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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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notevenat20 · 02/01/2021 12:38

This conversation is a little irrelevant in any case as I don't think secondaries are going to reopen any time soon.

Pastanred · 02/01/2021 12:39

the isolation is 10 days but they've been planning on dropping that with daily tests for last couple months

it was big news here in liverpool as we were trialling it

I expect its only lack of tests that's delayed it but its defo plan for all country long term

cantkeepawayforever · 02/01/2021 12:40

[quote Pastanred]see its not new

news.sky.com/story/covid-19-end-in-sight-for-contact-isolation-as-repeat-testing-trial-to-be-launched-12139843[/quote]
However, Pasta, the whole point is that the trial was abandoned because the Liverpool results talked about in the article were so poor.

The quoted 48% from Liverpool is from a SAGE paper in which Liverpool health board abandons the idea of lateral flow tests being used to allow family to visit relatives in care homes, precisely because of the low accuracy of the LFTs.....

So yes, the idea was floated, and abandoned for exactly the reasons i am explaining - the false negative rate is too high.

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Littlewhitedove2 · 02/01/2021 12:42

@moominmomma1234

And will the kids stick the swab far enough up their noses? I presume they will be doing it on themselves
They won’t need to? The stick on these tests goes 2cm up??
notevenat20 · 02/01/2021 12:43

So yes, the idea was floated, and abandoned for exactly the reasons i am explaining - the false negative rate is too high.

Do we know if the false negatives are statistically independent? What I mean is, is it like tossing coins? You might get a tail but the chances of getting lots of tails in a row is really small.

SansaSnark · 02/01/2021 12:47

@notevenat20

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.

  1. If they are not self isolating, they are breaking the law, and that is for the police to deal with. I haven't heard of any students doing this, btw.

  2. Even if they are out and about at home, they will still have less contacts than if they come into school and mix with hundreds of others.

  3. Reducing infection rates in schools reduces infection rates within the community.

notevenat20 · 02/01/2021 12:54

they are not self isolating, they are breaking the law, and that is for the police to deal with. I haven't heard of any students doing this, btw.

I haven't heard of any children who self isolated fully the entire time. I wonder if you are getting the truth from those you know.

cantkeepawayforever · 02/01/2021 12:55

@notevenat20

So yes, the idea was floated, and abandoned for exactly the reasons i am explaining - the false negative rate is too high.

Do we know if the false negatives are statistically independent? What I mean is, is it like tossing coins? You might get a tail but the chances of getting lots of tails in a row is really small.

3% for 5 tests at 50%.

If you look at it for 100 students who are infected:

On day 1, 50 will circulate freely, with false negatives.

On Day 2, 25 will continue to circulate freely with false negatives.

On Day 3, 12.

Day 4, 6

Day 5, 3.

That means from those 100 students, there will be 96-97 additional 'person days' of close contacts within school that wouldn't previously have happened at all. Each of those close contacts will then also have close contacts, and soon a chain of infection is set up which could easily result in having to test the whole school population each day - in the same way as some local schools had only 1 year group in under the previous isolation plan.

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cantkeepawayforever · 02/01/2021 12:57

@notevenat20

they are not self isolating, they are breaking the law, and that is for the police to deal with. I haven't heard of any students doing this, btw.

I haven't heard of any children who self isolated fully the entire time. I wonder if you are getting the truth from those you know.

I do know of an educational establishment that used an existing rule that threatened suspension for students who 'deliberately endangered the health and safety of others' to make sure compliance with isolation was pretty good....
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itsgettingweird · 02/01/2021 12:57

Very true what above poster said about attendance.

And they need attendance figures up because they've argued until they are blue in the face that schools are safe.

Slogans and promises above public health.

That's why we are in this mess so far down the line.

canigooutyet · 02/01/2021 12:58

If they test positive for the lateral flow they are also asked to get the other test and these will also be available through the school.

MrsSpenserGregson · 02/01/2021 13:01

We received details of our school's testing procedure in an email from the Head yesterday. I doubt whether the poor man has managed one single 24-hour work-free period since March 23rd.

We have an inset day on Monday, then online / remote teaching begins on Tuesday (I work at a secondary school). Friday's lessons will be set in advance and will not involve any interaction with teaching staff, because all staff members (if they consent) will be in school, at set times and properly socially distanced of course, for their first Covid test.

I love our Head, but nowhere in the email did he address the very real possibility of the tests and the equipment not showing up. How the Jeff is the government going to distribute millions and millions of tests to secondary schools on Monday? Are they sending them out via Hermes? We will be waiting weeks and the boxes / pallets will probably be delivered to the local Sainsburys instead. Or left behind the bins three doors down.

I have no idea how many of our staff will consent to being tested. I think it is a ridiculous "solution" which will only increase transmission for all the reasons already stated on this thread.

My own DCs are teenagers who read / watch the news and are old enough to decide for themselves if they wish to consent to being tested at school or not. I hope they don't consent.

What a shambles.

If anyone fancies a bet: my money is on no more than 30% of schools across England (sorry, I'm saying England rather than UK as Im not sure that Scotland, Wales and N Ireland are following England's ridiculous plan?!) receiving their testing kits as planned next week. And I would bet my house that secondary schools do not readmit all pupils, face to face, on 18th January. If they manage it before February half term I will be really impressed; I'll consider it a win if we can fully welcome the students face to face any time before Easter.

moominmomma1234 · 02/01/2021 13:14

Ah that’s good to know thanks

moominmomma1234 · 02/01/2021 13:16

@Littlewhitedove2 that’s good to know about the sticks only needing to go 2cm up the nose , thanks

Pamperedpet · 02/01/2021 13:23

Also, remember, dealing with children here. They get a negative result, they see it as a free pass to mix and mingle. Which is a worry if the tests are less accurate.

Littlewhitedove2 · 02/01/2021 13:30

[quote moominmomma1234]@Littlewhitedove2 that’s good to know about the sticks only needing to go 2cm up the nose , thanks[/quote]
No problem. It’s 4 swipes either side of throat and then 2cm in nose. I have a younger secondary aged child so was worried but think this is doable. There will be staff or trained volunteers overseeing all under 18’s

ByersRd · 02/01/2021 13:35

There will be staff or trained volunteers overseeing all under 18’s

Staff and volunteers from where?

cantkeepawayforever · 02/01/2021 14:24

The logistics are indeed challenging impossible. That's not the main point.

The main point is that the use of lateral flow testing instead of isolation for contacts of positive cases makes schools more dangerous, and will increase infection within schools and in the community at a time when we can least afford this.

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Littlewhitedove2 · 02/01/2021 14:26

@ByersRd

There will be staff or trained volunteers overseeing all under 18’s

Staff and volunteers from where?

The schools are advertising the covid testing role now and taking Applications! Training will be given apparently
SansaSnark · 02/01/2021 14:29

@notevenat20

they are not self isolating, they are breaking the law, and that is for the police to deal with. I haven't heard of any students doing this, btw.

I haven't heard of any children who self isolated fully the entire time. I wonder if you are getting the truth from those you know.

My Y8s aren't aware enough to lie about this. I didn't ask them, but when they came back to school, they were all moaning about how boring it had been, not being able to go out. They are absolutely the sort of class where one would have said "Oh, mum let me go to the park" or whatever.

I also live in the community where I teach, and I haven't seen a single isolating kid out and about- and I do see kids around a fair bit- I'm aware this is not scientific by any stretch.

If the children you know aren't isolating when currently told, then I don't think a lateral flow test will make any difference.

Panickingpavlova · 02/01/2021 14:35

Pamper, that false confidence is one of my biggest gripes with this.

It's hard enough trying to explain how the virus works and why we do what we do.

I remember when I was trying to explain sd to one student she said '' but we're in a bubble, we are safe in our bubble ''

'' no, any one of us could have this right now ''

'' people shouldn't be in with symptoms ''

'' the virus is infectious before you show symptoms which is why we must still sd in class, wear our masks ''

Oh!!

(head on desk).

It's hard enough.. How to now explain these these tests don't guarantee anything!!

Panickingpavlova · 02/01/2021 14:37

As far as I a aware, training is a video, and I'm not allowing a non trained professional medic near my dc to do an invasive test... Only a professional would know the risks and correct hygiene, you can't learn that in 2 hours

starrynight19 · 02/01/2021 14:38

This is not to make schools safer but to improve attendance.
It’s a National scandal they expect children and staff not to self isolate when they have been a close contact.
If it’s that safe why are we isolating at all just give everyone these tests.

SansaSnark · 02/01/2021 14:39

Also, as the converse to tests making people believe they should actually isolate- a negative test is more likely to make someone think they are safe.

So a student might visit a grandparent following a negative test, where they otherwise wouldn't have done. But that test could be wrong.

cantkeepawayforever · 02/01/2021 14:46

@SansaSnark

Also, as the converse to tests making people believe they should actually isolate- a negative test is more likely to make someone think they are safe.

So a student might visit a grandparent following a negative test, where they otherwise wouldn't have done. But that test could be wrong.

Exactly. That is exactly why the use of these tests as a way of showing whether it was safe to visit people in care homes was abandoned by Liverpool health authorities.
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