Clinical trial in secondary school children to replace isolation of close contacts with daily testing

(61 Posts)
noblegiraffe Sat 17-Apr-21 11:46:29

You might have thought that the government plan to replace isolation for school children with daily LF testing was binned in January when schools had to close. Not so. Apparently they realised that a planned nationwide rollout to children of an intervention when they had no idea if it would increase or decrease transmission rates in schools was not particularly well-supported.

So now they are running a clinical trial. A few schools started this on 15th March and it is being widened to more schools next week. A child who has been identified as a close contact of someone who has tested positive (not within their household as higher risk) will be able to choose 10 days of isolation or 7 days of supervised LF tests at school. Those sitting around them in lessons will not be asked if they are happy with this. Outside of school they will still be expected to isolate because of their increased risk, the testing only allows them to go to school.

Given the general picture of the government's proposals and actions - LF tests now available to all, plans for testing before sports events etc, it's clear that despite serious concerns over their sensitivity (false negatives), they will be forming a large part of future virus control measures. Operation Moonshot.

Expect to see something tested on school children rolled out to workplaces by September.

Details in this twitter thread: twitter.com/karamballes/status/1382838861714296833?s=21

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kindlekeeper Sat 17-Apr-21 11:54:56

Our school is doing this. Very happy with it and a much more rational approach.

DancesWithDaffodils Sat 17-Apr-21 11:55:41

Oh, fcuk.
Hope this doesnt come my way. I wouldnt be happy for my kids to be tested or exposed in this manner, and I definitely dont have time at work right now to spend the first hour of my work day watching kids not test properly and then process the samples.

noblegiraffe Sat 17-Apr-21 11:59:12

It's a trial, kindle precisely because they don't know if it's a more rational approach.

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noblegiraffe Sat 17-Apr-21 12:02:00

That's true, Dances, we've just taking down our testing lab and regained the use of our hall!

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Bellyfat Sat 17-Apr-21 12:02:15

In my daughters school I haven't heard of a single close contact going on to develop covid. Given how much face to face school they've missed this seems like a practical way to handle the situation.
I say this from a place of relatively low risk, I may have reacted differently if our household were in an at risk group.

mumsneedwine Sat 17-Apr-21 12:07:15

As long as the children are ok. Sod the staff yet again. Most aren't yet vaccinated and those that are have had one. Yeah, more of us can get sick again. 529 school staff have died during the pandemic. Thousands now have long term health issues. Obviously not one of them caught it at school because that's what Boris says.

noblegiraffe Sat 17-Apr-21 12:07:47

In my school I've seen covid go through a year group even with close contacts isolating because the school definition of what counts as a close contact (sat within 2m) is woefully inadequate when dealing with an airborne virus. I don't think this trial addresses that, although I guess they will claim that the LFT home-testing program will pick those up.

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Chessie678 Sat 17-Apr-21 12:08:13

Close contacts are not actually very likely to have covid. Last I read the chance of a non household close contact actually developing covid was about 1%. Chances are it’s less than that when the level of covid in society is low. There has to be a long term alternative to children missing two weeks of education multiple times a year because they have a 1% chance of having a virus which the majority of vulnerable people are vaccinated against. What would you suggest?

I actually think you could bin the close contact isolation altogether without seeing an increase in cases. The impact of test and trace has, by the government’s own admission, only ever been marginal. I don’t love the idea of continually testing healthy children either but would think it’s better than the alternative of them missing so much school.

noblegiraffe Sat 17-Apr-21 12:09:23

Last I read the chance of a non household close contact actually developing covid was about 1%

Is that in schools where non-household close contacts are an awful lot closer than is allowed outside of schools?

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mumsneedwine Sat 17-Apr-21 12:15:04

@Chessie678 but they'll miss school if teachers get sick again. No staff, no teaching. And I've seen it rip through a year group from one case, and then ripple out into homes. I know several children who have long COVID now.
But the press say schools are COVID safe so yeah, everything is ok because it hasn't happened to you. Yet.

Tonylepony Sat 17-Apr-21 12:24:51

Good. Really hope this approach is rolled out quickly. The disruption to education this past year has been horrific and will have long term ramifications for many. Vulnerable teachers and parents will by now have been vaccinated at least once.

noblegiraffe Sat 17-Apr-21 12:26:59

The disruption to education this past year has been horrific

Indeed. Perhaps putting mitigation measures into schools to stop covid spreading there would have been a good idea before March.

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mumsneedwine Sat 17-Apr-21 12:32:04

That's ok then. We've had one vaccine so shouldn't die. Just tough on anyone under 45, you can just get sick. Probably only get a bit of long COVID so don't worry.
My 48 year old colleague, healthy and lovely, died last year. It's not only the vulnerable that do.

Chessie678 Sat 17-Apr-21 12:34:16

There was a study done in Singapore which found 1.3% transmission for work contacts and separately for social contacts with a definition of 30min less than 2m contact. Another study done in China found similar and also that transmission risk fell with age. doi.org/10.1016/S1473-3099(20)30833-1 for the Singapore one. I’ve read a news article claiming similar for the Uk but not sure what it was based on. Of course these may not directly apply to schools but I’m just making the point that the chances of close contacts actually having covid is really quite low.

Clearly there is a non zero risk but at some point the approach to isolation will have to change and it seems sensible to think about a way to do that. At least they’re actually trying to gather some evidence this time rather than just implement random policies.

Saucery Sat 17-Apr-21 12:34:50

So my child could go to school but not to a sports club in the open air after school? What utter nonsense they are proposing.

OverTheRainbow88 Sat 17-Apr-21 12:42:31

The fact they are expected to isolate other than going to school says it all really.

If the LFT is good enough to replace isolation from
School, why can’t the close contacts then go to restaurants/shops etc?

I can’t imagine them being allowed to go to a GP appointment as a close contact with a negative LFT

noblegiraffe Sat 17-Apr-21 13:01:42

I don't think they've conducted a trial to ascertain how accurate LF tests are when administered by children?

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ConstantlyChanging Sat 17-Apr-21 13:04:15

Covid ripped through my child’s school a few weeks ago. The LFT tests and isolating contacts didn’t even vaguely stop it.

OverTheRainbow88 Sat 17-Apr-21 13:04:26

www.bmj.com/content/371/bmj.m4848

This isn’t a huge sample and is adults but says about 48.8% accurate

Swirlingasong Sat 17-Apr-21 13:04:59

Tonylepony

Good. Really hope this approach is rolled out quickly. The disruption to education this past year has been horrific and will have long term ramifications for many. Vulnerable teachers and parents will by now have been vaccinated at least once.

And what about children who were on the shielding list and their siblings?

nether Sat 17-Apr-21 13:11:52

This is a bad idea if it includes classes and subject groups where there are other pupils from CEV households.

One of the biggest risks they face is an infection coming home from school, and as the rate of the vaccine working as expected in some of the CEV conditions is as low as 13% (source BMJ, referencing blood cancer which is one of the commonest in younger people) this is concerning

DancesWithDaffodils Sat 17-Apr-21 13:18:02

It's not just getting the hall back, Noble, it's the (support) staff pulled in to oversee it all.
Where I am, it's the science tech, facilities manager, librarian and finance support who will be pulled back out of their day to day jobs.

catpoooffender Sat 17-Apr-21 13:22:17

Can we have more detail on the cases of Covid 'ripping through' schools? How many cases are we talking here? And how many symptomatic cases vs just positive tests?

RafaIsTheKingOfClay Sat 17-Apr-21 13:24:26

Chessie678

There was a study done in Singapore which found 1.3% transmission for work contacts and separately for social contacts with a definition of 30min less than 2m contact. Another study done in China found similar and also that transmission risk fell with age. doi.org/10.1016/S1473-3099(20)30833-1 for the Singapore one. I’ve read a news article claiming similar for the Uk but not sure what it was based on. Of course these may not directly apply to schools but I’m just making the point that the chances of close contacts actually having covid is really quite low.

Clearly there is a non zero risk but at some point the approach to isolation will have to change and it seems sensible to think about a way to do that. At least they’re actually trying to gather some evidence this time rather than just implement random policies.

The Kent variant is completely different though. For the most part, studies taking place elsewhere in the world, aren't looking at B1.17 and most people talking about infections in their schools on here are probably talking about autumn term in the uk.

Where I'm from has had 2 covid outbreaks. The 2nd was kent variant and it was driven largely by transmission in schools in the early stage. They had to close schools completely, even to vulnerable and key worker children and then hugely restrict the list of children allowed back in when they reopened to get rid of it.

I'm fairly certain the government will have been told this is a terrible idea so hopefully they'll be taking full responsibility when schools end up having to close again. Sensible governments would be looking at ventilation and how to keep schools open in the long term, not just the short term.

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