Attendees and apologies
Advisory Group Members
- Linda Bauld (Chair)
- Prof Marion Bain
- Iona Colvin
- Prof Brigid Daniel
- Prof Julie Fitzpatrick
- Prof Paul Flowers
- Gayle Gorman
- Prof Devi Sridhar
- Dr Eileen Scott
- Prof Chris Chapman
- Catherine Agnew
- Gaenor Hardy
- Prof Ian Rivers
- Will Wardrop
- Marianne Emler
- Sam Anson
- Judith Clark
Items and actions
1.The Chair welcomed members to the meeting and provided a brief update on actions from the previous meeting.
Update on recent sub-group advice
2. The sub-group received an update on their most recent advice on mitigations in schools and the associated guidance. It was noted that since the sub-group provided its advice, the Chief Medical Officer (CMO) had reviewed this advice along with a selection of other relevant data. While there was agreement with the principles of the advice, he was of the view that waiting for a further period of time before moving to implementation would allow a more cautious and sustainable approach.
3. In particular, he had reviewed the most recent data and was concerned that case rates in children and young people remained relatively high and that, in the intervening period since the sub-group offered their advice, the sharp decline in case rates that the subgroup observed had showed signs of levelling off in some age groups. He had highlighted that a short pause would enable a greater proportion of young people to become protected after immunity develops in the period after vaccination.
4. In discussion the following points were made:
- the Deputy Chief Medical Officer thanked the sub-group for their advice and support in reaching this decision in complex and changing circumstances, noting the high value placed on advice from the sub-group
- there was support in the education sector for the proposed relaxations when the data permits these to be implemented, albeit not universal support
- current case rates highlighted the ongoing importance of increasing vaccination uptake, particularly among 12-15 year olds
5. Sub-group members welcomed the update on the status of their advice and were supportive of the cautious approach taken by ministers. They also noted both the challenges of making decisions based on real-time data, and the emphasis which they had always placed on any of their advice being dependent on the subsequent continuation of the trends observed by the sub-group when providing their advice.
6. The sub-group agreed that their recent advice was an accurate representation of their views at the time, and that it would be helpful to publish this advice in the interests of transparency. Sub-group members also agreed to include an addendum with their published advice, noting the CMO’s views and the changing data.
Minute of meeting on 5 October
7. The minute was confirmed as an accurate record of the meeting.
Review of evidence
8. The sub-group considered the latest data on the state of the epidemic. Case rates appeared to be fluctuating or levelling off across all age groups, with the overall 7-day rate of positive cases decreasing overall across 2-17 year olds, though there was an increase in the total number of cases in 16-17 year olds. An increase in cases was starting to be seen in those aged over 22, mirroring trends across Europe. The R rate was between 0.8 and 1, and 85.1% of the population aged 16 and over were now fully vaccinated, with 74.1% of 16-17 year olds, and 48.2% of 12-15 year olds, having received their first dose of the vaccine.
9. Admissions to hospital and ICU had been fluctuating overall and may be declining slowly. In the three weeks to 13 October, the average number of hospitalisations of children and young people had reduced across all child age groups (age 2-17) compared to the previous week. There were 126 registered COVID related deaths in the week to 10 October, a decrease of 12% on the previous week.
10. It was noted that there had been a substantial decline in the number of schools with large numbers of cases, with the vast majority of schools presenting no or low numbers of cases. The variation in the rate of child cases by local authority area had increased, with high child case rates observed in Stirling, East Lothian, Scottish Borders, North Ayrshire, Falkirk, West Lothian, Aberdeenshire, and Fife. Lateral Flow Device (LFD) testing continued to decline, however this may be a decline in reporting rather than in uptake.
11. The sub-group noted the continuing need to balance direct and indirect harms of the virus. Concerns remained regarding COVID-19 infections in children and young people given the ongoing uncertainty around long COVID-19 and the potential for transmission from infected children to vulnerable adults. Additionally there is a risk of co-infections of COVID-19 alongside other infections, such as RSV and flu.
12. Following feedback from Ministers and the CMO, the sub-group also agreed that it would be helpful for a selection of sub-group members to discuss a key set of indicators on a weekly basis, in order to help inform any Ministerial decision on the timing of further easing of restrictions in schools. It was agreed that these indicators would include case rates (in both the wider population and in children and young people), and available information relating to seroprevalence (including vaccine coverage in child age groups).
13. Sub-group members noted the benefits of relaxing restrictions at the earliest possible opportunity indicated by the weekly monitoring. This included highlighting the potential impacts of restricting activities such as assemblies and parents’ evenings.
14. The importance of local flexibility for schools where possible in terms of parents evenings and assemblies was also emphasised. However, while face to face parents evenings do not need to happen, the important element of these is the interaction itself, whether this is in person or virtual. Sub-group members noted their concerns that these interactions may not be happening for some children and young people and their families.
15. The potential unintended impacts of face coverings being worn by adults were also noted, including the barriers these may pose to communication and language acquisition for young children and those with additional support needs.
16. Sub-group members noted that while it may not form part of their weekly monitoring, it was important to continue to consider available evidence on wider harms and long COVID-19. It was agreed that it may be helpful to further consider any available evidence on mental health and social harms, including developmental delays and any educational attainment disparities. This also applies to adults in schools and the impacts on their wellbeing. The sub-group will also wish to continue to look at data on child protection referral rates and related information.
17. It will be important to consider available evidence from an equalities perspective, as well as to consider possible mitigations and good practice across sectors which aims to address these. This might include looking at data on ethnicity, gender, deprivation and additional support needs, among other factors. When considering additional evidence which may be helpful, the importance of avoiding duplication or additional workload for staff was noted. There is a range of ongoing work on wider harms, including Education Scotland’s thematic review looking at local recovery, and work by professional associations regarding staff wellbeing which the sub-group may wish to consider when available.
Action – Public Health Scotland colleagues to present data on wider health impacts for children and young people at a future meeting.
Date of Next Meeting
18. The next meeting will be held on 2 November.
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