ESecretary of Documentation Gavin Williamson has announced the completion of school “bubbles.” in England from July 19, following the news that 375,000 children did not attend school for COVID-related reasons in June.
Under the current system, if a student becomes infected with the coronavirus, students who have been in close contact with them should be isolated for ten days. In some cases, year-round groups may need to isolate themselves.
This massive self-isolation is hugely disruptive. Despite the call to switch to other protective measures, such as rapid testing of students who have been in close contact with an infected student, the Unison utilities union has supported personal isolation as “one of the proven ways to keep cases under control.”
Self-isolation can be effective in preventing transmission, but it is a compelling tool. A child who has been in close contact with someone who has tested positive for the virus may not become infected himself.
Unnecessary exclusions they are expensive. Education has already been significantly disrupted by the pandemic and children can waste time wasting unnecessarily more time outside of school.
The proposal is that, instead, NHS testing and monitoring will coordinate school testing, offering a more specific approach. Children who have been in close contact with an infected person should only be isolated if they also test positive for the virus. This approach would lead to fewer children being sent home unnecessarily.
On the other hand, because the tests are not perfect, specific tests will mean that some people who are infected actually receive clear content, which can allow infected people to enter the school. The likelihood of this depends on the tests used (e.g., PCR versus lateral flow tests), as well as the nature of the deployment regime deployed and the prevalence of the virus at the time of testing.
Whether we should continue with school bubbles or adopt more specific tests depends on an ethical criterion about what matters most: minimizing the impact on education or minimizing the spread of the virus.
A more radical approach
But there is a more radical solution to the problem of school disruption. We could stop doing a full detection of COVID in children. Children would be excluded from school if they do not feel well. The virus would be tested if they are very ill and need to be treated in a hospital.
Why should we take more advantage of it? let it go approach? One reason is that this is the way we normally approach viral illnesses in children. There are viruses like the flu, RSV, and enterovirus that spread through schools every winter (and at other times of the year). In some cases they can cause serious illness and hospitalization. We could contain them and prevent some deaths by detecting and isolating children, but we don’t usually do that. The reason is that it would be incredibly heavy and disturbing to do so. Proportionality is the key.
Testing in schools can be justified during a pandemic as a way to curb the spread in the community and reduce the acute impact on the NHS (“flattening the curve”). However, a large proportion of the most vulnerable have been vaccinated against COVID-19 (93% of those over 50). Cases are on the rise, but two doses of vaccination appear to be very effective prevent hospitalization. In addition, most children have a low risk of severe COVID-19 damage.
On the other hand, the cost of excluding young people from schools has not decreased in the same way. There is a real concern that will cause the interruption of the last year lasting educational harm to a generation of schoolchildren.
We need to make sure that teachers have had the opportunity to get vaccinated. This will not only protect them and reduce the chance that they will have free time for studies, studies suggest this transmission within and between staff was the main engine of spread to schools in earlier stages of the pandemic.
Whether we should continue to test and have bubbles in schools is not a scientific issue, but an ethical one. It depends on whether it is proportionate to continue interrupting children’s education to reduce cases of viral illnesses.
There is a point where these measures, even if they were effective, would cause more harm than good in general. It is possible that we have now reached this point. There is a strong argument that when schools return, they should pass without routine COVID testing.
Dominic Wilkinson, Neonatologist Consultant and Professor of Ethics, Oxford University; Jonathan Pugh, Researcher in Applied Moral Philosophy, Oxford University, i Julian Savulescu, Visiting Professor of Biomedical Ethics, Murdoch Children’s Research Institute; Distinguished Visiting Professor of Law, University of Melbourne; Uehiro Chair in Practical Ethics, Oxford University