Test, trace, isolate. These three things are vital to the containment of Covid-19. As schools begin to reopen from August 25th, there are grave worries about how testing and tracing will operate. We are about to usher a million human beings into closer proximity than any other group in our society.
A query to the Department of Health about what structures are in place for testing as schools reopen elicited this terse response:
“The issue of a testing strategy for children will be discussed at NPHET on Thursday [August 20th] and is currently under development.
“There is currently no testing strategy for schools per se, however, any cases that arise in the school setting will be responded to and managed by Public Health in accordance with their policies and as Public Health have been doing previously with outbreaks in other facilities.”
While acknowledging how much the National Public Health Emergency Team (NPHET) have to do, it still seems very late to be discussing a testing strategy for children mere days before schools reopen. Nor is it reassuring that there is no particular testing strategy for schools.
If outbreaks are to be managed in schools in the same way they have been managed in facilities like nursing homes, direct provision centres and meat plants, there is little to inspire confidence. The response in those cases seemed to be to wait until there was a crisis and then react.
For months, people have been calling for rapid testing and tracing. People like Dr Tomás Ryan, associate professor in the school of biochemistry and immunology at Trinity College must by now empathise with John Hume and his single transferable speech.
Sadly, like John Hume for much of his career, it is not clear that anyone is listening, even though this, too, is a matter of life and death. Instead, as the numbers of infections increase, our testing capacity is already beginning to creak.
Young adults
And please do not trot out the line that children do not seem to transmit the virus. A well-regarded study from South Korea indicates that, from the age of 10, young people transit the virus as much as adults do.
Furthermore, at second level, many students are young adults. It is somewhat odd that an 18-year-old repeating the Leaving Cert will be subject to far fewer stringent social distancing requirements in her place of education than her identical twin who will be in college.
As the numbers of infections increase, our testing capacity is already beginning to creak
Teachers want the schools to open. More importantly, we want them to stay open. But without a robust testing system, that is not going to happen. Returning to remote learning is a terrible prospect. Nor do we have the capacity, even in terms of equipment, to run a hybrid model.
Last week, I developed very mild symptoms – a sore throat and dodgy tummy. My GP acted swiftly. I was tested the next day and had the results two days after that. But it still took more than three working days.
Thankfully, the results were negative but my son developed the same symptoms a day after I did and for him, it took four days. As a teacher, if this had happened during term time, there would be implications no matter whether I tested positive or not.
Contracting the disease could have dire consequences for teachers or students with underlying conditions.
Just like any workplace, no contact tracing will occur until a positive result is confirmed. Unlike many other workplaces, as a second-level teacher, every day I interact with between 180 and 240 students. I am with them in groups of 30 for 40 minutes at a time. Even though I will be masked, washing my hands, using sanitiser and doing my best to maintain two metres’ distance, these measures are not panaceas.
Pragmatic concerns
If every confirmed case in a second-level school leads to 240 extra tests, that will risk overloading a system that is already too slow. Four to five days’ delay in testing teachers or students could do a great deal of damage if students who may not even be showing symptoms carry it into the community.
Four to five days' delay could do great damage if students who may not even be showing symptoms carry it into the community
While containing the virus is the essential priority, there are also pragmatic reasons for rapid testing. Even if a teacher ultimately does not have Covid-19, there are still consequences for the school. Suppose four, five, six or 10 teachers in a second-level school develop mild sore throats at the same time and are out for four to five days each?
While the students will be supervised, in most cases they will not be taught, so schools will very rapidly become places to contain teenagers rather than educate them. This problem is even more acute at primary level, where students cannot be divided among other teachers. Primary schools might have to close.
Without rapid testing, students will be forced to stay at home with conditions with which it would normally be fine to come to school. Students will miss even more of their education.
There are promising signs that saliva testing may work well. Surely a system could have been ready for the opening of schools?
If circumstances allowed us to march, parents, staff and students would be out there chanting: What do we want? Rapid testing. When do we want it? Now.