The reopening of schools in September must be accompanied by a high-coverage test-trace-isolate (TTI) programme if the country is to avoid a second wave of coronavirus infections, a study has suggested.
Researchers analysed data from the first wave of Covid-19 and modelled the potential impact of schools in Britain reopening in less than a month to understand how the virus can be kept under control.
The study, published in The Lancet Child And Adolescent Health, simulated various scenarios to examine the possible consequences of schools reopening in tandem with parents returning to their offices and increased socialising within the community.
The researchers, from University College London (UCL) and the London School of Hygiene and Tropical Medicine, found that “with increased levels of testing… and effective contact tracing and isolation, an epidemic rebound might be prevented”.
A second study, also published in The Lancet, found low levels of transmissions in schools and nurseries where control measures are in place.
The modelling study found that, in a worst case scenario, a second wave could be over two times the size of the first if there is a “continual gradual relaxation [of] control measures and insufficient test-trace-isolate”.
Dr Jasmina Panovska-Griffiths, who lead the study, said: “Our modelling suggests that with a highly-effective test and trace strategy in place across the UK, it is possible for schools to reopen safely in September.
“However, without sufficient coverage of a test-trace-isolate strategy, the UK risks a serious second epidemic peak either in December or February. Therefore, we urge the government to ensure that test-trace-isolate capacity is scaled-up to a sufficient level before schools reopen.”
It comes after chief medical officer Chris Whitty warned the public may have to trade some liberties in order to secure others, to prevent losing control of the virus, and a member of the government’s Sage group suggested pubs and other venues may have to close in order for schools to reopen.
Professor Chris Bonell, professor of public health sociology at LSHTM and senior author on the study, said the findings should “not be used to keep schools shut” but should be viewed as a “loud call to action to improve the infection control measures and test and trace system”.
“Our findings suggests that it might be possible [to avoid] a second wave, if enough people with symptomatic infection can be diagnosed and their contacts traced and effectively isolated.
“This is a scenario with model, not a prediction of what is going to happen. It all depends on the other measures and the level of TTI coverage,” he said, adding that at the present moment, TTI is “not achieving the levels that we modelled”.
“Looking at the NHS reports from the TTI system, it looks like it’s about 50 per cent coverage.
“It looks from the ONS data like there are about 4,200 new infections per day. And it looks like from the testing data there are about 4,200 testing positive per week. So it looks like about one in seven. So, that’s not good enough, basically,” added Mr Bonnell.
The researchers cautioned that the level of infectiousness in children compared to adults in non-conclusive. The main study used a model that assumed children were as infectious as adults, and they re-ran the model with the assumption that children and young people were half as infectious as adults, with the results remaining the same.
The second study looked at real-world data from January to April tracking the spread of coronavirus within 25 schools and nurseries in New South Wales, Australia.
It found that the risk of children and staff transmitting the virus in educational settings was “very low” when contact tracing and other virus control restrictions were in place.
Commenting on both studies, Professor W John Edmunds from LSHTM, said: “Both studies give potential options for keeping schools open and show the clear importance of adequate contact tracing and testing.
“We urgently need large-scale research programmes to carefully monitor the impact of schools reopening, as Public Health England’s sKID study aims to do. Only in this way can we take the most appropriate measures to mitigate the risks and allow us to reassure parents, pupils and teachers alike that schools are safe to attend.
“There are no quick fixes to this terrible pandemic. However, it is becoming increasingly clear that governments around the world need to find solutions that allow children and young adults to return to full-time education as safely and as quickly as possible.”