European guidelines on testing and tracing in the pipeline for schools



Recommendations on testing and contact tracing in schools are among measures being considered by Health Minister Stephen Donnelly, according to chief medical officer Tony Holohan.

he measures are included in new European guidance on tracing, testing of close contacts and the use of antigen tests in classroom settings.

In a letter to Education Minister Norma Foley, Dr Holohan said European Centre for Disease Prevention and Control (ECDC) guidance has been brought to Mr Donnelly’s attention so he can consider how it “should be integrated into our existing public health response in the schools setting”.

It comes after weeks of pressure from primary school teachers concerned about rising Covid-19 caseloads among under-12s who are not eligible for a Covid-19 vaccine. They feel the recent withdrawal of testing and tracing in schools has contributed to the jump in cases.

Among recommendations in the new ECDC guidance is a “test-to-stay” strategy using antigen tests. It also suggests using “an optional stepwise approach” in addition to current measures, including ramping up PCR testing and contact tracing to minimise the risk of the virus spreading.

The report said enhancements to the current regime could include:

• Testing only the closest contacts of a confirmed case.

• If two or more cases are found in a class, test the entire class.

• If additional cases are found in a class, consider quarantining the entire class.

The ECDC report recognises different approaches are taken to antigen testing across the EU, but says: “’Test-to-stay’ strategies could additionally be considered in an attempt to minimise disruption in school settings and school absenteeism, while also limiting opportunities for further Covid-19 transmission.”

It cited a UK trial where daily testing of school-based contacts was found to be “a non-inferior and safe alternative to self-quarantine”.

Dr Holohan’s letter comes amid a series of high-level talks among ministers and public health experts about the impact of Covid-19 on schools. Discussions focused on antigen testing and the role it might play in keeping schools safe.

The Sunday Independent understands Ms Foley wrote to the chief medical officer before children returned from mid-term break last week seeking public health advice around testing, tracing and vaccinations.

Dr Holohan responded last Monday. He told Ms Foley Nphet has been reviewing recent trends, including increased incidence rates among children aged five to 12, but said many “are identified in large numbers as part of household settings as that is where the risk is highest for Covid-19 transmission”.

Reducing community transmission was the best way to protect schools, he wrote.

“Schools have not been identified as significant Covid-19 amplification settings,” Dr Holohan added.

Health Protection Surveillance Centre (HPSC) data shows five outbreaks (two or more cases) were linked to schools in the week to October 30, when children were on mid-term break. In the two-week period before mid-term 26 outbreaks were linked to schools but teachers argue this does not reflect the true caseloads because of a lack of testing and tracing.

Over those three weeks children aged five to 12 have accounted for about 15pc of all confirmed cases of Covid-19.

The ECDC said “whereas sharing a classroom can be considered a high-risk exposure, the presence of effective mitigation measures that would lower the risk of some children can be taken into account. Depending on the degree of prevention measures, vaccination and testing being implemented in schools, an optional stepwise approach can be taken in addition to current guidance.”

Contact tracing should be initiated quickly “to rapidly identify secondary cases in order to avoid large outbreaks and the interruption of school activities”.

It should be done in close collaboration with public health authorities and cause minimum disruption to pupils and staff.

“Prolonged and/or repetitive school disruptions have significant negative social, emotional, health and educational impacts on children and their families, as well as broader economic impacts on society,” it added.

“Mitigation and response strategies that avoid or minimise school closures should be given priority.”

Dr Holohan told Ms Foley he expects the European Medicines Agency will consider licensing Covid-19 vaccinations for children under-12s “in due course”. Any recommendation there will need to go to the National Immunisation Advisory Committee for approval, he added.



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