Staying vigilant and responding to COVID-19 symptoms
ELC settings should ask staff and parents and carers to be vigilant for the symptoms of COVID-19, and to understand what actions they should take if someone develops them, either onsite or offsite. It is essential that people do not attend a setting if symptomatic. Everyone who develops symptoms of COVID-19 must self-isolate straight away, stay at home and arrange a test via the appropriate method. Their household must also self-isolate.
The key COVID symptoms are:
- new continuous cough
- fever/high temperature
- loss of, or change in, sense of smell or taste (anosmia).
All staff and parents and carers should be advised that anyone with these symptoms, or who has had contact with a family/community member with these symptoms, should not attend or should be asked to return home. They should also be told to follow Test and Protect procedures.
All staff working in and with settings should be supported to follow up to date health protection advice on household or self-isolation and Test and Protect procedures if they or someone in their household exhibits COVID-19 symptoms, or if they have been identified by NHS contact tracers as a close contact of someone with the virus. Guidance on this is available from NHS Inform, Parent Club and gov.scot.
The National Clinical Director has also written an open letter to parents and carers providing guidance on how COVID-19 symptoms differ from those of other infections circulating at this time of year. Some of the key points to ensure that parents, carers and staff are aware of are as follows:
- It is essential that people do not attend a setting if symptomatic.
- Everyone who develops symptoms of COVID-19 – a new, continuous cough; fever or loss of, or change in, sense of smell or taste - must self-isolate straight away, stay at home and arrange a test via the appropriate method (see below).
- People who live in the same household as a person with symptoms must also self-isolate straight away and stay at home. Only those developing COVID-19 symptoms should be tested.
- ELC setting staff who opt to undertake asymptomatic testing do not need to self-isolate while awaiting results, as long as no symptoms develop, unless they are a close contact of a symptomatic or confirmed case, in which case they will need to self-isolate. If their symptomatic test is positive, the member of staff must isolate until a confirmatory PCR is received, even if they are without symptoms. If their symptomatic test is negative, they can remain at work unless symptoms develop but should not consider themselves free from infection and must still adhere to all mitigations.
- If the PCR test is positive, the person must remain in isolation until 10 days from symptom onset, or longer if symptoms persist or 10 days from the test date if there are no symptoms. The rest of the household must remain in isolation for 10 days from symptom onset in the symptomatic person, even if they don’t have symptoms themselves. These people should not attend settings. The date of onset of symptoms (or of test, if asymptomatic) is to be considered day 1 of 10.
- Everyone who tests positive for COVID-19 will be put in touch with the local contact tracing team so that other close contacts can be identified. All close contacts who are in the same household as confirmed cases must self-isolate immediately.
- Everyone who needs to self-isolate as close contacts of confirmed cases must continue to do so for 10 days from their last day of exposure to the case, even if they have a negative test result. In a household, the 10 days starts on the date of symptom onset in the first case.
- Unless otherwise advised by Test and Protect or local Incident Management Teams, where children or staff do not have symptoms but are self-isolating as a close contact of a person who is a confirmed case, other people in their household will not be asked to self-isolate along with them.
Staff can book a test through www.nhsinform.scot, the employer referral portal (for staff only – see below) or, if they cannot get online, by calling 0800 028 2816. Parents and carers can book a test on a child’s behalf.
Settings, other than in those areas detailed in the following paragraph, will also be able to register their symptomatic staff as category 3 key workers under the employer referral portal, to ensure priority access to testing. The nature of this portal is to prioritise tests and appointments over the general public. This route directs individuals through to a Regional Test Centre or Mobile Testing Unit (whichever is nearer). For those who cannot access an RTC/MTU (if they do not have access to a car or live too far away), they can order a home test kit.
For settings in Orkney, Shetland and Eilean Siar, there are different routes to accessing a test in your local areas. ELC settings in these areas should liaise with their local Health Boards to ensure priority access to symptomatic testing for ELC setting staff.
Unless staff are symptomatic or are advised to get a test by a healthcare professional, then testing is not a requirement. However, if members of staff are concerned that they have been at risk from infection, then they may request a test whether or not they have symptoms. If they have been identified as a close contact they must self-isolate regardless of any test result.
Staff should make such requests via their employer, who can book a test for them using the employer portal, or for staff in Orkney, Shetland and Eilean Siar, can advise staff on the testing arrangements with their local Health Board.
If a child develops symptoms of COVID-19 while in the setting, a ventilated space must be available for the child to wait in until they can be collected by their parent/carer. Where space allows, you should prevent contact with any other children in the setting. Ensure that guidance on the use of PPE is followed. Care must be taken however to ensure the appropriate levels of supervision of all children.
Staff and parents who are smartphone users should be encouraged to download The Protect Scotland contact tracing app to help suppress the spread of COVID-19.
Managers and staff must be aware of Test and Protect arrangements should someone become unwell. If a member of the staff team has symptoms, they must self-isolate and not attend the setting, and must contact the NHS to arrange to be tested at 0800 028 2816 or www.nhsinform.scot. You can find more information on the COVID-19 Test and Protect webpage.
All ELC settings are considered complex settings and cases will be prioritised and escalated to specialist local Health Protection Teams.
All parents should be asked to mention childcare arrangements if contacted by or contacting the Test and Protect service.
If a parent/carer or staff member is contacted by a contact tracer and told to self-isolate for 10 days, the person should leave the setting to self-isolate at home straight away and, if possible, wear a face covering on route and avoid public transport if symptomatic. The Scottish Government has published advice for employers on how to support people who are asked to self-isolate, available here.
If a child or staff member tests positive, the contact tracer will take into account the close contacts the person has had within the setting.
ELC providers must keep clear records of children, adults and staff attending their settings, and of the composition of groups undertaking activities. These records will help to ensure rapid response and contact tracing should a positive case occur. This will enable employers to maintain records on staffing capacity in individual settings and to make judgements about whether it will be necessary to close settings temporarily due to high levels of staff absence. All providers should plan as much as possible to minimise the operational impact of individual staff or groups of staff being required to self-isolate.
The management of single cases, clusters and outbreaks of COVID-19 is led by local health protection teams (HPTs) in health boards across all settings in society. For educational settings this occurs inclusively alongside local partners, such as ELCs, schools and local authorities as well as Public Health Scotland, as required.
The procedures for incident and outbreak investigation and management are well established through Managing Public Health Incidents.
ELCs and other settings should ensure that they know how to contact their local HPT and their designated person is for doing so is often the Head Teacher.
A cluster or outbreak of COVID-19 occurs when a setting has two or more confirmed cases of COVID-19 within 14 days. If a plausible transmission link between two or more cases is identified within the setting, this is indicative of an ‘outbreak’; if not, it is referred to as a ‘cluster’.
For educational settings, Public Health Scotland advise that the local HPT is contacted when a single confirmed (test positive) case of COVID-19 occurs in a pupil or staff or if there is suspicion of an outbreak of cases in a specific setting, e.g. an increase in the background rate of pupil absence due to suspected or confirmed cases of COVID-19. In this way, the HPT can provide quick advice to settings to support risk assessment of the situation and any further action required.
Early year settings will be expected to work closely with their local HPT to resolve such situations. Actions that ELC and other management teams may need to be involved in when cases of COVID-19 arise in staff or children include (but are not restricted to):
- attendance at multi-agency incident management team meetings
- communications with children, parents/carers and staff – these are vital to provide reassurance to school communities
- providing records of setting layout / attendance / groups
- implementing enhanced infection, prevention and control measures
- media communications.
ELC and other childcare facilities remain settings of low risk for COVID-19. The HPT will lead the incident management team (IMT) that usually co-ordinates such activities and through its members will investigate the circumstances of each incident and agree control measures. The investigation will involve reviewing risk assessments and compliance with existing guidance. Control measures may include hand hygiene reviews, enhanced cleaning regimes, adequate ventilation, reinforcement of messages on physical distancing, reminders about symptom vigilance and self-isolation and advice on face coverings and testing of children and staff, when needed. Usually childcare settings continue to operate throughout. In larger-scale clusters, it may be necessary to temporarily close a setting to facilitate cleaning or when staff capacity makes it unfeasible to remain open. Rarely do settings need to close on Public Health grounds. Any discussion of possible closures will be determined through the multi-agency IMT.
Setting should maintain appropriate records to support outbreak control measures and information flow between participating agencies must be facilitated respecting the principles of confidentiality and Data Protection legislation. In order to protect children and staff and to maintain access to education, confirmation of childand staff COVID-19 case and close contact numbers (including those self-isolating) are shared in confidence between the agencies.
Managers must notify the Care Inspectorate in the event of any confirmed or suspected outbreak of an infectious disease. Notifications and guidance are available through eForms.
The Scottish Government has produced an infographic that can be used to remind staff of what to do if there is a suspected outbreak.
Scotland has an excellent programme of community surveillance. This allows us to monitor actively trends in the pandemic, both nationally and more locally.
There is also specific surveillance in respect of schools and children/young people. This draws on COVID-19 related information from a range of sources and covers all school ages and ELC settings.
We are also launching an additional surveillance programme which will see antibody testing for substantial numbers of educational staff volunteers to identify the prevalence of COVID-19 antibodies over time.
Taken together, these sources will allow regular reporting on indicators such as: overall incidence and swab positivity for Scotland; incidence and swab positivity for children; number and proportion of cases that are among education workers; hot spots by local authority area; number of clusters or outbreaks that are under investigation within educational settings; levels and changes in antibodies in educational staff; and, if feasible, asymptomatic transmission among older children and school workers.
These data will inform decision-makers at different levels as they consider any adjustments to make to arrangements – including this guidance – or any investigations to be conducted at certain localities to explore what local responses are required.
In the 2020-21 academic year, there has been an expectation at national level that HNC Childhood Practice students will commence their placements from the end of the October break onwards, although timescales for commencement may vary across colleges. To support colleges and childcare settings to offer placements to HNC students in academic year 2020-21, SSSC have published an Employer Toolkit to provide further information to support placement providers, students and centres to support the safe return of students to placements. The toolkit provides guidance and links to more information to support the safe completion of the placement element where possible. It also contains links to risk assessment tools, current national guidance, frequently asked questions and an example contract. Read the toolkit here.
In addition, the Scottish Government has now established a Learner Journey Ministerial Task Force, comprising representatives from colleges, universities, students and unions, to consider the challenges that colleges and universities face this academic year in delivering practical learning across all subjects with a placement element, including the HNC Childhood Practice. The immediate priority for the task force is to help students complete their courses and move into further study or employment. The task force will also consider arrangements if some students need to defer a part of their course.