Politics Analysis

KERRYN PHELPS: NSW school return plan exposes children to heightened COVID risk

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NSW Premier Dominic Perrottet's approach to reopening schools has attracted considerable criticism (Image courtesy Scottie Marsh / @scottie.marsh)

The start of the school year is always exciting. But this year is different, writes Professor Kerryn Phelps.

PARENTS ARE WORRIED, really worried about the risks their children and their families will confront as schools return to face to face learning this week as COVID 19 case numbers, hospitalisations and ICU admissions in the eastern states are still dangerously high.

OzSAGE argued some weeks ago that the start of school should be delayed until case numbers dropped and appropriate mitigation measures were in place.

NSW Premier Dominic Perrottet has defiantly and unfathomably made the decision to send children and teachers back to the classroom before those measures have been implemented.

Just repeating the mantra “schools are safe” over and over in press conferences does not make it true.

Let’s take a look at what has been done and what should have been done before schools returned.

We know how important ventilation of classrooms is in reducing the rate of transmission of the virus. There has been ample time to address the problems of poor ventilation of classrooms and staffrooms, and installation of HEPA filters and CO2 monitors, but it just has not been anywhere near completed. Some classrooms have no windows that actually open and schools are yet to receive anything like a full quota of HEPA filters and CO2 monitors.

Having plans to address these problems is not enough. They should be completed before children occupy those classrooms.

Rapid antigen testing kits are in the process of being delivered to schools, enough for two tests per child per week for four weeks. The tests are voluntary and reporting the results is based on an “honour system”. 

How will we know the results? Which schools have outbreaks? Presumably, schools will send children home who are symptomatic, but by then they may have infected others in their classroom. But other parents will not know if their child has been a close contact because contact tracing for schools has been abandoned.

The cynical redefinition of “close contact” decided by the National Cabinet as being only within a household lacks any scientific basis.

The next unanswered question is what happens with rapid antigen testing of school children and teachers after four weeks if this wave has not yet receded or if another wave comes?

Over the summer period, we saw what happened with the workforce crisis in essential industries and the effect that had on the supply chain for essential goods and services. It doesn’t take much imagination to work out what will happen when teachers return to primary school classrooms full of children who are largely unvaccinated and unmasked, get infected and then have to take time out to isolate and recover.

The idea of recruiting former teachers, retired teachers and soon-to-be graduates will not stem the tide, at least not for long. Ask a few retired teachers what they think about returning to the classroom during an uncontrolled pandemic and the response is less than enthusiastic.

The other issue with the workforce is that if a child gets COVID, then parents have to isolate at home to look after their sick child and take time out from their work, as well as face the risk of getting the infection themselves. This has obvious knock-on effects on the economy.

Masks are compulsory for high school and recommended for primary school students. Teachers have told me that if masks were mandatory and simply expected to be worn, then not only would that reduce the spread of COVID in schools, but there would be less cultural difficulty within peer groups with mask-wearing. 

High-quality N95/P2 masks suitable to each age group should be supplied and expected to be worn by all students, from kindergarten to year 12. Unfortunately, the masks arriving at schools are the blue surgical type. They are definitely better than nothing, but not as effective as N95/P2 for protection.

The return to face-to-face learning under these conditions is having a particular impact on children who are medically vulnerable and children who have medically vulnerable family members.

There is no apparent plan for them and their needs have been conspicuously absent from the announcements.

The vaccination program for children aged five to 11 has barely kicked off. Without high levels of double vaccination in school-aged children, they are sitting ducks for some of the more serious consequences of the infection. 

Importantly, the stubborn “on schedule” return to school means many students will inevitably have to take time off school for illness, particularly in the first half of the term as the pandemic continues in such high numbers.

Many students with COVID infections will likely not be well enough to learn from home, so they will miss out or have to catch up. Some children will become extremely unwell and need to be admitted to hospital.

We also are aware that long COVID is afflicting many young people after the acute illness and that it has the potential for significant long-term effects such as neurocognitive effects and fatigue. Anxiety and depression are also documented post-COVID issues.

We have also learned from UK experience that people are catching COVID two or three times.

While we take inadequate precautions against children becoming infected with COVID, there has been scant official regard for how much we do not know about the potential long-term effects of COVID. There is already recent research showing an increased risk of developing diabetes in children who have recently had COVID. 

There are also concerns about persistent downstream gastrointestinal, neurocognitive and cardiovascular implications. All this should justify greater precautions.

What we do know is that COVID-19 does not negotiate, so mitigation strategies have to be comprehensive, evidence-based and efficiently conducted.

Unless Australia adopts an enthusiastic elimination strategy, we are likely to be playing dodgeball with COVID-19 for a long time to come. The pandemic will continue on an epidemic pattern of repeated waves as new variants emerge which may be more or less severe than the Delta or Omicron variants. 

Eventually, we can hope that vaccines will be developed that stop infection and transmission but we are not there yet by a long shot. The other hope is for effective treatments to reduce or prevent the damage done by the infection. Again, we are not there yet.

We do not just need to accept that “everyone is going to catch COVID”. That would be an admission of a monumental failure of public health planning and administration.

Neither do we have to accept that mass infection of children in schools is inevitable or inconsequential. 

We all have the same objective of having schools return to inclusive face-to-face learning and all of the other opportunities school life provides, but it should not be at the expense of another surge in COVID-19 cases amongst children and the wider community where those cases could be avoided with better planning.

In the meantime, schools will be scrambling to do their best to provide safer environments for their staff and students, and many parents will make their own decisions about their child’s safety.

It is right that the Government should allow families that choice and ensure that children have the option of learning from home until it is safer for them to go to school.

Professor Kerryn Phelps AM is an IA columnist, general practitioner, advisory board member and conjoint professor at NICM Health Research Institute, a Climate 200 advisory panel member, a member of OzSAGE and a former Sydney Deputy Lord Mayor. You can follow her on Twitter @drkerrynphelps.

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