Are schools safe during Covid-19? Academics take sides in an epic grudge match

Monday, March 8 marks the kick-off of a grudge match between two teams of leading Covid-19 scientists.

It’s the single biggest issue dividing academics, and the two teams, some of whom have resorted to dirty tricks ahead of the starting whistle, are not on the field for a draw.

The game is called 'Do English school kids spread the virus?' and only in three weeks time - when the infection data is clear - will we know the winner.

Reopening schools is a huge natural experiment and will dictate the speed at which the remaining control measures are lifted.

The man in black is Professor Chris Whitty, England’s chief medical officer. The playing field, England’s 24,000 primary and secondary schools, which fully reopened to all children on Monday.

Sage has set the odds so wide - predicting an increase in the R rate from the reopening by anything from between 10 to 50 per cent - that there is everything to play for.

On one side are 'Team Super Spreaders', a squad convinced that children and teenagers are walking Covid-factories who will seed a resurgence of coronavirus in the community.

Against them are the 'Openers', a normally measured bunch who have - in recent months - seen some of the domestic data move against them.

Such is the ferocity of competition between them that complaints have been filed to universities and medical journals seeking to have papers withdrawn, and key strikers shown the red card even before the match has started.

The Telegraph’s Global Health Security team previews the winner-takes-all match ahead…

Team Openers

“Children are not ‘human bodies’. Children are not ‘vectors’. Children are our future; a vulnerable and precious element of our society,” tweeted Dr Alasdair Munro, a paediatric registrar and clinical research fellow at University Hospital Southampton.

“It’s high time we put them first.”

If 'Team Openers’ has a captain, Dr Munro - who has been reviewing all the evidence on children and the pandemic for the UK Royal College of Paediatrics and Child Health since the pandemic began - might be it.

He has been a leading voice insisting that children have not been a major factor in outbreaks anywhere in the world, and that keeping them out of the classroom is causing untold damage.

His Twitter thread kicks off with a “myth-busting” section on children, schools and Covid-19, pointing to many studies. There’s a summary at the top: “Young children seem significantly less susceptible, probably less likely to transmit. Less clear for teens. Schools mainly follow community trends, but secondary much higher risk than primary.”

Like all good captains, he’ll also step in to settle disputes with the other team, notably when Dr Muge Cevik, an infectious diseases expert at the University of St Andrews - another who has a wealth of evidence supporting her stance - was accused of spreading “disinformation” by another scientist.

“The personal attacks are disappointing,” he said.

Also on the team - the non-too subtle defender who sometimes goes in studs raised - is the director of the University College London Genetics Institute, Professor Francois Balloux.

Last week he shared a US study based on a huge dataset, the Covid-19 Symptom Survey, which gets half a million responses weekly. It showed that there is an increased risk of “Covid-19 related outcomes” for a respondent living with a child attending school in-person.

However, it found that mitigation measures - including daily symptom checks, teachers wearing masks and the suspension of extra-curricular activities - saw the risk “all but disappear”.

Professor Balloux wrote: “I’m personally not convinced any school would have been closed if we had been ‘following the science.”

Picking up that pass, Professor Oliver Johnson, a statistics professor at the University of Bristol, points out there is little evidence of a huge spike in infections when schools went back in England in September last year.

‘Team Openers’ also cites examples from other countries, like Scotland, which partially re-opened schools two weeks ago without yet reporting a new surge in infections.

Others point to figures from the Office of National Statistics showing teachers are no more at risk of Covid-19 than other key workers.

Moreover, they say, schools have had far more pupils attending during the most recent lockdown and cases have still declined.

Team 'Super Spreaders'

Going in for a sliding tackle for 'Team Super Spreaders' is Dr Eric Feigl-Ding, a health economist at Harvard University and one of Twitter’s most outspoken Covid commentators.

Dr Feigl-Ding was keen to get stuck into the schools debate from across the pond this morning.

“God save England and its children from B117,” [the Kent variant] was the message from the Covid controversialist.

“Schools across England are reopening again today. No school mask requirements. No school air quality and ventilation guidelines - it is so dangerous that it is ‘medieval’, says Professor Alice Roberts,” he tweeted.

Prof Roberts, professor of public engagement in science at Birmingham University and a regular on TV, is a member of Independent Sage - a group of academics providing alternative Covid advice to the government’s own group of experts. Independent Sage provides a solid back four for 'Team Super Spreaders'.

In a paper last month, the group of respected academics, who include Trish Greenhalgh, professor of primary care at Oxford University and Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, said returning to school as soon as possible was “imperative” for the welfare of children.

However, not enough is being done to make schools safe for students and staff, they warned.

They called for a range of measures including staggered start and finish times, remote and blended learning to reduce the number of children on site at any one time, teaching outdoors and the installation of high-grade HEPA filters in ventilation systems.

And they warned: “Testing is in addition to other measures, not instead of.”

Without the extra measures they said an increase in cases is likely “this time with more infectious and possibly more virulent variants, resulting in further lockdowns, school closures, and absenteeism”.

And even when schools were open last term “at points of high community transmission, around 20 per cent of secondary school children were self-isolating, reaching around 40 per cent in deprived areas”.

The paper said evidence cited by academics who say schools have little impact on community transmission has “serious limitations”. They pointed out that, in the UK and around the world, closing schools has been linked to low infection rates - although 'Team Opener' would probably say that school closures have also occurred in tandem with large-scale lockdowns of society.

The role of schools and school children in transmission was a big question last November and December when the infection rate among those aged 12 to 16 climbed steadily - particularly in London and the south east - from less than one per cent at the end of September to 2.19 per cent at the beginning of December.

Subbing for 'Team Super Spreaders' are Professor John Edmunds and Dr Stefan Flasche, who wrote in the Lancet in December that secondary school children are “likely to be an important source of infection to peers and others”.

The paper highlighted a large-scale outbreak in a summer camp in the US that was effectively closed off to outsiders.

It also cited an analysis of Office for National Statistics infection data that showed secondary school aged children are about eight times more likely to introduce an infection to a household than adults.

They argued that because children are less likely to experience severe disease, outbreaks in schools are likely to have been missed from passive surveillance.

Lay your bets

While ‘Team Opener’ are happy to see kids back at their desks and in the playgrounds, some - just as in our somewhat teasingly named ‘Team Super Spreader’ - would have been happier with a slower, more age-differentiated approach to re-opening.

Both teams are likely, however, to back the move to keep the rest of society largely closed, and not just to make it easier to ascertain the victor in the great game of ‘Do English kids spread the virus?’.

You could argue that both teams are actually on the same side: they want what’s best for children and young people.

For now, we’re nervously biting our nails, waiting to see whether it’s a goalless draw, or a 10-nil pasting.

Protect yourself and your family by learning more about Global Health Security