Covid, strep A and flu: teacher’s call for 'bug-banishing' devices in every Lancashire classroom to slow infections
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That is the call from the Lancashire-based health and safety chief of the UK’s largest teaching union, who says that it should be a “no-brainer” for the government to kit out classes and other communal school spaces with air cleaning units.
Ian Watkinson, who chairs the health and safety forum of the National Education Union (NEU) and is a primary school teacher in Preston, was speaking as pupils returned to their desks following the Christmas break.
The start of the new term has coincided with what the UK Health Security Agency (UKHSA) has warned is the high circulation of Covid and flu, as well as scarlet fever - caused by strep A - which it says has reached “exceptional levels”.
The organisation this week urged parents to keep children at home if they are unwell and have a fever. The guidance came against the backdrop of what has been described by the NHS Confederation as the “unbearable strain” currently being put on the health service.
Mr. Watkinson welcomed the UKHSA advice, but told the Local Democracy Reporting Service (LDRS) that more could be done to curb transmission of the bugs coursing through classrooms, which can then go on to cause an increase in community rates of disease.
He said that he wants to see air cleaning systems - sometimes known as HEPA [high-efficiency particulate absorbing] filters - installed as standard in every class setting.
The devices can strip up to 99.9 percent of particles - including viruses, bacteria and allergens - out of the air being shared in a room and breathed in and out by its occupants.
“It’s not a magic cure-all, but it’s tried and tested - and where it's used, it's acknowledged that it makes a massive difference,” Mr. Watkinson explained.
“The benefits of clean air are well known and air cleaning devices would 100 percent have an impact [on the spread of infection]. There are a number of hospitals that use particular types of HEPA filter and they [do so] for good reason.
“Yes, you can open windows and check your CO2 monitors [which provide an indication of the ventilation in a room] - and that’ll make a difference, too. But the extra layer of mitigation comes from air cleaners.
“Obviously, there is a cost associated with that, but if [the government] were to put the right sort of kit into every classroom, then that would be a meaningful investment in education - not only protecting learning, but also the health and safety of kids and education workers.
“We knew - and fought hard to get Boris Johnson and his government to admit - that schools act as ‘vectors for transmission’ two years ago.
“The tragedy is that they clearly still are and it’s pretty obvious what we are all going to be facing once again as everyone returns to school this week.”
The government started to roll out around 350,000 carbon dioxide monitors to schools during the autumn term of 2021, at a cost of £25m. But that scheme still left half of all classrooms without one - and it was only in November last year that the Department for Education (DfE) committed to extending it so that every class had access to a monitoring device.
Exactly 12 months ago, the government also announced that it would be providing 7,000 air purifiers to schools with areas where “quick fixes to improve ventilation are not possible, such as being able to open a window”. That was in addition to the 1,000 units which had already been given to special schools and sites for alternative education provision.
A new round for schools to apply for an air cleaning unit has recently opened, but Ian Watkinson - who also represents Lancashire on the NEU’s national executive - said that headteachers should not have to “justify” why they need or want them.
He warned that the current arrangement was leading to a two-tier system in the county and said that the devices should be provided on a universal basis instead.
“Those schools that have got the cash and can afford it - and there are some in Lancashire - have bought them, so that their staff, their kids, their parents and families have got that extra layer of protection.
“But the vast majority can't afford them - and surely every child, every education worker and every family deserves to have that same level of extra protection.”
The price of air cleaning units varies significantly depending upon the type of filter they use and the size of the room for which the equipment is needed.
The government set up a “marketplace” in December 2021 via which schools could purchase the kit at a discount. The two products that were made available cost £425 and £1,170 each at the reduced price.
Lancashire County Council secured more than 100 air purifiers, intended for use in schools, shortly before the free government scheme for eligible schools was introduced a year ago.
The authority’s director of public health, Dr. Sakthi Karunanithi, told the LDRS: "The county council purchased 105 government-approved Dyson Air Cleaning Units in late 2021.
"We distributed around 50 of these to Lancashire schools prior to the government schools offer - and a further 20 to nurseries who were not eligible for the national scheme.
"The national scheme for monitors and air cleaning units has reopened and we have encouraged all of our schools to take up this offer.
"We have a small stock of air cleaning units remaining and have already made them available to the libraries, should they identify any issues relating to poor ventilation.
“Taking sensible measures, such as practising good hygiene, taking up vaccinations when offered and not mixing with vulnerable people when you are poorly, is something we can all do to stop bugs spreading.
"If your child is unwell and has a fever, they should stay home from school or nursery until they feel better and the fever has resolved," Dr. Karunanithi added.
The DfE was approached for comment on the issues raised by Ian Watkinson.
SCARLET FEVER AND STREP A SPREAD
A total of 33,836 cases of scarlet fever were notified in England between 9th September and 25th December, 2022 - compared to an average of just 2,670 for the same approximate period over the last five years.
In the last comparatively high scarlet fever season in 2017/18, there were 30,768 scarlet fever notifications across the entire 12-month timeframe.
However, the UK Health Security Agency says that “increased health-seeking behaviour as a result of national alerts is likely to have contributed to the increased reports” in recent months.
Strep A, or group A streptococcus, can cause scarlet fever - a rough-feeling rash, often accompanied by a sore throat and sometimes a swollen tongue and flushed cheeks - and a range of other complaints, including:
***flu-like symptoms, such as a high temperature, swollen glands or an aching body
***‘strep throat’ or tonsillitis
***scabs and sores (impetigo)
***pain and swelling (cellulitis)
***severe muscle aches
***nausea and vomiting
According to the NHS, most strep A infections are not serious and can be treated with antibiotics, but in rare cases, the infection can cause serious problems as a result of what is known as "invasive group A strep" (iGAS).
Between mid-September and 29th December, there were 151 iGAS cases in children aged 1-4 and 102 in those aged 5-9 years, compared to 194 and 117, respectively, across the whole of the last relatively high season in 2017/18.
Over the mid-September to late December last year, there were 122 iGAS deaths across all age groups in England, including 25 in under-18s in England.
However, the majority of iGAS cases are - and continue to be - in those over 45 years old.
Sources: NHS and UK Health Security Agency
WHAT TO DO IF YOUR CHILD IS UNWELL
In its advice on strep A, the NHS acknowledges that it can be “difficult to tell when a child is seriously ill”, but tells parents and guardians that “the main thing is to trust your instincts”.
It adds: “You know better than anyone else what your child is usually like, so you'll know when something is seriously wrong.
“If your child does not seem to be seriously ill, you can usually look after them at home. They should feel better in a few days.
“If they're uncomfortable, you can give them children's paracetamol or children's ibuprofen. Check the leaflet to make sure the medicine is suitable for your child and to see how much to give them.
“A pharmacist can give you advice about how to ease your child's symptoms and whether you need to see a doctor.”
‘TAKE SIMPLE STEPS TO PUT THE BRAKES ON INFECTION’
Professor Susan Hopkins, chief medical adviser at the UK Health Security Agency, said this week that it was “important to minimise the spread of infection in schools and other education and childcare settings as much as possible”.
As the organisation issued guidance on how to slow rates of Covid, flu and strep A - amongst others - it advised that “simple steps can help protect children”.
Professor Hopkins said: “If your child is unwell and has a fever, they should stay home from school or nursery until they feel better and the fever has resolved.
“Helping children to learn about the importance of good hand hygiene is also key, so practise regular handwashing at home with soap and warm water. Catching coughs and sneezes in tissues then binning them is another simple way to help stop illness from spreading.
“Adults should also try to stay home when unwell and if you do have to go out, wear a face covering. When unwell don’t visit healthcare settings or visit vulnerable people unless urgent.
“Remember that flu vaccination is still available for all eligible groups and is the best protection against the virus. We have seen good uptake in older age groups but vaccination among young children remains low.
“Flu can be very unpleasant and in some cases can lead to more serious illness. Getting your child vaccinated protects them and others they come into contact with, and it’s still not too late.”
FLU AND COVID JABS FOR KIDS
Children who are eligible for a flu vaccine - usually in nasal form - include those aged two and three on 31st August, 2022, all primary school pupils and some secondary school-aged pupils with long-term health conditions.
Youngsters aged between six months and two years - and who have a long-term health problem that puts them at high risk from flu - can receive a flu vaccine injection, because the nasal shot is not licensed for the under-twos.
All children aged five and over on or before 31 August, 2022 can get a first and second dose of the coronavirus vaccine.
Those who turned five after that date can only get the shots if they’re either at high risk themselves because of a health condition or a weakened immune system - or if they live with someone who has a weakened immune system
Children aged five and over and with a severely weakened immune system can get an additional primary dose. Some children at high risk from Covid may also be able to get booster doses.