By Helen Goss
Lead Rep for LCK Scotland
15th December 2021
Since the very beginning of the COVID-19 pandemic we have been living with various public health measures; changing and evolving with new data and science that emerges. Schools have faced monumental challenges over the past 20 months and many parents have struggled to keep up with frequently amended rules.
The chart below compares Scottish school COVID-19 mitigations in August 2020 (Alpha Variant) to restrictions in November 2021 (Delta Variant)
The Scottish Government's guidance on reducing the risks in schools states:
"Changes to the rules on self-isolation for contacts of positive cases were made on 9th August. These changes were made because the health risks that arise when people are in contact with others who test positive have changed significantly, most notably due to vaccination. Vaccine uptake is very high, particularly among individuals who are at greater risk of harm from COVID 19, and the vaccines are highly effective at preventing severe disease (with 96% effectiveness against hospitalisation for the Delta variant). Children and young people have a very low risk of health harm from COVID-19, and children and young people with asymptomatic infection are at a relatively low risk of transmitting COVID-19 to adults. This means that the risk environment has changed significantly, and our approach to managing COVID-19 is evolving to reflect that." (page 10, note 55.)
This is based on three key assumptions, notably:
"Children and young people have a very low risk of health harm from COVID-19" (1)
"Children and young people with asymptomatic infection are at a relatively low risk of transmitting COVID-19 to adults" (2)
"The risk environment has changed significantly" (3)
1) This is concerning because as yet we do not know the true scale of Long Covid in children. The prevalence of Long Covid is not being recorded in the UK; it is only estimated and modelled. The emerging data and research suggest that 1 in 7 children will develop Long Covid which is a significant harm.
2) How are the Scottish Government defining asymptomatic infection? Using only the three "cardinal symptoms"? Unfortunately, NHS Scotland's symptoms list isn't up-to-date therefore the general public may not be aware of what alternative symptoms to look for.
Furthermore, there is evidence that "symptomatic and asymptomatic children can carry high quantities of live, replicating SARS-CoV-2, creating a potential reservoir for transmission and evolution of genetic variants" (paper explained by Deepti Gurdasani) What is the risk of children transmitting to each other? Surely only considering the risk of children transmitting to adults is childism?
3) Yes, the risk environment has changed for adults with vaccine eligibility. Children, however, are still ineligible for vaccination in Primary schools, ages 12-15 only have one dose, and ages 16-17 are only now getting their second doses. Mitigations in schools need to reflect that.
Before schools in Scotland returned in August 2021, between 23.9% - 30.3% of children under 19 were estimated to have Covid antibodies in Scotland.
Updated figures for 24th November 2021 now estimate between 61.5%-69.4% of children under 19 are now estimated to have Covid antibodies in Scotland.
For some 12-19 year olds, antibody data will be due to vaccinations but the remainder of the children will be antibodies from infection. Natural immunity wanes over time whilst vaccination antibodies are widely accepted as being more robust and longer lasting.
Will vaccines be available to ages 5-11 before their natural immunity wanes?
Will the Scottish Government improve mitigations in schools before the Omicron variant seeds in Scotland's schools?
We don't yet know the impact of Omicron on Long Covid, are we willing to find out?
LongCovidKids.org is a UK based international charity supporting and advocating for families, children and young people living with Long Covid. Our story started with a short film on the long-lasting symptoms of Covid in children.
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