Rational thread on the risks of schools staying open

[WhatWillSantaBring]

I understand that there are a lot of strong feelings on this so hoping that we can limit this thread to facts and data (rather than emotions).

What (formal) evidence is there that teachers are at a greater risk than the general population?

What (formal) evidence is there that children are passing the infections to adults?

I've seen the data that educational institutes are associated with increased infection rates (though really unhelpful that the data isn't split between nursery/primary/secondary/tertiary) but that doesn't distinguish between the numbers of the pupils getting infected and the numbers of adults in those settings getting infected. In my head, if schools were responsible for the spread, you would expect to see (a) a higher incidence of C19 in teachers and (b) a higher incidence of C19 in the parents of school aged children. Is there data to back this up?

The only study I've found so far is one in Sweden (where schools stayed open throughout the spring) which gave a relative risk of between 0.7 and 1.1.

I'm really curious about this, and hoping that some epidemiologists are lurking and will post me some links to peer reviewed studies. (Disclaimer: I'm not a scientist but I can read and follow most scientific papers)

[RigaBalsam]

inews.co.uk/news/politics/scientists-urged-government-to-close-secondary-schools-744795

[LurkingEpidemiologist]

Hi WhatWill,

There are some assessments of "which non-pharma measures worked" articles that showed that cases/deaths declined when schools closed, first wave. "Natural experiments" or "quasi-experimental" studies. They addressed schools open as normal, they can't distinguish if it's parents not nattering at school gate & staff not interacting as normal OR kids not interacting that led to lower transmission.

You could try this phrase in google scholar:
educational settings coronavirus.
Keep in mind The literature is currently flooded with unreliable studies. Quality assessment takes a while, though.

There are lots of validated reasons to think that 'covid secure' schools should have very low transmission rates. Below studies may be more robust than others and are suggesting low transmission in school settings. If universities are only offering 3-4 contact hours/term, then the Uni danger place isn't Uni classes at all, but the student residences.

www.sciencedirect.com/science/article/pii/S2352464220302510
papers.ssrn.com/sol3/papers.cfm?abstract_id=3675431

Look up the sKIDS study for ongoing monitoring in English schools.

[MillicentMargaretAmanda]

I would be careful reading any studies on other countries. Pretty much every other developed country already had smaller class sizes than us and/or put in additional measures such as mask wearing in class.

[MillicentMargaretAmanda]

I'd say also take with a pinch of salt studies done in June-July. Schools were socially distancing with small bubbles and lots of outside time. Not a good comparison to the current situation.

[Breadandroses1]

I'd also understood that the teacher was much more likely to pass it to children rather than vice versa. There's a nice visual of that here: english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html

I think a few t & t datasets (for what it's worth) have shown that most school infections are community acquired and brought into schools rather than kids passing it in school. I'd be quite interested to see if schools that have a 2 week half term (we did as do lots of schools in our area) show lower rates in surrounding community without any other measures.

It's fascinating- I've worked in education in all sorts of humanitarian settings (including Ebola and during the HIV crisis) and NEVER seen demand for schools to close anywhere before, even when they are being deliberately targeted.

[MillieEpple]

I dont understand why your measure is "greater risk'. Surely we need to show something about schools creates less risk to teachers so normal safety measures like social distances, mask wearing and handwashing, and minimising contact time are unecessary?
I also dont understand why you've picked just teachers. When much of the measures in other places are to slow down/stop community spread.
I think the discussion needs to be wider and look at if schools are driving community spread.

[notevenat20]

It's fascinating- I've worked in education in all sorts of humanitarian settings (including Ebola and during the HIV crisis) and NEVER seen demand for schools to close anywhere before, even when they are being deliberately targeted.

I agree. And at least on MN, I get the impression that people don’t really value education as being of vital importance either to the child or the country.

[MostDisputesDieAndNoOneShoots]

I don’t have anything to add to this OP but wanted to thank you for starting it. Me and DP are teachers in secondary with two kids in primary. It’s good to have a place to talk about this without being greeted with “BUT OUR KIDS NEED AN EDUCATION!” Yes, of course they do. But schools need to be safe.

[notevenat20]

I think the discussion needs to be wider and look at if schools are driving community spread

Yes. In countries/places where most things are shut apart from schools, I am guessing this will make it easier for scientists to estimate how much schools are driving infection rates.

[Beebityboo]

Is there a consensus on whether primaries are generally safer than secondaries? If so is that just due to size or is it the actual ages or the children?
Anecdotally round here all of the big outbreaks have been in secondaries. My DC's primary has had one case in eight weeks.

[BluebellsGreenbells]

Hasn’t there been a rise in woman between 20/40 being in hospital?

Does that answer your question

[noblegiraffe]

I've seen the data that educational institutes are associated with increased infection rates (though really unhelpful that the data isn't split between nursery/primary/secondary/tertiary)

Here you go.

Primary is better than secondary, secondary Y7-11 is getting close to sixth form/uni rates of infection.

An increase in hospitalisations in women 20-40 has been linked, in part, to educational settings.

[Beebityboo]

Thanks Noble. Wr deregistered our secondary DD yesterday (not just due to Coronavirus) but still have two in primary. I wonder how much this has reduced the risk.
I am aghast at the levels of infection in secondaries. Something desperately needs to be done.

[Breadandroses1]

There was an interesting international comparison dataset here as well: www.cgdev.org/blog/back-school-update-covid-cases-schools-reopen

At that point, evidence was that 25 days after reopening schools were not driving a surge in cases in any of the countries surveyed.

[Breadandroses1]

(Hopefully they will revisit it)

[midgebabe]

This might sound brutal, but objective was asked for

Schools don't need to be...and can never be even in normal times fully safe. So let's forget that notion. It's about being safe enough. And by that, I mean at a population level, not keeping individual teachers safe ( I am ignoring children because they are so little affected by the virus)

At a population level, we can "afford" some teachers and children to become ill and even die as the long term health and economic cost needs to be taken into account. Some deaths now to ensure that millions of children get properly educated which is causally related to children being wealthier and healthier later is ( I suspect) considered a good deal. Small numbers now or large numbers later.

At a population level, we can afford some virus deaths, but we need to have R below 1.

I have seen nothing that's conclusive on the impact of schools on R. We are basically working out what we have to shut to get R below 1 whilst minimising short and long term economic harm. So you have a provisional ranking, impact on R and impact on economy of every action and you try to optimise that balance. How much of the economy can you save keeping r just below 1. The obvious conclusion is that it is believed the economic harm from school,closures is greater than the harm from shops and pubs (given there has been no evidence to suggest some settings such as pubs are disproportionately responsible for virus spread )

Add into that balance the fact that children and younger adults are relatively safe from the virus, so the only worry is community spread...which when r is less than 1 is not a Problem at a population level. Clearly it's a problem for the individuals affected. I did say it seems brutal.

Add also the vulnerable children who may have suffered great harm already being out of sight

Vulnerable teachers...overweight and over 50 for example, or diabetic.....personally it would be good to understand the impact of setting those teachers into furlough in areas with high virus levels

[Sunflowers246]

The discussion needs to be wider and include social scientific aspects, such as the negative consequences to children of missing school and of the unintended consequences to wider society and the working population of schools closing.

It also needs to take into account the possibility of children developing some immunity (more evidence today of long term immunity via T cells), as they probably won't get any vaccine soon.

[notevenat20]

The discussion needs to be wider and include social scientific aspects, such as the negative consequences to children of missing school and of the unintended consequences to wider society and the working population of schools closing.

And also the consequences for the country of having a less educated next generation.

[WhatWillSantaBring]

@MillieEpple I've chosen to discuss education because there seems to be a really strong community (e.g. the NEU) calling for schools to be closed but also a really strong community (e.g. parents) desperate for them to stay open. We don't see this in the care, health or food sectors, despite the fact that there are almost certainly increased risks in at least some parts of those chains.

What I'm trying to understand is whether there is a real risk to teachers. "Increased risk" is surely the only measure, because until this virus has gone completely, there is no such thing as "no risk". Every one of us is at risk of contracting the disease, so to me it is case of measuring the increased risk that teachers have over the gen pop AND THEN. If there is no increased risk, then I see no need for a debate about whether schools should stay open. If they are at an increased risk, then there is a legitimate need to have a debate about whether that risk is necessary for the provision of an essential service (but that debate is not what this thread is about).

I've read a lot on these threads about how scared teachers are, but I'm not seeing the hard data to show that this is a legitimate fear.

The secondary question is whether children are responsible for community spreading. Given the level of physical contact parents have with DC, I would be expect every parent of a Covid positive child to get infected - if DC are, in fact, responsible for the spread. I would also expect any childs' best friend/desk neighbour to catch the disease if that child gets it.

These seem like reasonably simple studies* to do if you pick a few schools in an area with high rates - follow the child with with positive test and see who around him/her gets the disease.

*again, realise that this is entirely relative - simple in the context of "track and trace 5000 pupils" rather than "track and trace 60 million people".

[WhatWillSantaBring]

Also recognise that studies done in this country before September are meaningless, hence looking at Sweden.

[Sonnenscheins]

You can't just look at the 'risks' of keeping schools open.

You need also to look at the massive 'costs' or 'risks' of closing them!

[TheKeatingFive]

Ok. Irish data.

covid19ireland-geohive.hub.arcgis.com/

Schools open, rates dropping significantly.

R estimated to be close to 1 now after being as high as 1.8 a few weeks ago.

Only major difference is mask wearing at secondary (certainly not universally enforced, but let’s assume mostly for the sake of argument).

Class sizes, building types, room size all on a par with U.K.

[WhatWillSantaBring]

Schools don't need to be...and can never be even in normal times fully safe. So let's forget that notion. It's about being safe enough. And by that, I mean at a population level, not keeping individual teachers safe ( I am ignoring children because they are so little affected by the virus

YES this exactly.

[BunsyGirl]

This is latest data for my local authority area. The cases in under 20’s appear to be levelling out.

[notevenat20]

The secondary question is whether children are responsible for community spreading. Given the level of physical contact parents have with DC, I would be expect every parent of a Covid positive child to get infected - if DC are, in fact, responsible for the spread. I would also expect any childs' best friend/desk neighbour to catch the disease if that child gets it. These seem like reasonably simple studies to do if you pick a few schools in an area with high rates - follow the child with with positive test and see who around him/her gets the disease.*

Yes with some comments. First, I personally know families where only one person has had symptoms for covid despite their all living in the same house. The virus is mysterious that way. Second, it seems relatively simple to look at the prevalence of covid in parents of school aged children to see if that is much higher than those without children. If it’s not much higher then that would suggest that teachers are not at a much higher risk. Maybe it’s already been done?