Members of the National Public Health Emergency Teams expressed “some hesitancy” about curtailing contact tracing and testing of close contacts in schools before ultimately going ahead with the measure, documents show.
Nphet members were broadly supportive of the proposal to end automatic contact tracing of close contacts, and to discontinue the testing of asymptomatic close contacts, in schools and childcare, minutes of its September meeting show.
However, they drew attention to other countries that have continued to test schoolchildren “and to the possibility of children aged less than 13 bringing the virus into a family household where there may be a medically vulnerable person”.
They also noted that there is “no certainty” that booster doses for medically vulnerable people will prevent breakthrough infections.
Some members asked whether “additional mitigating measures” could be considered for these groups.
A proposal to discontinue automatic contact tracing and testing of close contacts more generally elicited differing responses from Nphet members. Some called for this to be done at the same time as changes were made for schoolchildren while others warning of “knock-on effects” such as for access to testing, the ability to detect cases and the protection of healthcare workers.
The meeting decided to make the changes in three phases, but so far only those relating to schoolchildren have been implemented. Since the meeting, cases have increased and the criteria for making further changes have not been attained.
So far this year, 30 children have been admitted to ICU with Covid-related issues, the meeting on September 16th also heard. Only 10 tested positive, and “a small number” of these required ventilation.
The remaining 20 tested negative but developed paediatric inflammatory multisystem syndrome (PIMS), which is associated with Covid-19 infection. Seven of these children required ventilation.
The meeting also discussed whether children aged under 13 should have to wear face-masks while at school. Nphet was “cognisant” the potential benefits of a requirement for children to wear masks must outweigh concerns about potential harms associated with face-mask use, the minutes state.
The limited evidence available suggested the harms of face-mask use in children are minor, the meeting heard. “The evidence for the additional benefits of face mask use in younger age groups is of low certainty and benefits are likely to be small in the context of an existing suite of mitigation measures.”
Where these measures are in place, the evidence suggests transmission of the virus within schools and childcare facilities is “limited” including with the delta variant, members agreed.
However, parents should be supported if they choose for their child to wear a mask in primary schools or other public settings.
The meeting also considered whether children who are not confirmed Covid-19 cases should have to self-isolate for 48 hours after resolution of respiratory symptoms.
The 48-hour time interval “did not appear to be supported by evidence”, according to the minutes, and accordingly it was suggested there was merit to considering an end to self-isolation as soon as symptoms have resolved.
“It was however also noted that the 48 hour interval is based on established custom and practice. The discussion resulted in no change to the 48-hour interval.”
