NOTE: the below was written on 2020-04-11. After this BBC Panorama revealed the Government’s mismanagement of Personal Protective Equipment (PPE). The BBC also report a rare COVID-19 related syndrome affecting children. These developments together mean that it is unlikely to be safe to reopen schools in the near future. Teachers would not be able to source sufficient PPE. Children may be at higher risk than previously understood. I would not at the current time support reopening schools.
I am not an epidemiologist. This blogpost is only about the things I think the UK Government must do next. I’m writing it because we’re in a scary situation. All choices look like they could hurt people. Doing nothing will hurt people too. We should talk about working out the safest things we can do.
I used to be a mathematician and recently I’ve been working on graph problems in large computer systems. Graph problems are closely related to how epidemics spread. In this blogpost I’ll explain why and how I would support partially reopening primary and secondary schools. Germany has started reopening schools. Denmark has started reopening schools too. I talk about the other options for starting to release the lockdown too.
The UK has almost stabilized its number of cases of COVID-19. We can see this by comparing the number of new cases each day. A typical case takes around 14d for the person to either recover or sadly pass on. So when the number of new cases today is the same as the number of new cases 14d ago, and this is consistently true, we know the number of current cases is stable. This is called a ‘steady state’. It’s not good to be in a steady state as every new case puts a human life at risk. Before now, we were in a state of exponential growth which put hundreds of thousands of lives at risk. It’s better to be in a steady state than in a state of exponential growth.
I estimate that the UK has around 68,000 people who are infectious right now. This is based on the Government Coronavirus dashboard. There has been lots of discussion about whether the official data is missing some cases. Leaving that aside, this number is going up by around 1,000 people per day, so the UK is not in a steady state yet. The region that was initially worst hit was London. I estimate that London has around 8,300 people who are infectious right now. This number hasn’t increased for the last week, so London might be in a steady state. This number stopped increasing because of the lockdown, so it’s really important we keep respecting the lockdown.
How do we release the lockdown?
We can’t release the lockdown all at once. If we did, the exponential growth would start again and more people would die. We want to release the lockdown to get life back to normal. To do this, we need to know we won’t put people at risk.
Option: Wait for a vaccine
Vaccines take around 18 months to develop. Vaccines for other coronaviruses only offer temporary immunity.
We should do this, but we shouldn’t wait and do only this.
Option: Wait for antibody tests
Antibody tests tell you if a person has already had COVID-19. It’s not clear whether having had COVID-19 already makes you immune long-term. Antibody tests are being developed, but they need to be accurate. If they’re not accurate you could think you were immune when you weren’t. This would be dangerous for those people.
We should do this, but we shouldn’t wait and do only this.
Option: Wait for improved treatments
Improved treatments mean the NHS can handle more patients. It should also mean those patients have lower risks. Plasma transfers from recovered patients might be effective. Lots of other drugs are being tested to see if they help with COVID-19. However, exponential growth means COVID-19 would still overwhelm the NHS eventually.
We should do this, but we shouldn’t wait and do only this.
Option: Release lockdown industrial sector by industrial sector
We could release the lockdown for industrial sector that are at low risk first. For example, people that work outside might be at lower risk because they will be farther from other people. Office workers could continue working from home for a long time. Businesses like restaurants and pubs would reopen last. This would let us go some way back to normal without much risk. This could be enforced because the government can tell businesses what to do.
This might be difficult if workers in those industries wanted PPE (Personal Protective Equipment). There is already a shortage of PPE for the National Health Service.
Option: Release lockdown in age groups
We could release the lockdown for young and healthy people first. This is because young and healthy people are at lower risk from COVID-19. This would let us go some way back to normal without much risk.
The problem with this is that it might feel unfair. Older adults might feel envious of younger adults. If you are just above an age range that is allowed to go out, you might be tempted to go out anyway. It wouldn’t be practical for the police or businesses like shops to enforce this because you can’t tell age from looking at people. It wouldn’t be practical for employers to enforce this because age is a protected category. Employers won’t want to make decisions based on the age of their employees.
Option: Release lockdown in geographical regions
We could release the lockdown for safer regions first. This could be rural regions where people live farther apart, or this could be regions with a lower number of cases. This would let us get some way back to normal without risking every region.
The problem with this is that people might move to the regions not under lockdown. There would also be a risk of exponential growth starting in those regions again. Hospitals can’t move from region to region easily. This means a region’s NHS could still get overwhelmed even if the rest of the UK holds steady.
This isn’t a good option by itself, but might be a good option combined with others. We could release one industry from lockdown in one region. This would let us check that it was safe to release that industry from lockdown in more regions.
Proposal: Reopen schools for some children
I think that soon we should partly reopen primary and secondary schools, with
- Young and healthy teachers for…
- Young and healthy children with…
- Young and healthy families.
These groups are all at very low risk for COVID-19. It would let us get some way back to normality. It would let children get back to education and play outside with other children. This is important for a happy childhood. It would let those parents have less stress. This is why Denmark and Germany have announced they will reopen schools.
COVID-19 seems not to affect young children. This virus could be like measles or chickenpox. It might be safest to get it when you are a child. This even means that the longer before any particular child gets COVID-19, the more risky it might be for them.
If we partly reopen primary and secondary schools, the people it could infect could all be young and healthy. Below I discuss some ways to make them even safer. Keeping people safe is what this blogpost is about. But young and health people would have low risk and be able to build up an immunity. They would have good access to the NHS because it wouldn’t be overwhelmed.
Immunity is important for individuals, because it means they can’t get sick again. It’s important for groups, too. If you can’t get sick again, you can’t pass on an infection. (We still have to all keep washing our hands.) If any infection did spread between young and healthy people, even after we work out how to keep them as safe as possible, they probably couldn’t get reinfected when they recovered. This means when more of the lockdown is released, COVID-19 would spread slower. When more of society goes back to normal it will help everyone if some of us are immune.
(There has been confusion about whether people can get reinfected. Euronews has reported that you probably can’t get infected twice.)
Reopening schools is practical because schools already know the age of the children. Schools, like businesses, can be told what to do by the government. Parents could be allowed to choose to keep their children home if they or their children are vulnerable. The parents wouldn’t have to give a reason to the school for now. Teachers could be allowed to choose to stay home if they are vulnerable. They wouldn’t have to give a reason to the school for now.
Adults wouldn’t be envious of children for being able to go to school. This means there wouldn’t be the same risk of adults ignoring the lockdown.
This option is especially good because it works well with all of the other options:
- We can do it soon without waiting for more medical advances,
- Regions: It works in all regions, but it could be tried in one region first without making anyone envious. People won’t move across the country because children can’t join a school in the middle of a term.
- The young and healthy parents that would build an immunity to COVID-19 will work for lots of different industries. This would make it safer when those industries reopen. Those parents would be immune and that would mean they couldn’t spread COVID-19.
We should be cautious and only reopen schools for one yeargroup at a time. Reopening schools for one yeargroup only would let the school practise social distancing. We should reopen schools for Year 10 only for now. All other yeargroups have more time left at school to catch up with what they’ve missed. The safest region should reopen first.
We should wait for several more weeks to see what happens in Denmark and Germany. Those countries have decided that reopening schools is the right thing to do. I think they are right, but maybe they are wrong. We should start preparing to reopen schools and only do so if nothing goes wrong in those countries. We would need to make sure we had enough PPE for teachers and other school workers too. Since health workers in the UK haven’t had enough PPE we probably don’t have enough PPE to reopen schools yet.
Keeping children safe
No-one wants to put children at risk. Even though the risk from COVID-19 to young children might be low, can we make that risk even lower? If we release the lockdown in any other way, are children safer?
- If we reopen by geography, children will mix with people who might be sick.
If we reopen by industrial sector, family members that go to work might get sick.
They would then mix with children at home.
- Lots of people won’t be able to go back to work unless someone cares for their children during the day.
For some children school is safer than their home. Other children might rely on free school meals. Children missing out on education and playing with other children is bad too. I think slowly reopening schools is the safest option. It’s still a scary option.
Keeping children, teachers and other school workers safe
If schools reopened, teachers and other school workers would have to go back to work. You can’t ask someone to go to work in an environment that isn’t safe. It’s morally repugnant. Also, their unions will tell them they have the legal right to refuse to work in unsafe environments. Teachers and other school workers need to know they will be safe before the UK can reopen schools.
If only one school yeargroup came back to school initially, the school would be a lot emptier. Even if only the young and healthy teachers that volunteered came back to work, there might be more teachers per student than normal. Each class could be split between several rooms, with one teacher in each. This would let students sit two metres apart from each other.
Teachers should get appropriate PPE such as gloves for handling schoolwork. Each classroom should have soap or hand sanitizer and students should wash their hands each lesson. Other school workers should get appropriate PPE too. They should all get regular COVID-19 tests to make sure the school environment has successfully been made safe. Schools with positive tests should be shut again temporarily.
If the data were not stored anywhere, daily temperature checks at the school gates could be a good option. COVID-19 has an asymptomatic phase that people can infect others without realizing. However, it still makes sense to send teachers and students home if they have a fever. If anyone has a fever, they should be offered a COVID-19 test. If that test comes back positive, they should shut that school again temporarily.
NOTE: as noted at the top of this blogpost, the situation has changed. I would not at the current time support reopening schools. The final three sentences of my original conclusion stand: schools can only reopen when safe.
I’m not a teacher, and I don’t have children.
Maybe I’m the wrong person to write this blogpost.
I want everyone to be safe.
I think this is the safest option.
We should prepare for UK schools to reopen partially.
We should discuss how to do that most safely, and whether that level of safety is enough.
If Germany and Denmark reopening their schools goes well over the next few weeks, I think the UK should start reopening its schools.
But first, the UK Government needs to show teachers and other school workers that this will be safe. Part of this will be showing that there will be enough PPE for teachers and other school workers. The UK Government should start working on that now.