- 26 Apr 2021
Attendees and apologies
Advisory Group Members
- Prof Carol Tannahill (Chair)
- Prof Sheila Rowan
- Prof Chris Chapman
- Prof Brigid Daniel
- Prof Devi Sridhar
- Prof Marion Bain
- Prof Paul Flowers
- Dr Eileen Scott
- Gaenor Hardy
- Gayle Gorman
- Iona Colvin
- Prof Aline-Wendy Dunlop
- Dona Milne
- Prof Ian Rivers
Public Health Scotland
- Dr Diane Stockton
- Gery McLaughlin
- Mick Wilson
- Audrey MacDougall
- Liz Levy
- Elizabeth Sadler
- Paul Fagan
- Daniel Kleinberg
- Victoria Ayre
- Mariana Cover
- Laura Merenciano Sanchis
- Elizabeth Morrison
- Judith Tracey
- Frank Creamer
Items and actions
The meeting was chaired by Carol Tannahill. The Chair welcomed members to the meeting.
Minute of meeting on 9 March
The minute was confirmed as an accurate record of the meeting, subject to one additional point on vaccination.
Review of evidence
The sub-group considered the latest evidence on transmission and children, and the latest data on the state of the epidemic. The published evidence base in relation to the role of children and young people in the transmission of the B.1.1.7 variant remains limited. One English study of COVID related school absences between September and December 2020, showed that in London and Kent, where high numbers of the B.1.1.7 variant were first reported, more secondary schools reported a greater number of students absent with confirmed COVID-19 infection in the last week of term compared to early November before lockdown. Recent evidence from Wales suggests that adults mainly transmit to other adults and children mainly transmit to other children.
It was difficult to identify any clear trend in case rates over the most recent weeks, and there was little headroom to keep the R number below 1. COVID-19 NHS admissions and occupancy of ICU beds continue to fall, registered COVID related deaths have decreased by 27% in the week to 14 March, and the uptake of vaccinations remains high – over 2 million people have now been vaccinated. Compliance data indicate a decrease in the proportion of the population complying fully with all the restrictions. The sub-group also considered the most recent projections from the modelling reflecting the various proposed easings of restrictions during March and April.
Since mid-February there has been an increase in the total number of COVID-19 infections in children, with the highest proportion of cases currently observed in those aged 5 to 11. Alongside this there has been a substantial increase in testing for this age group, and an increasing proportion which are asymptomatic. This increase was not unexpected following the phased return to school and early learning and childcare.
In discussion, the following points were made:
- a point of fatigue appears to have been reached on compliance. Sub-group members highlighted the value of emphasising the range of activities that the population can undertake, as a means of reinforcing these and sustaining morale
- the importance of continued adherence to mitigations and of relaxing restrictions in a slow and methodical manner
- there have been a few outbreaks in schools since pupils have returned to in-school learning, including some with considerable numbers of mainly asymptomatic cases. There is a need to communicate that cases and outbreaks will occur, and that they can be dealt with effectively on a school-by-school basis with support from local public health teams. Learning from those schools who have experienced outbreaks this term should be compiled and shared with others
- overall attendance data remains encouraging
- there has been a great deal of modelling of the health impacts and transmission of the virus, but it would be helpful to see some modelling of the social and educational impacts too
- it is important to be clear about all the harms, to shine a light on future priorities. Children and young people who were already disadvantaged have suffered more as a result of the pandemic, and this needs addressed as soon as possible
- Audrey MacDougall to consider modelling with only full re-opening of schools included
- Chris Chapman and Audrey MacDougall to discuss options for modelling of the wider harms and report back to the sub-group
- Iona Colvin to invite Craig Kellock and Alex McTier to speak to the sub-group and present the findings of a report on the impacts of COVID-19 on families once it has been completed
The sub-group considered the evidence regarding the role of physical distancing as a measure to reduce the transmission of COVID-19, whilst recognising that the full return to school after Easter is dependent on an easing of the current requirement for two metre distancing in secondary schools.
The sub-group acknowledged that physical distancing is a key measure to prevent close range transmission of COVID-19. The fundamental science around distance and transmission remains unchanged, showing that maintaining at least two metre distancing is safer than staying between 1 or 1.5 metres apart. However, distancing should be seen as one of a package of mitigations, and considered in the context of the constraints of the environment.
It remains the case that the likelihood of cases within schools is strongly correlated with local community prevalence. This reinforces the need to ensure and sustain low levels of community transmission, alongside approaches that enable pupils to return to face-to-face education.
Based on the generally improving situation in terms of prevalence of COVID-19 within the community and especially among those more susceptible to COVID-19 disease, and the continued success of the vaccination programme, the sub-group was supportive of getting children and young people back into school fully, and accepted that 2 metre distancing will not always be possible or realistic within a school setting. It should however be implemented where possible.
As such, the sub-group recommended that the planning assumption should remain for a full return after the Easter break with a return to the policy of physical distancing that was in place in the 2020 autumn term. Two metre distancing should remain in place between adults, and between adults and children who are not from the same household, but should not be required at all times between pupils.
The sub-group emphasised that it would be important to have a checkpoint closer to the planned date for full reopening, in order to assess fully the impact that the Phase 2 return (from 15 March) has had on case numbers and transmission: three weeks’ data are required to assess that impact effectively.
There was some concern about how well the current guidance on cohorts (bubbles) in ELC settings was working, and whether it needed to be re-examined in the light of practical experience since ELC returned on 22 February.
- PHS to work with Directors of Public Health to look into whether the cohorts are working as intended.
The sub-group had been asked to review the use of face coverings during Ramadan. It was noted that advice had been sought from a local mosque which had concluded that there was no need for an exemption and that such a suggestion could be counterproductive.
The sub-group discussed the need for a package of mitigations in schools where two metre distancing could not be maintained, including increased focus on ventilation, good hand and respiratory hygiene, testing and staying home with symptoms, and the wearing of face coverings indoors in line with previous sub-group advice.
The sub-group stressed the importance of ventilation and using outdoor learning as much as possible as schools move into the summer term and the weather improves. It noted that the importance of ventilation should be further emphasised in communications, including when FACTS are communicated.
The sub-group felt it needed more time to consider the issue of ventilation further, particularly the viability of using CO2 monitors as a proxy measure for identifying areas of poor ventilation within schools. It will be seeking further expert advice on this issue, and the issue of ventilation as a whole in the light of the new variant and increased transmissibility.
- the sub-group will consider the package of mitigations at its meeting on 6 April, when data from the English experience of school return, without physical distancing but requiring face coverings throughout the day, will be available
Date of next meeting
The next meeting will be held on 6 April. The meeting on 20 April will focus on education recovery.
- sub-group members to provide any thoughts on by 6th April on what should be considered at the meeting on 20 April in terms of education recovery