Missing school ‘worse than virus’ for children

Statement from the Chief Medical Officers and Deputy Chief Medical Officers of England, Scotland, Northern Ireland and Wales on the evidence of risks and benefits to health from schools and childcare settings reopening:

This is a consensus statement from the Chief Medical Officers and Deputy Chief Medical Officers of England, Scotland, Northern Ireland and Wales on the current evidence of risks and benefits to health from schools and childcare settings reopening.

It takes into account UK and international studies, and summaries of the scientific literature from SAGE, the DELVE Group of the Royal Society, the Royal College of Paediatrics and Child Health, and data from the Office for National Statistics.

The current global pandemic means that there are no risk-free options, but it is important that parents and teachers understand the balance of risks to achieve the best course of action for their children.

Children

We are confident that multiple sources of evidence show that a lack of schooling increases inequalities, reduces the life chances of children and can exacerbate physical and mental health issues. School improves health, learning, socialisation and opportunities throughout the life course including employment. It has not been possible to reduce societal inequalities through the provision of home-based education alone. School attendance is very important for children and young people.

We are confident in the extensive evidence that there is an exceptionally small risk of children of primary or secondary school age dying from COVID-19. The infection fatality rate (proportion of those who are infected who die) for those aged 5 to 14 is estimated at 14 per million, lower than for most seasonal flu infections. Every death of a child is a tragedy but COVID-19 deaths in children and teenagers are fortunately extremely rare and almost all deaths are in children with significant pre-existing health conditions.

We are confident that there is clear evidence of a very low rate of severe disease in children of primary and secondary school ages compared to adults, even if they catch COVID-19. The percentage of symptomatic cases requiring hospitalisation is estimated to be 0.1% for children aged 0 to 9 and 0.3% among those aged 10 to 19, compared to a hospitalisation rate of over 4% in the UK for the general population. Most of these children make a rapid recovery.

We are confident that there is clear evidence from many studies that the great majority of children and teenagers who catch COVID-19 have mild symptoms or no symptoms at all.

There is reasonable, but not yet conclusive, evidence that primary school age children have a significantly lower rate of infection than adults (they are less likely to catch it).

Evidence that older children and teenagers are at lower risk of catching COVID-19 is mixed. They are either less likely to catch COVID-19 than adults or have the same risk as adults.

Transmission of COVID-19 to children in schools does occur. On current evidence it is probably not a common route of transmission. It may be lower in primary age children than secondary age children.

Control measures such as hand and surface hygiene, cohorting to reduce number of daily contacts, and directional controls to reduce face-to-face contact remain key elements of maintaining COVID-19 secure school environments and minimising risk.

Children and young people who were previously shielding were identified on a precautionary basis at a stage when we had less data on the effects of COVID-19 in children than we do now. Based on our better understanding of COVID-19 the great majority have now been advised they do not need to do so again, and that they should return to school. A small number of children under paediatric care (such as recent transplant or very immunosuppressed children) have been or will be given individual advice about any ongoing need to avoid infection.

Our overall consensus is that, compared to adults, children may have a lower risk of catching COVID-19 (lowest in younger children), definitely have a much lower rate of hospitalisation and severe disease, and an exceptionally low risk of dying from COVID-19. Very few, if any, children or teenagers will come to long-term harm from COVID-19 due solely to attending school. This has to be set against a certainty of long-term harm to many children and young people from not attending school.

Teachers, other school staff and parents

Data from the UK (Office for National Statistics (ONS)) suggest teachers are not at increased risk of dying from COVID-19 compared to the general working-age population. ONS data identifies teaching as a lower risk profession (no profession is zero risk). International data support this.

Transmission of COVID-19 to staff members in school does occur, and data from UK and international studies suggest it may largely be staff to staff (like other workplaces) rather than pupil to staff. This reinforces the need to maintain social distancing and good infection control inside and outside classroom settings, particularly between staff members and between older children and adults.

If teachers, other school staff, parents or wider family catch COVID-19 their risks of severe illness are similar to those of other adults of the same age, ethnicity and health status. Younger adults have a much lower risk of severe COVID-19 than older adults. The greatest risk is to those over 80 years old.

Current international evidence suggests transmission of COVID-19 from children of school age to parents or other adult family members is relatively rare compared to transmission from adults, but this evidence is weak. Teenagers may be more likely to transmit to adults than younger children.

Children and young people should be engaged in the process of establishing COVID-19 secure measures as key participants and promoters of safe communities to help protect their wider families, teachers and other school staff and other social networks. This will help reduce the risk of school outbreaks.

Impact of opening schools on wider transmission (R)

Because schools connect households it is likely opening schools will put some upward pressure on transmission more widely and therefore increase R. We have confidence in the current evidence that schools are much less important in the transmission of COVID-19 than for influenza or some other respiratory infections. Other work and social environments also increase risk and are likely to be more important for transmission of COVID-19.

The international real-world evidence suggests that reopening of schools has usually not been followed by a surge of COVID-19 in a timescale that implies schools are the principal reason for the surge. There has, however, not been sufficient time to say this with confidence.

On the other hand, a local or national surge in transmission in the community may lead to an increased risk of school outbreaks occurring.

Opening schools may be as important in linking households indirectly as through direct transmission in school. For example allowing parents to go back to work, or meeting at the school gates, on public transport or in shared private vehicles, via after school social or sport activities or wrap-around care may be as important as what happens within the school.

It is possible that opening schools will provide enough upward pressure on R that it goes above 1 having previously been below it, at least in some local areas. This will require local action and could mean societal choices that weigh up the implications of imposing limitations on different parts of the community and the economy.

Early identification and quickly managing outbreaks of COVID-19 in schools is essential as part of a local response to COVID-19. Clear advice for pupils and staff not to attend school with symptoms, and prompt availability of testing, appropriate isolation advice, and careful public health surveillance and monitoring of educational establishments are key to support the safe return to schools.

From:

  • Prof Chris Whitty, Chief Medical Officer, England
  • Dr Michael McBride, Chief Medical Officer, Northern Ireland
  • Dr Gregor Smith, Chief Medical Officer, Scotland
  • Dr Frank Atherton, Chief Medical Officer, Wales
  • Dr Lourda Geoghegan, Deputy Chief Medical Officer, Northern Ireland
  • Dr Nicola Steedman, Deputy Chief Medical Officer, Scotland
  • Prof Jonathan Van Tam, Deputy Chief Medical Officer, England
  • Dr Jenny Harries, Deputy Chief Medical Officer, England
  • Prof Chris Jones, Deputy Chief Medical Officer, Wales
  • Dr Naresh Chada, Deputy Chief Medical Officer, Northern Ireland
  • Dr Aidan Fowler, Deputy Chief Medical Officer, England
  • Prof Marion Bain, Deputy Chief Medical Officer, Scotland

Steep decline in mental health of young Scottish carers

New Carers Trust Scotland survey shows pandemic’s dramatic impact on wider wellbeing of young carers in Scotland:

  • 45% of young carers and 68% of young adult carers in Scotland say their mental health is worse as a result of Coronavirus. 
  • 71% of young carers and 85% of young adult carers in Scotland who responded to the survey were more worried about the future since coronavirus.
  • 51% of young adult carers in Scotland who responded to the survey are spending more money due to coronavirus.
  • 58% of young carers in Scotland who responded to the survey say their education is suffering as a result of Coronavirus.
  • 42% of young adult carers in Scotland who responded to the survey say they are unable to take a break from caring as a result of Coronavirus.

[Coronavirus] has made me more anxious, lost, unconnected, unsure and very sad that we can’t hug our dad, nanna, aunts/uncles, cousins and friends. Future so uncertain.” – 15-year-old female carer in Scotland

The results of a new Carers Trust Scotland survey, published yesterday, point to a steep decline in the mental health and wellbeing of young people across Scotland who provide unpaid care at home for family members or friends.

The survey is the first of its kind to provide a base of evidence for how worries relating to Coronavirus and increased isolation caused by the lockdown has affected the mental health and wellbeing of Scotland’s young people with caring responsibilities.

It is part of a larger Carers Trust survey of young carers from across the UK. Young carers aged 12 to 17 and young adult carers aged 18 to 25 responded to the survey.

Coronavirus increases caring hours and pressures on young carers

Even before the outbreak of Coronavirus, young carers and young adult carers were all too often spending significant amounts of time caring for a relative in addition to the time they needed to spend on education, work and time for themselves.

Coronavirus has significantly increased those pressures. The survey found that 10.6% of young carers in Scotland who responded to the survey said that they had seen the number of hours they spend caring per week increase by 30 hours.

A similar proportion of young adult carers reported the same increase in caring hours per week.

Most disturbing of all, 6.4% of young carers and 10.59% of young adult carers who responded to the survey, said that they are now spending over 90 hours a week caring for a family member or friend.

When asked what difference Coronavirus had made to them, 58% of young carers in Scotland said their education was suffering and 45% said their mental health had worsened. Asked the same question, 68% of young adult carers said their mental health had become worse and 42% said they had been unable to take a break from caring.

Responding to findings published today, Director of Scotland and Northern Ireland at Carers Trust, Louise Morgan, said: “This is the first snapshot of how Coronavirus is affecting thousands of young people with caring responsibilities across Scotland.

“And the results are extremely concerning. It’s clear that the pandemic has made what was already a very worrying picture for young carers in Scotland far, far worse. That’s why we are calling for more support and more services to ensure that young people with caring responsibilities get the support they need.”

Other key findings from the survey:

69% of young carers and 76% of young adult carers in Scotland who responded to the survey felt less able to stay in touch with friends since coronavirus.

74% of young carers and 73% of young adult carers in Scotland who responded to the survey said they are feeling less connected to others since coronavirus.

69% of young carers and 76% of young adult carers in Scotland who responded to the survey said they are feeling more stressed since coronavirus.

59% of young adult carers in Scotland who responded to the survey are struggling to look after themselves.

56% of young adult carers in Scotland who responded to the survey are feeling overwhelmed by the pressures they are facing now.

See below a series of quotes from young carers and young adult carers in Scotland on how they have been affected by Coronavirus:

The voices of young carers  in Scotland

All the responses below were given in response to the following question in the Carers Trust survey: “What difference has coronavirus made to your life as a young carer or young adult carer?”

“It’s made it harder. I don’t get any respite, no time away or family support.” 12-year-old female carer in Scotland

“Coronavirus has made it harder to get a break from my caring role and has made me feel more unsafe at home” 14 year-old-female carer in Scotland

“Has made me more anxious, lost, unconnected, unsure and very sad that we can’t hug our dad, nanna, aunts/uncles, cousins and friends. Future so uncertain.” 15-year-old female carer in Scotland

“I’m stressed with having to care and take care of myself as well as struggling to sleep” 17-year-old male carer in Scotland

“I feel as if it has made it more difficult to care for my father as I have been unable to take care of myself properly” 18-year-old male carer in Scotland

“The difference now is that I can’t get out of the house for a day and we can’t afford to do or get anything. We are just getting by with only making 80% of our wages. It’s a lot harder to keep on top of the rent and we spend more money on alcohol and cigarettes which makes it harder to afford electricity and some foods.

It’s harder to eat fresh and healthy because we can’t afford it at the moment. I have gained a lot of weight since lockdown and it really affects my mental health. Everyone in my household including myself are sick of constantly seeing each other and cabin fever is really bad as well.” – 19-year-old female carer in Scotland

“I have no help or support whatsoever now – I’m caring 24/7 and I’m exhausted and mentally drained. My young carers service is closing before lockdown ends so I now won’t have any support and I don’t know how I’m going to cope” 22-year-old female carer in Scotland

“It has made my caring role more pronounced/taken away other outlets of my life such as study. It has made me feel more isolated from my friends who don’t have caring responsibilities.” 24-year-old female carer in Scotland

Heading Out!

The Scottish FA has published updated heading guidelines for all age groups from six to 17 years old.

The guidance will be introduced with immediate effect and will provide clubs, coaches, players and parents with clarity on the governing body’s recommended coaching approach to heading in training sessions and in matches.

The Scottish FA recommends no heading practice in children’s football, defined as primary school age, and a graduated approach in youth football, defined as secondary school age.

It comes in light of the study led by the University of Glasgow, published in October  last year, which reveals the first major insights into lifelong health outcomes in former professional footballers.

Although there was no evidence in the study to suggest that heading the ball was the cause to the link with incidence of degenerative neurocognitive disease, the updated heading guidelines have been produced in consultation with UEFA and The English FA to mitigate against any potential future risks being established.

The recommendations will incorporate all children’s and youth football in Scotland and include the following recommendations:

  • Heading should not be introduced in training sessions from the age of six through to 11.
  • Heading should be considered a low coaching priority between the ages of 12 to 15 years however training sessions can be introduced. These should be limited to one session of no more than five headers per week at 13 years, increasing to 10 headers per session at 14 and 15.
  • It is acknowledged that heading will begin to form part of the game at 12 and should be permitted, however, coaches are encouraged to promote a style of play that limits long passing.
  • Heading burden will remain restricted to one training session per week for 16 and 17 year olds and coaches should be mindful of limiting repetitions during that session.

The updated guidelines have been overseen by the Scottish FA Medical Consultant, Dr John MacLean, who co-authored the FIELD study report, in consultation with Andrew Gould, the Scottish FA’s Head of Football Development. It has also been approved by the Scottish FA Board and endorsed by the Non-Professional Game Board.

Ian Maxwell, Scottish FA Chief Executive, said: “While it is important to re-emphasise there is no research to suggest that heading in younger age groups was a contributory factor in the findings of the FIELD study into professional footballers, nevertheless Scottish football has a duty of care to young people, their parents and those responsible for their wellbeing throughout youth football.

“The updated guidelines are designed to help coaches remove repetitive and unnecessary heading from youth football in the earliest years, with a phased introduction at an age group considered most appropriate by our medical experts.

“It is important to reassure that heading is rare in youth football matches but we are clear that the guidelines should mitigate any potential risks. We will also look to monitor and review the guidance as part of our commitment to making the national game a safe and enjoyable environment for young people.

“I would like to thank our colleagues at the English FA for their collaboration in this process and UEFA’s Medical Committee for their guidance.”

Dr John MacLean added: “I am proud that the Scottish FA has taken a positive, proactive and proportionate approach to the findings of the FIELD study. Scottish football has taken a lead on the subject of head injury and trauma in sport, from becoming the first country in the world to produce cross-sport concussion guidelines – If In Doubt, Sit Them Out – to having one of the most advanced medical education programmes in sport.

“Since the publication of the report we have consulted with colleagues on the football and medical sides at The English FA and UEFA and I believe the guidance will help provide reassurance for young players and their parents nationwide.”

Scottish FA Heading Guidelines

Scottish FA Heading Guidelines FAQs

Concern over effect of social media on young people’s wellbeing

A national report, carried out every four years, has provided insights into child mental health in Scotland.

The 2018 Health Behaviour in School-aged Children (HBSC) study in Scotland, led by researchers at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow and funded by NHS Health Scotland, provides data on the health and wellbeing of the nation’s young people.

Key findings include the majority (85%) of young people reported high life satisfaction in 2018, while almost one in five adolescents rated their health as excellent.

However, the report also revealed the lowest levels of adolescent confidence seen in 24 years, with only 51% of adolescents in Scotland reporting often or always feeling confident in themselves.

Beyond mental health and wellbeing, the HBSC study covers areas such as sleep habits, time spent online, physical activity as well as school and home life. The report presents data collected from surveys with a representable sample of 11, 13 and 15-year-olds in Scotland in 2018. The surveys were conducted in schools, with all pupils in the selected classes asked to fill in the confidential questionnaire anonymously.

This is the 8th consecutive World Health Organisation (WHO) cross-national HBSC survey in which Scotland has participated, providing data on the health of the nation’s young people over the last 28 years. A wider pan global report on the health of young people across the world is due to be published later this year.

Lead author of the study Dr Jo Inchley, from the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, said: “These latest findings from HBSC provide a comprehensive picture of young people’s health across Scotland.

“We’ve seen significant improvements in recent years in areas such as substance use and eating behaviours. But at the same time, new challenges such as social media are increasingly impacting on how young people live their lives and these can have a significant impact on their wellbeing.

“This report helps us to better understand the challenges young people face and the areas where more support and investment is needed.”

Dr Rory Mitchell, Public Health Intelligence Principal, NHS Health Scotland said: “This report highlights some positive trends as well as ongoing challenges. The data shows that children from wealthier families tend to report better health and wellbeing than those from poorer families. This highlights the need for a continued focus on tackling health inequalities in Scotland. 

“The information provided by this long-running study has enormous value in helping to improve health and wellbeing. Using such information to make a real difference requires a collaborative effort that co-ordinates local and national action. The formation of Public Health Scotland in April this year will contribute to this.”

Findings of the report include:

Mental health and wellbeing

  • 22% adolescents rated their health as ‘excellent’ but 15–year-old girls were the least likely to report ‘excellent’ health (12%).
  • The prevalence of multiple health complaints is at its highest for both boys and girls since 1994. Overall 35% of young people experienced multiple health complaints every week. The most common health complaints were sleep difficulties, feeling nervous and feeling irritable.
  • 37% adolescents were classified as having low mood (33% boys, 41% girls) and 14% were at risk of depression (11% boys, 17% girls). Both low mood and risk of depression increased with age.
  • All the mental health and wellbeing indicators were significantly associated with family affluence, with poorer outcomes for those from families with lower affluence.

Sleep

  • The average sleep duration on weekdays was 8.3 hours for 13-year-olds and 7.8 hours for 15 year olds – the recommended sleep for teenagers is 8 to 10 hours each night.
  • The proportion of young people reporting sleep difficulties more than once a week has increased from 23% in 2014 to 30% in 2018.
  • Among 13 and 15-year-olds, sleep difficulties were more common among girls than boys and young people from lower affluence families were more likely to report difficulties in getting to sleep than those from higher affluence families (25% versus 35%).

Social media and online communication

  • Nearly all (95%) young people said they owned a smartphone with connection to the internet.
  • The vast majority (92%) of 15-year-olds kept their smartphones in their bedroom at night.
  • Preference for online (versus face-to-face) communication was higher amongst 15-year-olds than 11 and 13-year-olds.
  • Nearly one in ten (9%) adolescents were categorised as having problematic social media use.

At home and school life

  • Overall 38% of young people reported high teacher support
  • The proportion of girls who find it easy to talk to their father has increased from 48% in 1990 to 67% in 2018.
  • 36% of young people reported eating a meal with their family every day.
  • Vigorous physical activity was higher among boys than girls. 47%) of boys and 41% of girls reported taking part in leisure time vigorous exercise at least four times a week. The gender difference was greatest at age 15 (40% vs 29%)

Jo Inchley added: “Many young people report high life satisfaction and have good support from their families and friends. However, the declines in mental health and increase in sleep difficulties are concerning.

“There’s been a small but steady increase in the proportion of girls taking part in physical activity in their free time but overall levels are still very low and screen time has been increasing at a much faster rate.

“It’s important that young people have opportunities to be active and spend time outdoors as these can have substantial benefits for both their physical and mental wellbeing.”

A spokesperson for the Scottish Children’s Services Coalition commented: “As a coalition whose members provide support to vulnerable children and young people we are deeply concerned by a lowering in confidence levels as outlined in this report, which indicates that just over half of adolescents report often or always feeling confident in themselves.

“In addition to this, one in ten adolescents are categorised as having problematic social media use and screentime use has been increasing.

“Clearly social media is having a major impact on young people and their wellbeing, as they often try to meet unrealistic standards as seen on social media, leading to anxiety and depression. This is especially relevant to girls.

“The fact that over 90 per cent of 15-year olds keep their smartphones in the bedroom at night, with a potential impact on sleep patterns is worrying. It is notable that the proportion of young people reporting sleep difficulties more than once a week has increased from 23 per cent in 2014 to 30 per cent in 2018.

“Now we have a greater awareness of the challenges it is vital that there is greater research to gain a clearer understanding of the link between social media and wellbeing, which is also impacting on confidence.

“There is a desperate need to educate young people on how to use social media healthily and how social media promotes unrealistic expectations.”

Scottish Government to strengthen children’s rights

UNCRC to be incorporated into Scots Law

Scotland will incorporate the United Nations Convention on the Rights of the Child (UNCRC) into law to the maximum extent possible within the powers of the Scottish Parliament.

Deputy First Minister John Swinney announced the approach following an extensive public consultation.

The UNCRC is the most complete statement of children’s rights ever produced and sets out the rights of every child, irrespective of where they live, their religion or make-up of their society. This includes rights relating to health and education, fair and equal treatment and the right to be heard.

To incorporate the UNCRC into law a Bill will be laid before Parliament next year. The Bill will allow for incorporation of the provisions of the Convention currently beyond the powers of the Scottish Parliament, should these powers change in the future.

Speaking on the 30th anniversary of the Convention, Mr Swinney said: “Through the responses to our consultation, it is clear there is widespread support for directly and fully incorporating all of the rights set out in the Convention.

“Our Bill will take a maximalist approach. We will incorporate the rights set out UNCRC in full and directly in every case possible – using the language of the Convention. Our only limitation will be the limit of the powers of this Parliament – limits to which many of us obviously object.

“This approach will mean that the Convention on the Rights of the Child is enshrined directly into Scots law. This represents a huge step forward for the protection of child rights in Scotland.

“Every devolved body, every health board, every council and the Scottish Government itself will be legally obliged to make sure they respect children’s rights. And, if they don’t, children and young people will be able to use the courts to enforce their rights. I hope the example of Scotland incorporating the convention will spur the UK and other countries to follow suit.”

Jump in growth for Active Schools

The latest data published by sportscotland shows that the national Active Schools programme continues to have a positive impact on children’s physical activity levels.

It revealed that 7.3 million visits were made to activities across Scotland in 2018/19, an increase of 0.4% on the previous year. Continue reading Jump in growth for Active Schools

Civil Service Strollers looking for players for new team

Civil Service Strollers Community Youth Football Club are looking for boys and girls born in 2014 to start a new football team.

First training session takes place tomorrow evening at Craigroyston Community High School from 6 – 7pm.

For further information call Paul Ramsay on 0795 822 4797.