonald
- Audrey MacDougall
- Beth Macmaster
- Eleanor Passmore
- Gary Sutton
- Katrina Troake
- James Wilson
- Carolyn Younie
- Sam Anson
- Judith Tracey
- Judith Clark
Items and actions
The chair welcomed members to the meeting and provided a brief update on actions from the previous meeting.
Minute of meeting on 6 January
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 overall 7-day rate of positive cases had decreased for 2-17 year olds, with those decreases being observed in all child age groups. The R rate was between 1.2 and 1.5 as of 7 January. As of 6 January 84.3% of the population aged 12 and over had received a second dose of the vaccine, with 63.6% having received a booster vaccination.
Hospital occupancy, admissions and ICU occupancy had increased overall in the week to 6 January. There were increases in the rate of hospitalisation in all child age groups in week 1 of 2022. However, hospitalisations remained low in absolute terms for children, with the proportion of hospitalisations to positive cases appearing consistent for cases of Omicron compared to Delta for this age group. It was also noted that the majority of children currently in hospital with COVID-19 were in hospital with rather than because of COVID-19. In an age-standardised population, individuals were 4 times more likely to have a COVID-19 related acute hospital admission if they were unvaccinated compared to individuals that had received a 3rd dose of the vaccine.
There were 44 registered COVID related deaths among the population as a whole in the week to 2 January, a decrease of 17% on the previous week. While Omicron remains the dominant variant in Scotland, there is still a very small percentage of Delta cases. It was noted that there had been high case numbers across all local authorities areas over the school holiday period. Additionally, the ONS infection survey estimated high rates of COVID-19 in the community, including diagnosed and undiagnosed cases.
The sub-group discussed their advice on mitigations and remained supportive of current measures in schools at the current time, particularly when schools have just returned and any impact of that return is not yet known. As one point of discussion, they considered whether or not their advice on face coverings should be extended to upper primary pupils in light of the spread of the Omicron variant. There was agreement that the potential harms of wearing face coverings continue to outweigh the possible benefits for under 12s.
Action: the sub-group agreed to review the evidence on the efficacy of face coverings in light of recent evidence, to ensure advice on this remains current.
Sub-group members also discussed their advice on assemblies and large gatherings. It was agreed that prescribing numbers for assemblies and large gatherings would be a move in the wrong direction, given the aim to devolve decision making to local authorities and schools, which have a better understanding the capacities of individual schools.
The sub-group received an update on work to improve ventilation in schools and early learning and childcare settings. Sub-group members noted the significant work undertaken to monitor and improve ventilation, including:
- an initial comprehensive assessment of ventilation in all local authority learning, teaching and play spaces
- work with local authorities to ensure appropriate strategies for continuing effective CO2 monitoring, with a particular focus on balancing good ventilation with user comfort and warmth
- work by local authorities to improve ventilation where necessary, such as the repair of windows to allow full opening, relocation of staff/pupils to better ventilated spaces, installation of additional fan systems or mobile fans to assist with airflow and providing improved guidance to building users
- providing information to all education staff on how to raise concerns around ventilation
- updates to guidance in December addressed both monitoring frequency and device ratios, with work underway with local authorities who are experiencing particular challenges in these areas
- up to £5 million funding recently being made available for local authorities to undertake urgent remedial work to improve ventilation
Sub-group members welcomed plans for further communications to raise awareness of this work, and improve confidence in ventilation for staff, pupils and families. The key role played by internal communications between local authority facilities management and school staff was also emphasised.
It was noted that following initial monitoring, there were only a relatively small number of spaces where ventilation issues could not be easily resolved, for example by opening windows. The aim is to embed this monitoring as a regular process, given the benefits of good ventilation for both learning and reducing the risks of COVID-19 transmission. This will be the first winter period that schools and local authorities will be implementing the ventilation guidance fully, and officials were working with local authorities to understand the extent to which this approach can be used successfully in practice.
It was also reiterated that both evidence and guidance are clear that air cleaning devices do not replace ventilation, as they do not remove the need to ensure fresh air enters classrooms, and attempts to use them as a substitute for natural or mechanical ventilation may increase risks to staff and pupils.
COVID-19 related staffing pressures
The sub-group noted significant efforts by local authorities and staff to keep schools and early learning and childcare (ELC) settings open, and discussed the particularly significant pressures on staffing in ELC and out of school care settings, which were linked to large numbers of staff self-isolating. There were concerns that this may be due to the young workforce, with staff being potentially less likely to have had their booster vaccine. It was reported that in some settings providers were running a restricted service due to staff absences.
Action: public health colleagues to work with officials on targeted vaccination activity in the new few weeks for those who are eligible, with potential afternoon or twilight sessions for specific groups.
Vaccination of 5-11 year olds
The sub-group discussed the evidence of wider harms of missing time in school which the sub-group planned to provide to the Joint Committee on Vaccination and Immunisation (JCVI) to inform future discussions on universal vaccination of 5-11 year olds. The paper will form part of the evidence on wider considerations of vaccination for this age group, and sub-group members welcomed the opportunity to contribute to this. It was noted that the purpose of the paper was only to highlight wider evidence for consideration by JCVI, and was not a recommendation from the sub-group on vaccination, as that would be outwith the remit of the group.
It was agreed that the paper should emphasise the evidence of wider social, developmental and educational harms of pandemic on 5-11 year olds. A further paper, summarising the evidence on the wider harms of the pandemic for all children and young people, will be produced by the sub-group for publication in due course.
In discussion, the following points were made:
- while the immediate priority within the vaccination programme in Scotland remains addressing severe illness, hospitalisation and mortality arising from the virus, if we are to achieve the strategic priority of supporting children and young people, it is essential that wider impacts are considered as well as health impacts
- there is increasing evidence of the negative effects on children and young people of the pandemic and time out of school. This is particularly the case for more disadvantaged children, and those with additional needs
- vaccination of 5-11 year olds is unlikely to have an immediate impact on the levels of infection in that age group but, looking towards the medium to longer term, vaccination might have an impact on school absence and school closures in terms of a future wave
- vaccinating children at a younger age may also provide a foundation for vaccine confidence and countering later misinformation, by establishing vaccination as a routine event for children and young people. It was noted that in some cases schools and families have been targeted by those spreading vaccine disinformation
Date of next meeting
The next meeting will be held on 25 January.
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