- 26 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
- Catherine Agnew
- Iona Colvin
- Prof Paul Flowers
- Gaenor Hardy
- Prof Chris Chapman
- Prof Brigid Daniel
Public Health Scotland
- Colin Sumpter
- Liz Levy
- Daniel Kleinberg
- Niamh O’Connor
- Andrew Drought
- David Millson
- Orlando Heijmer-mason
- Eann Munro
- Sam Anson
- Judith Tracey
- Judith Clark
Items and actions
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 provided an update on a meeting with the First Minister and education officials to discuss the return to school.
Minute of meeting on 13 July
The minute was confirmed as an accurate record of the meeting, with one minor addition.
Review of evidence
The sub-group considered the latest data on the state of the epidemic. In the week to 19 July, R was between 0.9 and 1.2. There was a decrease in the 7-day case rate in all population groups, as well as a slight decline in hospitalisations for 0-21 year olds. 89.3% of the adult population have now been vaccinated with one dose, and 68.0% have received their second dose.
The number of patients in hospital and admissions to ICU had increased over the last week, though hospital admissions had started to decline. There were 47 registered COVID related deaths in the week to 18 July, with the Delta variant remaining the dominant strain in Scotland. The overall number of cases and test positivity across all child age groups had decreased.
It was noted that child protection figures are the lowest since 2002, including for Looked After Children. It was expected there will be a significant surge in these figures towards the autumn, with work being planned to look at this in more detail. There was ongoing concern that periods of absence from school and ELC settings have led to a “hidden harm” where there are children and young people not previously involved with social services who are experiencing harm, ill-health or exposure to risks and who, outwith school, might not be able to actively reach out for support. Sub-group members noted that, due to the pandemic, some children would be heading into their third academic year of school or early learning and childcare without normal socialisation, and the impact of this needs to be considered.
There is a need to provide proactive wider support at a local level to children, young people and families following the return to school, given both the direct impacts of home circumstances and wellbeing on learning, and to avoid the need for future escalation of concerns. It is also important for education practitioners to know where they can direct children, young people and families for support with wellbeing concerns.
Physical distancing in early learning and childcare (ELC)
The sub-group discussed possible changes to the physical distancing restrictions in ELC settings. It was noted that current 2 metre distancing requirements for staff can reduce setting capacity, with resulting impacts on access to ELC for children and families.
In discussion, the following points were made:
- it is important to have clear messaging around the rationale for any changes. For example, transmission between adults is far more likely than child-adult or child-child transmission
- there is a need for consistency across ELC and schools, particularly for shared sites, to avoid confusion and ensure compliance
- staff confidence and wellbeing, and the need to feel safe in a workplace was also an important consideration
The sub-group agreed that the current 2 metre distancing requirement should be maintained at present, with distancing changes for beyond level 0 to align with those for schools. This would mean advising distancing between adults of at least 1 metre when beyond level 0, noting that where existing 2 metre distancing arrangements work well and do not limit capacity, settings may wish to retain these.
The sub-group also discussed proposed changes to restrictions on visitors to ELC settings, to allow for induction events to take place. It was suggested that visits could take place provided this is limited to visits planned in advance, with a maximum of 3 households indoors and 10 households outdoors.
Action: ELC colleagues to return to the sub-group with proposed baseline mitigations when appropriate.
Mitigations in schools post-summer
The sub-group discussed its draft advice on the return to school in the new term, including proposed changes to self-isolation requirements for children and young people.
In discussion, the following points were made:
- it is important to avoid placing greater restrictions on CYP than adults unless absolutely necessary. Self-isolation is not always taken seriously, so the rationale and messaging around any requirements needs to be made clear to ensure compliance
- the evidence remains clear that children and young people as a group have relatively low risk of direct COVID-19 harm, but relatively high risk of wider – and potentially long-term – social, educational, economic and wellbeing harms
- continuing the current self-isolation requirements would have a detrimental impact on learning
- there is a need to be clear about the role of testing following changes to self-isolation requirements. There is a strong focus on testing in the guidance for schools, and work is being done to address barriers to testing indicated by survey results. This includes work with Young Scot, and changes to the reporting portal to make recording test results from the same household easier.
- careful monitoring of the impact of the return to school will be essential, and the continuing uncertainty around long-COVID also needs to be considered
The sub-group also discussed the issue of outbreak management. It was noted that concerns remain around transmission in schools, though fewer than there were previously. The response to local outbreaks needs to be proportionate and appropriate to the environment. Public Health colleagues noted that the focus should be on potential health harms rather than simple case rates.
The following points were noted in discussion:
- a consistent approach to outbreak management, based on both health and other harms is needed. Community based approaches have been successful, but it is important to avoid major disparities between the response in local areas
- it is important to take a risk assessed approach to manage expectations and avoid the perception that not enough is being done
- directors of Public Health and local health protection teams will play a critical role in working with local authorities and schools/ELC staff in managing any future significant outbreaks in schools if there are associated concerns about emerging health impacts on school communities or on the wider community
- having a clear system to follow is helpful for schools, and guidance to support a local approach would be helpful, e.g. on managing staff and pupil morale and anxiety
Action: Secretariat to update draft sub-group advice in light of discussions and circulate for comments.
Action: Sub-Group members to consider the draft evidence summary and respond with any comments.
The sub-group discussed whether or not schools should mix on dedicated school transport, following the anticipated move to beyond level 0 and the resulting changes to distancing requirements. Sub-group members agreed that pupils are mixing on public transport, and given the current state of the epidemic there is no longer a requirement to separate schools on dedicated school transport.
Date of next meeting
The next meeting will be held on 24 August.