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'Mass testing' in secondary schools

80 replies

cantkeepawayforever · 02/01/2021 11:45

The Government has been very poor in spelling out what 'mass testing' in secondary schools means, and the mainstream media has not been clarifying the issue. I am repeatedly seeing misconceptions on MN based on this poor messaging.

The guidance released (obviously dates will now change to an extent) is here:

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/947799/schools_and_colleges_testing_handbook.pdf

Leaving aside arguments about practicality (it is interesting that they have removed an earlier version of the guidance in terms of numbers of people required, but even this version says that a secondary school of 1000 will need 13 members of staff to administer testing), let us think about the TWO SEPARATE types of testing and whether they make schools and their communities safer or less safe.

The initial testing is of two separate tests 3-5 days apart (a total of 6.8 million tests would be needed for this phase). This would, if done successfully, improve the safety of schools temporarily, by identifying some cases that would not otherwise have been detected, and requiring them to isolate.

Of course, within a short time, as students go about their daily lives and potentially pick up infections but are not tested again, this marginal improvement in safety is not maintained.

The second test of testing is not, as a rational person might assume, an ongoing randomised testing programme that could pick up outbreaks within schools quickly and remove infected individuals from circulation.

Instead, it replaces the current isolation of close contacts of someone who tests positive with 'serial testing' over a period of 7 days (in effect, 5 tests, due to weekends). Again on a note of practicality, given the number of students isolating as close contacts towards the end of term, this will need between 2.5 million and 3.5 million tests per week, almost certainly significantly higher given the new variant.

On a much more important point, this is MUCH more dangerous in terms of spread of the virus in and via schools, given the high false negative rate found for LFTs. In effect, someone who has sat for an hour, maskless, sharing a desk with a positive case will continue to circulate freely in the school context (despite the fact that contact of a quarter this length, even with a mask, would lead to isolation for 10 days if it had happened outside school).

Even if they have been infected and would test positive using a PCR test, there is only a 50% likelihood (at a conservative estimate) that their first LFT will pick up their infection. There is only a 25% change that they will be picked up on the second day. Even after 5 tests, there is a 3% possibility that a positive case will have tested negative every single time.

But this infected student - who under current protocols would not have been in school for 10 days after contact with a confirmed positive, thus breaking the in-school chain of transmission - instead remains in school, creating their own chain of close contacts and potential infections, for days.

So be careful when you say 'oh, secondary schools will have mass testing, so they will be safer'. No, they will not. Initial mass testing will make them (very briefly) safer. Replacing isolation with repeated lateral flow tests will make them MUCH more dangerous in terms of viral spread.

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Noellodee · 02/01/2021 12:14

Better and safer than France, maybe.

That's like saying pizza is healthier than ice cream, though.

cantkeepawayforever · 02/01/2021 12:15

@notevenat20

The main advantage is catching pupils who have no symptoms. At the moment we catch none of those. If we only catch 50% that will be a huge improvement.
Which is why the FIRST of the two sorts of testing is sensible and would - briefly - improve safety.

At the moment, close contacts of a confirmed positive isolate, removing them from school entirely. You really cannot claim that leaving them in school but testing them with a test that is only 50% reliable makes everyone in school SAFER.

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fiveoldteddies · 02/01/2021 12:15

Well, sure better for DC to be told by school on day 9 (after contact) to self isolate..... Meant dd only needed to stay at home for 1 day...other DC was told on day 7.

Abraxan · 02/01/2021 12:16

The French system is not to send anyone else home if there is a positive case but to make all pupils wear masks. I think our proposed system is better and safer.

I'm not sure that just because one system used elsewhere is even more problematic is a good reason to use this system, which also have its flaws. Should it be really a case of the better of two poor systems?

We definitely should be testing
We definitely show have masks

But we also should definitely isolating close contacts too.

IFeelAMalenkyBitPoogly · 02/01/2021 12:16

And I would suggest anyone that realised how risky this is (ie everyone who has actually read the whole guidance and realises the LFT replaces self isolation) writes to their MP and asks the school how they can support them.

From a parental POV, I would prefer parents not to consent to this scheme as if enough of us did that we could (well you would hope) force yet another U turn and provide proper testing procedures. But the trouble is (as illustrated on this thread) people don't realise and just see the headline "students to be tested"

cantkeepawayforever · 02/01/2021 12:17

@fiveoldteddies

Well, sure better for DC to be told by school on day 9 (after contact) to self isolate..... Meant dd only needed to stay at home for 1 day...other DC was told on day 7.
Can you explain how the new system would be better? The delay in being told to self-isolate is because of the delay in the initial student testing positive - which is completely unaffected by this plan - not anything connected with the school.
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Panickingpavlova · 02/01/2021 12:17

Noel exactly.

I can't see how gathering up pupils to test them is a good idea, whoever is over seeing the testing is exposing themselves to huge viral loads.

Ppe needs processing with medically trained professionalism.

Children pulled out of class to be told they have the plague? How will that help their mental health . GDP out the window and everyone knowing it was Johnny who was pulled out, cue other parents gossiping about their lock down etticute etc... And whilst Johnny was sat there he was unwittingly infecting others.

This can lead to bullying, alienating... What if one dc falls really ill and they all know it was Johnny who came in sick??

Noellodee · 02/01/2021 12:17

Also, one of the new variants has not yet become established as the dominant strain in France.

People need to realise that in terms of Top Trumps, Covid v1.2 has a lot more dangerous stats than Covid v1.1 It changes how we need to deal with it. Comparing what works with the old strain and what works with the new strain is just plain wrong.

Abraxan · 02/01/2021 12:18

We should also be looking at this from the point of view of the CEV and CV staff and pupils expected to still be in our schools with this system. Also consider these now non-isolating children are also heading home where they maybe in contact with cev and cv family.

notevenat20 · 02/01/2021 12:20

At the moment, close contacts of a confirmed positive isolate, removing them from school entirely. You really cannot claim that leaving them in school but testing them with a test that is only 50% reliable makes everyone in school SAFER.

I don't fully understand what the current system is. I read here today only close contacts are sent home but at DCs secondary they have sent the entire year home every time and that has been a regular event.

I am not sure we should quote this 50% figure as fact. I know where it comes from but there are other figures that contradict it. For example from www.bartshealth.nhs.uk/lateral-flow

The test has an overall sensitivity of 76.8% for all PCR positive individuals but detects over 95% of individuals with high viral loads.

cantkeepawayforever · 02/01/2021 12:20

The French system is not to send anyone else home if there is a positive case but to make all pupils wear masks. I think our proposed system is better and safer.

Well, our current system of isolation led to 700-800,000 close contact students and STILL having skyrocketing cases. Replacing it with something LESS safe really doesn't feel 'better and safer' to me....

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SansaSnark · 02/01/2021 12:20

@notevenat20

The main advantage is catching pupils who have no symptoms. At the moment we catch none of those. If we only catch 50% that will be a huge improvement.
But if the pupils would otherwise be isolating, having them out and about in the community and school, and only catching 50% would be worse.

Bar the first initial tests, these tests are to be used for students who would otherwise be isolating for 10 days- that's the issue.

If it was just random sampling or something, it would be completely different.

Noellodee · 02/01/2021 12:22

Are people really this obtuse? Notevenat20 has been on millions of these threads. You would think they would understand the issue by now.

canigooutyet · 02/01/2021 12:26

School sent us emails yesterday about this.
Students to self test and instructions how to do this, plus video link. Parents can also attend their time slot test.

Close contacts the choice to test for 7 days or SI with the emphasis geared more towards SI. If anyone at home waiting results, student need to isolate.

Did HT's manage to get a break during their holiday?

notevenat20 · 02/01/2021 12:30

But if the pupils would otherwise be isolating, having them out and about in the community and school, and only catching 50% would be worse.

Yes sending more children home will probably decrease infection rates within schools. As ever nothing is really obvious as pupils who have not tested positive may not do much self isolating when at home whereas those that test positive via a lateral flow test may be much more likely to self isolate properly.

cantkeepawayforever · 02/01/2021 12:30

I agree that there are a range of sensitivity results for LFTs.

These range from 3% (Birmingham university students performing the test on themselves under supervision, but a small sample), through 49% (Liverpool adults performing tests on themselves under military supervision) through to a quoted level of 76.8% from the Oxford / PHE study (though this reduced to 57.5% when the tests were done by self-trained members of the public using a protocol, the scenario that will happen in schools www.ox.ac.uk/sites/files/oxford/media_wysiwyg/UK%20evaluation_PHE%20Porton%20Down%20%20University%20of%20Oxford_final.pdf)

50% seemed a reasonably conservative 'first guess' given these figures.

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notevenat20 · 02/01/2021 12:32

50% seemed a reasonably conservative 'first guess' given these figures.

There is also the 90+ figure for this with high viral load. I have no scientific view on this.

Pastanred · 02/01/2021 12:32

The plan was always to use tests to stop isolation given so few contacts go on to be positive.

stopping isolation is going to be the new target - thats why holiday isolation now stops at 5 days after negative test.

like i say Liverpool was meant to trial 'daily testing of contacts to avoid isolation' last month (workers not kids) but it was delayed and then i presume now its being used in school

Its a positive step. far too many sent home and hardly any test positive later

cantkeepawayforever · 02/01/2021 12:34

As ever nothing is really obvious as pupils who have not tested positive may not do much self isolating when at home

There is a HUGE difference in number of new close contacts between a potentially positive close contact who doesn't self isolate perfectly at home, and the same person circulating freely within a school environment.

Consider a GCSE student with 5 lessons + form time per day. They may well have 100 contacts within enclosed classrooms or lunch halls in each day, with 6 different members of staff. The same student imperfectly self-isolating at home may, yes, have 6-8 contacts, or some additional distant contacts while out for a walk, but this is not of the same magnitude.

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MissMarpletheMurderer · 02/01/2021 12:34

And these close contacts, who have an been tested with something which is at best 50% accurate, are getting on to busses, going into shops, attending weekend sports, seeing granny..... Rather than isolating at home.

Pastanred · 02/01/2021 12:35

www.cityam.com/test-and-trace-to-scrap-14-day-isolation-period-for-covid-contacts/

schools may start it but its going to run everywhere

cantkeepawayforever · 02/01/2021 12:36

@MissMarpletheMurderer

And these close contacts, who have an been tested with something which is at best 50% accurate, are getting on to busses, going into shops, attending weekend sports, seeing granny..... Rather than isolating at home.
Exactly. It is the risk for the community as a whole, not specifically for schools, that should be considered at this point.
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cantkeepawayforever · 02/01/2021 12:36

@Pastanred

www.cityam.com/test-and-trace-to-scrap-14-day-isolation-period-for-covid-contacts/

schools may start it but its going to run everywhere

Pasta, The isolation period has been 10 days for some time now....
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