- 9 Aug 2021
Attendees and apologies
Advisory Group Members
- Carol Tannahill (Chair)
- Gayle Gorman
- Prof Marion Bain
- Dr Eileen Scott
- Dona Milne
- Prof Ian Rivers
- Prof Devi Sridhar
- Prof Julie Fitzpatrick
- Prof Brigid Daniel
- Catherine Agnew
- Iona Colvin
- Prof Chris Chapman
- Prof Paul Flowers
- Gaenor Hardy
Public Health Scotland
- Diane Stockton
- Colin Sumpter
- Liz Levy
- Daniel Kleinberg
- Audrey MacDougall
- Amy Harron
- Mick Wilson
- Victoria Ayre
- Katrina Troake
- Niamh O’Connor
- Orla Keenan
- Sam Anson
- Judith Tracey
Items and actions
1. 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.
2. The Chair thanked Gayle Gorman for chairing the previous meeting, and welcomed Orla Keenan who was observing the meeting as part of her participation in the Scottish Government career ready programme.
Minute of meeting on 29 June
3. The minute was confirmed as an accurate record of the meeting.
Review of evidence
4. The sub-group considered the latest data on the state of the epidemic. In the week to 9 July, R was between 1.2 and 1.5. Cases per 100,000 increased in all age categories, with the sharpest rise in cases per 100,000 for under 21s being in the 18-21 age group. 85.9% of the adult population have now been vaccinated with one dose, and 62.2% have received their second dose. All 18-29 year olds were expected to have been offered their second dose by mid-September.
5. The number of patients in hospital and admissions to ICU had increased over the last week, and there were 21 registered COVID related deaths in the week to 5 July, with the Delta variant remaining the dominant strain in Scotland. The overall number of cases and test positivity across all child age groups increased.
6. Action – PHS to look at the data from PHE to see if it is possible to compare the case rates when schools returned in England after Easter (particularly in higher prevalence areas) with those in Scotland.
Self-isolation/asymptomatic testing programme
7. The sub-group discussed whether the existing self-isolation policy for contacts of cases, requiring children and young people to self-isolate, sometimes repeatedly, remains proportionate in light of the updated Strategic Framework and the evidence that vaccination provides significant health protection to those who are fully vaccinated.
8. In discussion, the following points were made:
- The evidence base continues to suggest that children and adolescents (in particular those under the age of 14) transmit the virus at lower rates than adults, and are more likely to transmit among themselves than to adults, and the clinical risk to children of COVID-19 is very low.
- Self-isolation of children and young people as close contacts is primarily for the benefit of other age-groups who are more likely to experience adverse health effects from the virus.
- Repeated instances of isolation of children and young people disrupts their education, learning and development. This is in addition to the disruption caused by previous lockdowns
- If Scotland moves beyond level 0 on 9 August, there will be a change in the self-isolation requirements for fully vaccinated close contacts of people who test positive for COVID-19. Unless a similar change is proposed for children and young people, it will mean they will face greater restrictions than the rest of society.
- The current position on self-isolation for children and young people as contacts is not commensurate with the risk going forward and should be revised to exempt all children and young people from isolation as close contacts unless they are symptomatic or have a positive test.
- Given that there are some risks associated with this change in approach to self-isolation, there are a number of possible options for the timing of when this change should occur. A decision should be taken based on the relative balance of COVID related health risks, with the wider health and educational harms, and with deliverability constraints.
- There needs to be ongoing communication to ensure that everyone remains alert to the core symptoms of COVID-19 i.e. loss/change of taste/smell, fever or persistent dry cough, and that they should not go to a school or ELC setting if they have even mild symptoms, unless they have a negative PCR test. The need for ongoing support for those people who do have to self-isolate will remain, even if the numbers reduce as a result of a change to the policy.
- In order to ensure that schools re-open safely, staff in all education settings and secondary pupils should be asked to undertake an LFD home test no more than 2 days before they return to school in August.
Mitigations in schools
9. In line with previous sub-group advice, schools have been advised to plan to begin the new term in August with the current mitigations in place. The sub-group considered how long the current mitigations should remain in place to ensure safety, and how to balance ongoing mitigations in schools with other harms, for example to children and young people’s education and wellbeing. This will be important for a range of reasons, including ethical and legal ones.
10. In discussion, the following points were made:
- it is important to balance what we know about the low risk of transmission of the virus in the context of the vaccination programme, with the potential long-term educational impact on senior phase pupils, particularly those living in less stable households where parents or guardians are less likely to be able to support them to continue their education whilst self-isolating.
- also need to consider the health and wellbeing of staff who have yet to receive both doses of the vaccine, and what is known about long-COVID in relation to unvaccinated adults and to children and young people.
- following the move to beyond Level 0, schools should move to a position where a number of baseline mitigations remain in place to reduce the risk of transmission and stop the virus resurging. All other (non-baseline) mitigations should be removed within 4 weeks from the start of term (earlier if feasible). This timeframe is to allow for the logistical challenges of removing mitigations.
- some non-baseline mitigations, such as face coverings in secondary schools, and the need for adults to maintain at least 1 metre distancing, may need to be retained for a longer period than 4 weeks in order to provide an additional level of security if there is a change to the self-isolation policy for close contacts of children and young people (as had been discussed earlier).
11. It was agreed that the baseline mitigations should be:
- children, young people and staff should stay at home and self-isolate if they:
- have symptoms of COVID-19, whether they feel unwell or not
- have tested positive, even if asymptomatic
- are required to self-isolate for travel-related reasons
- good hand hygiene and surface cleaning in school environments and on dedicated school transport;
- a renewed focus on the importance of good ventilation and the potential for CO2 monitors to be utilised to ensure good air quality in enclosed spaces;
- requirement to wear face coverings on dedicated school transport in line with the position on public transport;
- ongoing need for outbreak management capability, including active surveillance;
- assessments on the use of PPE should continue to be undertaken for those who work in close contact with children and young people.
12. It was also agreed that, in the period immediately after the return to school and subject to decisions about the self-isolation policy, face coverings should continue to be worn by adults and secondary-aged pupils in communal areas and when moving around the school building, and that asymptomatic testing for the same cohort should remain in place, but that consideration should be given to adjusting the approach thereafter so that they are only required where indicated by community prevalence and based on the advice of the local Director of Public Health/IMT.
13. Action – the sub-group to publish advice on the safe return to schools in August which will cover mitigations, self-isolation, and testing.
Summary of latest evidence
14. The sub-group discussed whether it would be appropriate to produce a further evidence summary in advance of the return to school in August, recognising the different nature of the epidemic now, the learning from the past year in schools and ELC settings, and the updated evidence base. The sub-group agreed that such a summary would be helpful and would sit alongside and underpin the sub-group advice on the safe return to schools and ELC settings, as well as the operational guidance provided to the sector.
15. Action – the sub-group to produce and publish an evidence summary in August.
16. The sub-group held a brief discussion of the proposals for an education recovery strategy.
17. Action– secretariat to ask 2 or 3 members of the sub-group to help support the development of the education recovery plan via correspondence (members to volunteer if they would like to be involved).
Date of Next Meeting
18. The next meeting will be held on 27 July.