ECDC says education must prepare for Covid outbreaks in unvaccinated children

The education system needs a “high level of preparedness” for Covid-19 outbreaks among unvaccinated children in time for the next academic year, the European Centre for Disease Control has warned.

Rapid antigen tests should be used to test contacts of school cases, it suggests. With adult populations largely vaccinated in many regions, increasing proportions of cases will be among children, says the EU-wide body.

However, school closures should be used as a last resort, the ECDC advises. "The benefits of keeping schools open would likely outweigh the benefits of closures, as interruptions would negatively impact children physically, mentally, and educationally," according to its director Andrea Ammon.

Children of all ages are susceptible to and can transmit Covid-19, it says in a new update. However, cases in younger children appear to lead to onward transmission less frequently than cases in older children and adults.

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Recent rises in the share of reported cases among children probably represents increased ascertainment of mild cases, it suggests. “Children aged between 1-18 years have much lower rates of hospitalisation, severe disease requiring intensive hospital care, and death than all other age groups,” according to surveillance data.

“The exact burden of Covid-19 and its long-term consequences in the paediatric population is still to be determined and is a priority for further research.”

Face masks

Physical distancing as well as hygiene and the use of “face masks in certain circumstances” to reduce transmission risks will continue to be essential in schools, according to the update. Measures should be adapted to the level of transmission in the community and to the educational setting and age group.

“Implementation of measures should consider the need to provide children with an optimal learning and social environment while also reducing transmission risks.”

The ECDC says it is important testing strategies in education are established to isolate cases and trace contacts.

“When positive cases are identified, the school should be informed, contact tracing should be initiated according to local guidelines, and communication to and the testing of close contacts, ideally with rapid diagnostic tests, should be considered.”

The HSE said on Thursday it was in discussions with the Department of Education, and the Department of Higher Education about the provision of antigen testing in schools and colleges next autumn.

Closures

The ECDC update says that while closures can reduce transmission, they are by themselves “insufficient” to prevent infections spreading in the absence of other measures and the expansion of vaccine coverage.

The effectiveness of school closures appears to have declined in the second wave as compared to the first wave of the pandemic, possibly in part due to better hygiene measures in school settings, the ECDC notes.

“Given the likely continued risk of transmission among unvaccinated children, it is imperative that there is a high level of preparedness in the educational system for the 2021/2022 school year,” Ms Ammon said.

“By the time schools reopen for the upcoming school year, children and adolescents will have become the age groups with the lowest rates of Covid-19 vaccination coverage in the EU and EEA.

“Therefore, in the absence of a strict adherence to effective public health mitigation measures, concentrated circulation of Covid-19 is expected, including outbreaks in this age group.”

Most of the studies quoted in the report were conducted before the emergence of the more transmissible delta variant; the ECDC says this should be taken into account when interpreting their results.