We still don’t know how severe the Omicron wave will be, and debates are raging about closing nightclubs, alcohol curfews and work-from-home guidance. It can sometimes feel like last Christmas all over again. But one decision should be clear. Given the tools and knowledge we have now, school closures should be off the table.
Why were schools closed at all in previous lockdowns? The best approach was to minimise risk, given the limited knowledge about Covid-19 transmission and with no vaccination available to protect against severe health outcomes and death. Concerns about many different groups factored into policy decisions on schools.
The first concern was the risk to teachers and school workers such as cleaners and security guards being in an environment where they could contract Covid-19 during their working day. Then there was risk to family members, particularly grandparents and vulnerable parents, of children first contracting Covid-19 at school and then bringing it home to their households. There was also the risk to children themselves of contracting Covid-19 at school; the concern for children was less about severe outcomes and death, and more about long Covid and potential long-term health impacts.
The final concern was modelling data that suggested that schools being open led to wider overall societal mixing, and a greater number of contacts per person, which could increase the R number and drive exponential growth in transmission levels. But vaccines, testing and knowledge on how to manage Covid-19 transmission have radically altered all of the previous considerations.
We now have safe vaccines that are effective at reducing the severe health outcomes of Covid-19, especially with boosters for over-18s. It is positive news that the JCVI has supported vaccinating at-risk children aged between five and 11 and those living with immunocompromised people. However, the UK is again out of line with other countries, many of which opened up vaccination to all children in that age group some months ago.
We know that we can reduce transmission in indoor settings such as schools through good ventilation and air-filtration systems: this can range from opening windows to allow a breeze through classrooms and hallways to HEPA filters that completely clean the air several times in an hour.
And rapid at-home lateral-flow testing is a simple, quick way of identifying infectious individuals and ensuring they stay out of the school environment until they’re past the infectious period. Probably the biggest impact on slowing Covid-19 spread and breaking chains of transmission is to have infectious individuals isolate and not pass on Covid-19 to anyone else. The UK has led in offering free at-home testing to teachers, school staff and pupils, and that is seen as one of the factors in slowing spread within schools.
We also now have concrete evidence on the harms of children being out of school, which we must balance against the risk of harms from Covid. While some cling to the idealised version of online learning with middle-class children with devoted parents sitting next to them teaching with fast broadband and a laptop per child at home, this isn’t the reality for most children, especially those in low-income households.
Access to devices such as computers and tablets, and the internet – and having parents with enough free time to support students – are not guaranteed. Children may also have to do work within the household, for example taking care of younger siblings. And they may have to figure out how to set up the technology themselves if they are in households where parents are working outside or absent. In short, virtual learning works for rich families, but not for poor people.
This is not just about educational attainment. In-person schooling is also about providing children with a safe, heated space during the day, food, books, outdoor play areas and access to adults trained in teaching and interacting with children. School closures also lead to a loss of play and social interaction, they’re associated with increased domestic abuse, a decrease in physical activity, delayed access to paediatric care, and more mental health issues.
Whatever Covid-19 control measures are discussed, school closures should be off the table. Home or remote schooling just doesn’t work and shouldn’t be seen as an acceptable outcome for children. The risks from Covid are better known, and we have more tools to fight it.
So instead of closing schools, we need to focus on improving the protections we now have: better vaccination coverage, ventilation and filtration of the air, and identifying infectious individuals with rapid testing. Now is the time to start making plans for schools as essential societal infrastructure, just as hospitals, supermarkets and other essential institutions stayed open even during the strictest lockdown measures.
Prof Devi Sridhar is chair of global public health at the University of Edinburgh