Thread by @SchoolsWeek

Government deputy chief medical officer Dr Jenny Harries and DfE chief scientific adviser Osama Rahman are among witnesses giving evidence to @CommonsEd shortly on the science of school closures. Stay tuned for live tweets...

committees.parliament.uk/committee/203/…

@CommonsEd First question to the scientists is about school reopenings.

Harries says ambition "should always be that schools should be open where that is appropriate", but there's a caveat around "current epidemiology" and "very high rates" seen recently.

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@CommonsEd Rahman says government will be "looking at what the balance of risks are" and doing continued monitoring.

Asked if there could be a regional or phased system of reopening, Harries says it's "highly likely" there will not be consistent patterns of infections

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@CommonsEd "It may well be possible that we need to have some differential application, but as Osama has said, clearly schools will be right at the top of the priority" - Harries

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@CommonsEd Harries adds it's "likely that we will have some regional separation of interventions"

Rahman says DfE's contingency framework is aligned to the tier system "so it may be that that is appropriate"

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@CommonsEd Professor Russell Viner says there's still "quite a lot of uncertainty about the roles of schools in transmission"

@CommonsEd But Viner says the role of school children is "more clear", and younger children play "relatively minor role" in transmission "but they do play a role, and it's foolish to think they do not"

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@CommonsEd Viner says "we think that children under 12 are probably less susceptible to catch the virus", and children are "less likely to be symptomatic", but children and teenagers "socially mix" more than most adults #edselctte

@CommonsEd Viner says no clear answer yet on how much transmission is in schools or through "fairly uncontrolled mixing" outside schools #edselctte

@CommonsEd "We still remain unclear. The systematic review identified 10 papers on impact of closing schools on community transmission. They found 8 papers that found there was a protective effect, but there were 2 papers that found no impact, and they were the highest quality" #edselctte

@CommonsEd Viner says the answer is that school closures "as a straight-up on-off thing is a bit simplistic a way to think about it". Need to think about ages of children involved, how much schools are closed...what happens around schools...

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@CommonsEd "I think in one sense it's a no brainer that if we close schools and stop children and young people mixing outside schools, you will reduce social contact, you will have an impact on community transmission" - Viner #edselctte

@CommonsEd Harries says it "still remains very difficult to put a figure on each of the different components" of school closures - age, type of establishment, size, etc #edselctte

@CommonsEd Harries also says they're trying to understand the new variant, so all models and understanding "need to be adapted and considered" #edselctte

@CommonsEd Harries says looking at evidence to date, it's difficult to draw out transmission in school and transmission "in school children when schools are open" #edselctte

@CommonsEd "Overall what we should say is school children definitely can transmit infection in schools...but it is not a significant driver as far as yet as far we can see of large-scale community infections" - Harries #edselctte

@CommonsEd Halfon asks if overall damage of school closures on young people has been assessed. Harries says she's "acutely aware" of negative impact school closures can have, and there is "work ongoing currently" and it is considered in SAGE discussions #edselctte

@CommonsEd Harries says it's "quite difficult to quantify" negative impact on pupils of closures, but there is other evidence and SAGE will "take acknowledgment" of it #edselctte

@CommonsEd Halfon asks Rahman and his deputy Dr Dougal Hargreaves what risk assessment is done at DfE on whether school closures will present "even worse" risk to children in terms of mental health, etc #edselctte

@CommonsEd Hargreaves, a pediatrician, says children's mental health issues, physical health issues and changes in eating patterns are a concern, and they're "on the agenda" at the DfE

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@CommonsEd Hargreaves says DfE is looking at how children are falling behind and impact on mental health, and are finding things "broadly in line" with external partner organisations #edselctte

@CommonsEd Rahman says "range of survey evidence" does "point to worsening mental health situation for children and young people". That is provided to colleagues and "up to ministers" #edselctte

@CommonsEd "But what we don't have is a single quantitative assessment of the total mental health impact," says Rahman #edselctte

@CommonsEd But Rahman says ministers do take survey evidence on mental health impact into account when making decisions #edselctte

@CommonsEd On impact on pupils, Viner says when schools were closed "we closed their lives, not to benefit them, but to benefit the rest of society". Lot of activity trying to quantify harms, but "much of the data" is from first pandemic wave

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@CommonsEd Viner says he's aware of 75 "reasonable quality" international publications on the harms to children and young people from the first wave. They tell "consistent" story - one of "considerable mental health harms" #edselctte

@CommonsEd Viner says best study, the National Children's Mental Health Study by NHS Digital and England, found that rate of serious mental health problems had increased from 1 in 9 in 2017 to 1 in 6 in July

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@CommonsEd Viner also points to "range of other studies" showing mental health harms. But says a couple of studies have shown a "reduction in anxiety in some children out of school" #edselctte

@CommonsEd Viner says there's also evidence around child protection, suggesting that referrals fell "by around 30 to 40 per cent during the first pandemic wave". Assumption is "much of that" is due to school closures #edselctte

@CommonsEd Viner also points to a lot of evidence about reduced access to healthcare. "So we had both an increase in problems and a reduced access to care and a reduced surveillance system in terms of the protective safety net we put around our children" #edselctte

@CommonsEd Viner points to issues around sleep, reduction in physical activity, and "some evidence around diet" and reduced wellbeing.

"If we close schools and when we close schools again we must make sure we mitigate those risks"

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@CommonsEd Viner says social distancing has reduced transmission of other viruses, and wards are seeing "a bit of a shift towards mental health being the reason children come into children's wards" #edselctte

@CommonsEd Viner says anecdotally pediatricians and psychologists report "more pressure on eating disorder services, pressure on pediatricians who see children" #edselctte

@CommonsEd "Those with learning difficulties, those with autism have been affected I think in a range of different ways by the pandemic and school closures," says Viner, who adds it brings "own set of risks" for children who find change more difficult #edselctte

@CommonsEd Viner is asked what can be done to reduce burden of mental health problems/.

"I think the easy answer, the first answer, is to get children back into school as quickly as possible"

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@CommonsEd In terms of what can be done now, Viner says message to parents is that NHS is open, and we could accelerate plans to improve mental health provision in schools #edselctte

@CommonsEd Viner says there's a "longer-term issue", and he wants clear strategy and clear focus on "health and wellbeing of this generation"

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@CommonsEd On online learning, Rahman says LAs and education providers have been allowed to deem "certain students who otherwise wouldn't be as vulnerable", and they can use this to "bring them into school to help manage their mental health and help access support more easily"

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@CommonsEd Harries is asked whether unions are wrong in calling for schools to close because teachers are at "particularly marked" risk.

Harries says govt looks at a number of sources, including lateral flow testing in schools, but "really important one" for unions is ONS data #edselctte

@CommonsEd "At the moment there is no evidenced increased risk to the teaching profession or educational staff in schools, and I think that is a really important one" - Harries #edselctte

@CommonsEd The scientists are asked about early years staying open and whether there's enough evidence on risks to EY teachers.

Harries says social connections and infections risks among early years "appear to be much lower"

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@CommonsEd Hargreaves says his understanding is the plan is for the early years and primary workforce to all be included in the twice-weekly testing programme

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@CommonsEd Asked whether it's likely reception and year 1 classes will reopen earlier, Harries says she knows everyone wants "very certain dates" for reopening, but "that's not how the virus works" #edselctte

@CommonsEd Harries says it's likely countries are going to see "changes in mutations and new variants...over coming months and potentially years", but that "doesn't mean schools are going to have to stay in the position they are in now" #edselctte

@CommonsEd Halfon says if they can't give dates, why did govt say it wanted schools to reopen after half term.

Harries says it's for the DfE, "but it seems a perfectly reasonable assumption" because we can "start to see" numbers being contained. But no "guarantee" that won't change

@CommonsEd Scientists are asked when they knew about the new strain, and whether Williamson knew when he issued Greenwich direction on Dec 14.

Rahman says letter was written about 1.50pm (though sent later). Hancock stood up and mentioned the strain "a bit later in the day" #edselctte

@CommonsEd Rahman says on Dec 17 SAGE the new strain was discussed and that it "may" be more transmissive. On Dec 21, government chief scientific adviser called a meeting of departmental advisers and later that day they were sent first PHE report confirming 50% more transmissive #edselctte

@CommonsEd Asked whether there needs to be faster decision-making on new strains and school closures. Harries says there are variants of interest and variants of concern, and there are "hundreds of variants arising all the time all across the world" #edselctte

@CommonsEd Harries: "Clearly we can't have an individual meeting for every variant...and so there is this sequence timeframe if you like of monitoring the genetic makeup of the virus and then trying to link that with information...about what impact that might have" #edselctte

@CommonsEd On issue of moving on SAGE advice, Rahman says advisers and SAGE secretariat "will normally have within 48 hours of a SAGE meeting summarised the key papers that are relevant and circulated them both to our policy colleagues and ministers" #edselctte

@CommonsEd Harries is asked about SAGE minutes of Dec 22 and whether it was inevitable schools would have to close.

She says there's a "balance of risk and harm", and it is only when "growth rates are rising so rapidly" that you have to "pull in the school element" #edselctte

@CommonsEd "These are simply stepped controlled mechanisms," says Harries. Over Christmas period, the strain on the NHS was seen and "unprecedented" growth in London and the south east #edselctte

@CommonsEd Asked what significantly changed over the first few days of January, Harries says CMOs recommended alert level rise to 5 on Jan 4th, which signalled "very significant risk to life" of potential overwhelming of health services #edselctte

@CommonsEd Harries says rates changed from 10s per 100,000 in some areas in the summer, "but then what we saw was a completely changing pattern which was this very rapid growth in the new variant" #edselctte

@CommonsEd Viner says there need to be better studies connected up across schools and the community using "genomics and genetic analysis", but there's "no way that can be done by half term" but DfE and others are looking at how things are operating #edselctte

@CommonsEd Scientists are asked whether school staff should be prioritised for vaccine.

Rahman says decisions are made by the JCVI, "and they will make those decisions based on risk factors as they see them". But Williamson has made clear he'd like to see education staff prioritised

@CommonsEd Harries is asked whether prioritising vaccinations for education staff could mean schools open sooner. She says JCVI has prioritised certain groups based on risk of mortality "so it's very much a clinical vulnerability risk" #edselctte

@CommonsEd Harries also says "we don't yet understand the characteristics of the vaccine outcomes". Says they're confident it will protect individuals, but "we are not clear yet" on impact it has on transmission risk #edselctte

@CommonsEd Harries is asked about timescale of vaccinations. She says by middle of Feb, first four groups will hopefully have been vaccinated, including school staff who fit in those groups, but it will take a while to get to phase two #edselctte

@CommonsEd The scientists are asked whether they've seen bigger impact on mental health of black pupils. Viner says the situation is "really complex", and national mental health survey "didn't find any increased risk for BAME young people", but it's a "complex area" #edselctte

@CommonsEd On vaccine priority, Harries says "anybody providing direct care in a clinical capacity which I know does happen with some educational settings, then they would be included within the health and social care staff group" #edselctte

@CommonsEd Harries says vaccinating staff is "not the limiting factor to opening schools, it is community transmission rates". So once we see decline, we'll be stepping back "probably to some sort of tier system or approach and schools will reopen" #edselctte

@CommonsEd "[Schools] weren't shut because there was a specific risk in that setting" - Harries

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@CommonsEd "It is a JCVI decision but I cannot see the link between vaccinating staff and a decision to open schools sooner or later. They're not running in the same vein" - Harries #edselctte

@CommonsEd Harries says DHSC and the scientists don't set opening and closing dates for schools, but do work closely with DfE. Says the suggested date in Feb "fits logically and reasonably with as much as we know currently". But not suggesting schools will or won't reopen then #edselctte

@CommonsEd Harries says that in the event schools do reopen, schools "already have very good systems of controls". She says the fact we "haven't seen vast numbers of schools with major outbreaks", we can be "reasonably reassured" system of controls are "pretty effective" #edselctte

@CommonsEd Harries says mechanism for transmission of the virus hasn't changed, so measures DfE have recommended for schools previously "still apply". But new variant is more transmissable and all of those interventions will be "monitored" #edselctte

@CommonsEd Scientists are asked about lateral flow testing of pupils, and the confidence they have in their safety. Harries says they are "accurate but with provisos". Says they help detect asymptomatic cases #edselctte

@CommonsEd Harries says doing two lateral flow tests a week "means that two tests in a week is equivalent in effectiveness and accuracy of one PCR". This is because of speed and the fact you can take positive cases immediately out of circulation #edselctte

@CommonsEd Harries adds accuracy of the tests "has perhaps been misunderstood in some circles".

"We're finding it's highly effective at probably around 80-85% at picking up cases in their most infectious period where a PCR test will pick up viral fragments but over a much longer period"

@CommonsEd Hargreaves says no test is perfect, and "what we need to try and do is find the appropriate use of lateral flow tests in schools".

Says one use is to pick up additional cases, and there's "broad consensus" that can be useful. But concern is not "over-interpreting negative test"

@CommonsEd "If you get a negative test it doesn't mean that you can ignore the usual mitigation procedures, you still need to be doing all of the social distancing, all of the hand washing, all of the mask wearing where appropriate" - Hargreaves #edselctte

@CommonsEd Hargreaves says the concern is around the daily contact tracing. Aim is different: to improve attendance. "And there is at least a hypothetical risk of increasing transmission". Says there's a "huge issue of professional judgment" #edselctte

@CommonsEd Hargreaves says he thinks experts are "all broadly agreed that there are potential benefits we're all agreed there are potential risks in doing this" #edselctte

@CommonsEd "Where we are now is I think we need to be looking at a more detailed evaluation process, and we've got the time until half term to do that," says Hargreaves. Will look at performance of LFD testing in school settings, and behavioural impacts #edselctte

@CommonsEd On masks, Viner says it's a "complex area", because evidence on masks and children and young people "is practically zero".

"Very little evidence" that masks make a "significant difference" to children and young people, meaning we have to rely on adult evidence #edselctte

@CommonsEd Viner says balance is about educational harms to development and language development that come from wearing masks against "potential epidemiological benefits" #edselctte

@CommonsEd Harries says PHE has been looking at the issue of masks in light of new variant, but older children behave much more like adults, so "in areas where social distancing can't be maintained in communal areas", then there's a "reasonable case" for masks in secondary #edselctte

@CommonsEd "But as you go down the age groups, for the reasons Russell's highlighted, it becomes less obvious that this is an overall benefit" - Harries #edselctte

@CommonsEd Hargreaves says that last term, "we had broadly a system that was working. Schools were largely open and the R rate of transmission went down across most of the country"

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@CommonsEd "Face coverings can be an additional mitigation. The big question...is whether the new variant changes that position, and I think we'll know more about that in the next few weeks" - Hargreaves #edselctte

@CommonsEd Rahman is asked for the DfE's rationale for wanting school staff be prioritised for the vaccine. He says it's "not on a science risk basis", but it's "alongside the same with other critical workers" #edselctte

@CommonsEd Rahman is asked to supply the committee with the case the DfE is making for school staff to be moved up the priority list. He says he will write to them #edselctte

@CommonsEd Viner is asked if there was anything else government could have done other than the current partial closures.

He says he supported the school closures "with a very very heavy heart"

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@CommonsEd "When your back's against the wall, you do close schools, but schools need to be the first to open" - Viner

He adds one of the important things to think about when we reopen schools is what happens to other parts of society at the same time #edselctte

@CommonsEd "We can open schools earlier if we maintain restrictions in other parts of society" - Viner

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@CommonsEd Viner harks back to June when schools started to reopen, but "much of the other restrictions had been reduced on May 26 and I think we should be thinking differently this time about the potential for us to go back to a November-style harsher lockdown" #edselctte

@CommonsEd Viner: "I think we should be thinking about schools being first to open, not opening as part of a broader reopening. In that way we may get all of our schools opened earlier. We also need to think about differential opening and are there years and classes that can open earlier"

@CommonsEd "We saw in November that we could have a national harsher lockdown with schools open, and the R would fall. It did rise in London, and of course that was related to the new variant we think, and it rose at the end of the month" - Viner #edselctte

@CommonsEd And that's it. Thanks for following