Impact on hospital admissions after schools return hard to predict – expert

Vaccines should prevent the “significant wave” of hospital admissions seen last autumn after schools returned, but it will be around a month before the true effect of pupils getting back to class for the new term is known, an expert has said.

The impact on cases and hospital numbers will be “critical in determining what we might expect to see as we move into the winter”, Dr Mike Tildesley said.

The University of Warwick professor, who is a member of the Scientific Pandemic Influenza Group on Modelling (Spi-M) which advises the Government, said cases are likely to rise once schools return but the “biggest unknown” is whether that translates to a lot of people needing hospital treatment with Covid-19.

He told the PA news agency: “Probably what we will see is maybe middle of September we might see cases picking up a little bit and it may take a week or two or more for that to spill over into a rise in hospital admissions.

“But to me the biggest unknown, and I think it’s very hard for any of us to call this now, is exactly how big that rise is going to be.”

He added: “I’m certainly optimistic that we hopefully shouldn’t get the same significant wave of hospital admissions that we saw last September but the key thing for me is how big is that going to be? I don’t think any of us could say that we believe they won’t rise.

“I think the vaccines are clearly helping but the big uncertainty for me is how much are they helping?”

He said seeing what effect children going back to school has on hospital admissions “will really sort of dictate what we might expect to happen as we get into the winter”.

Dr Tildesley stressed that any rise in cases is not just about children returning to school, but also things around that like people coming back from summer holidays, going back to work and the mixing associated with schools reopening.

Covid-19 vaccine doses in the UK
(PA Graphics)

As a parent, he said he will remain “cautious” when it comes school drop-offs and pick-ups, and try to avoid mixing too much.

People will need to be “a little bit sensible as we move into September” in an effort to avoid restrictions coming back in, he added.

“I think what we want to do is, I really, really want to avoid more restrictions being put in place in the autumn, and I think in order for that to happen I think we just need to be a little bit sensible as we move into September and just give it time to observe what we think is going to happen when children go back to school.”

As for measures in schools, he said the top priority needs to be rapidly identifying cases.

Department for Education (DfE) guidance states that secondary school pupils in England should be tested twice on site on their return in the autumn term, with lateral flow device tests carried out between three and five days apart.

Dr Tildesley said the removal of the requirement of contacts to isolate is a “necessary balance of risks” in avoiding the disruption seen in the last school year with high numbers of pupils isolating.

He said: “I think it’s probably a necessary balance of risks to allow children to remain in school whilst putting in a mechanism to try to capture positive cases as soon as possible.

“So it’s a difficult one but probably on the balance of risks continuing that (lateral flow testing) makes sense.”

Daily confirmed cases of Covid-19 in the UK
(PA Graphics)

Face coverings are no longer advised by Government for pupils, staff and visitors either in classrooms or in communal areas, but some unions have suggested secondary schools leaders should be supported in weighing up the case for continuing the requirement for masks, including potentially in classrooms.

Dr Tildesley said he has always thought they should be a “last resort” in schools because they make it more difficult for children to interact in the classroom, but added: “Clearly schools want to do what they can to minimise risk”.

Recent Government guidance has also suggested schools should consider outdoor lessons if five pupils who are likely to have mixed closely test positive for Covid-19.

The suggestion, which appears in a Department for Education document, was branded “total fudge” by one teaching union which called for “an urgent plan, backed up by cast-iron investment” to install ventilation equipment in school buildings as soon as possible.

Dr Tildesley said he could see how “if you have a good September it might be possible to do a bit of outdoor teaching but of course that gets much harder (in winter)”.

He added: “The key thing always is still rapidly identifying cases, so I think they (schools) have to maintain that level they have been doing so far as they move into the autumn when the risk might be a little bit higher again.”