Learning from International Schools: Outbreaks after COVID-19 Re-openings: The Case of the United Kingdom

By guest blogger Nathan Storey, Johns Hopkins University*

For much of the summer, U.S. education leaders and media have questioned how to safely reopen schools to students and teachers. Districts have struggled to put together concrete plans for how to structure classes, how much of the instruction would be in person, how to maintain social distancing in the classroom, and how to minimize health risks.

Most school districts have focused on preventing outbreaks through masks and social distancing, among other measures. However, this has left a gap—what happens to these well-thought-out plans if and when there’s an outbreak? While many school districts (including 12 of the 15 largest in the United States) have opted to start schooling remotely, many others plan to or have already restarted in-person schooling, often without detailed prevention and response plans in place.

For those districts committed to in-person schooling, outbreaks in at least some schools are all but inevitable. Community positivity rates within the United States remain high, with some states experiencing positivity rates of up to 5.4% (CDC, 2020), compared to 2.3% in Scotland or 0.8% across the entire United Kingdom (JHU, 2020). The image of students without masks packed into the hallways of a Georgia school have already spread nationwide. It is clearly important to put these plans into place as soon as possible in order to stem any outbreaks and allow schools to remain in session.

In a series of case studies, I will examine the experiences of how other countries with similar education systems dealt with outbreaks in their schools and share lessons learned for the United States.

United Kingdom

Schools in England and Wales finally reopened last week for the fall semester, but Scottish schools reopened the week of August 10. Outbreaks in Scotland have been minimal, but a cluster of school outbreaks cropped up in the Glasgow region, most notably at Bannerman High School. Affected schools soon closed for one week following the positive tests, but students who tested positive remained at home in self-isolation for 14 days.

What makes this outbreak notable is that through testing of students and community members, researchers were able to trace the outbreak to a cluster of infections amongst senior managers at McVities biscuit factory, also in Glasgow. Having successfully traced the infections to this source, education leaders and researchers were able to determine that cases were not being transmitted within schools, and put into effect appropriate isolation procedures for potentially infected students and faculty.

Testing and contact tracing were conducted first during the spring and summer months when schools first reopened in the UK, following the national shutdown in March. Researchers (Ismail et al., 2020) were able to determine sources of outbreaks and prevalence amongst students and faculty, finding that transmission was less common within schools, providing crucial information to improve COVID understanding and informing quarantine and school lockdown protocols in the country.

Scotland has put into place a strong contact tracing protocol, coupled with self-isolation, social distancing, and more intensive hygiene protocols. Scientists from England have urged weekly testing of teachers, as well as “test and trace” protocols, but the schools minister, Nick Gibb, instead committed to testing of symptomatic individuals only. Researcher Michael Fischer recently launched the COVID-19 Volunteer Testing Network, hoping to create a network of laboratories across the UK using basic equipment common in most labs (specifically, a polymerase chain reaction or PCR machine) to provide rapid testing. Eventually, as many as 1,000 labs could each do 800 tests a day, providing rapid response to COVID-19 tests and enabling more effective contact tracing and allowing schools to isolate students and staff members without requiring entire schools to be shut down.

Another means of accelerating testing and contact tracing is through group or pooled testing. One scientist in England pointed to this form of testing—in which multiple individuals’ samples are pooled together and tested simultaneously, with subsequent individual tests in the event of a positive test result—as a means of providing quick testing even if testing materials are limited. This could be particularly useful for schools implementing clustered classrooms or educational pods, keeping students together throughout the day and limiting contact with other students and staff.

Through careful and thorough testing and contact tracing, as exemplified by the United Kingdom’s efforts, coupled with careful social distancing and preventative measures, United States school districts in areas with low positivity rates, comparable to those in the United Kingdom, could more systematically address outbreaks, avoiding entire school shutdowns, which can be disruptive to education for students. Preventative measures alone are not likely to be enough to get students and staff through what promises to be a difficult school year. These outbreak responsive systems are likely to be necessary as well.

References

Brazell, E. (2020, April 2). Scientist donates £1,000,000 to massively increase UK coronavirus testing. Metro. https://metro.co.uk/2020/04/02/scientist-donates-1000000-massively-increase-uk-coronavirus-testing-12499729/

CDC. (2020, September 4). COVIDView, Key Updates for Week 33. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html

Davis, N. (2020, August 10). Scientists urge routine Covid testing when English schools reopen. The Guardian. https://www.theguardian.com/education/2020/aug/10/scientists-urge-routine-covid-testing-when-english-schools-reopen

Duffy, E. (2020, August 19). Scots school closes with immediate effect after multiple confirmed cases of Covid-19. The Herald. https://www.heraldscotland.com/news/18662461.kingspark-school-dundee-school-closes-multiple-cases-covid-19-confirmed/

Government of United Kingdom. (2020, September 8). Coronavirus (COVID-19) in the UK: UK Summary. https://coronavirus.data.gov.uk/

Ismail, S. A., Saliba, V., Bernal, J. L., Ramsay, M. E., & Ladhani, S. N. (2020). SARS-CoV-2 infection and transmission in educational settings: Cross-sectional analysis of clusters and outbreaks in England (pp. 1–28). Public Health England. https://doi.org/10.1101/2020.08.21.20178574

Johns Hopkins University. (2020, September 8). Daily Testing Trends in the US – Johns Hopkins. Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/testing/individual-states

Macpherson, R. (2020, August 16). Coronavirus Scotland: Another pupil at Bannerman High School in Glasgow tests positive as cluster hits 12 cases – The Scottish Sun. https://www.thescottishsun.co.uk/news/5937611/coronavirus-scotland-bannerman-high-school-covid19/

Palmer, M. (2020, April 1). Call for small UK labs to embrace Dunkirk spirit and produce Covid-19 tests. Sifted. https://sifted.eu/articles/uk-labs-coronavirus-testing/

*Nathan Storey is a graduate student at the Johns Hopkins University School of Education

This blog was developed with support from Arnold Ventures. The views expressed here do not necessarily reflect those of Arnold Ventures.

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