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Letter from the Deputy Chief Medical Officer, Dr Jenny Harries

Sent by email 

Thank you for your letter of 22nd May. I am pleased that you and your colleagues found the technical briefing on May 15th informative and I hope my comments below will add further clarity to the points you have raised.
 
My role is to advise the Government on medical, public health and scientific matters. As you know, education is an essential element to a child’s healthy development and a positive educational start in the early years of life will strongly influence individual health and economic outcomes in adulthood, particularly for the those in our most deprived communities. Great care is therefore taken with the scientific evidence provided to support decisions relating to closure or opening of all school and educational settings. Closing schools has helped to reduce the rate of coronavirus transmission and it is important that reopening them does not undo that important work and put the school or the wider community at greater risk.
 
As COVID-19 is a disease caused by a new virus, scientists around the world will continue to learn more detail of the virus itself, including its transmission, in coming months and years. As a result, my advice here is caveated with the simple fact that it may change in light of new evidence.
 
In your letter you state: Regarding children I think the position is compressively explained. I understood the explanation to be that children carry the virus, but they deal with illness well. Secondary illness recently discussed, for example Kawasaki disease, is rare. There is less certainty regarding the transmission from children to adults. It is not thought that children transmit the disease any more than adults, there is some evidence that they may transmit the disease less but there are low levels of confidence in that respect at present.
 
I can confirm this is correct.  Since our meeting on the 15th May further papers from the Scientific Advisory Group on Emergencies (SAGE) have been published and it may be helpful for your members to access the most relevant ones directly at https://www.gov.uk/government/groups/scientific-advisory-group-for-emergencies-sagecoronavirus-covid-19-response.  It is important also to realise that the levels of confidence to
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decisively answer scientific questions posed will frequently relate to the lack of high quality evidence available currently. Over time, and with specific studies, we will gain increasing levels of confidence in some of these areas of enquiry.
 
In relation to working in schools, it is currently not possible to predict a totally risk free environment for any community, occupational group or setting. The purpose of my comments was therefore to report any signals that could indicate a greater or lower risk using published data.  The ONS data, which described deaths registered to 20th April 2020 in those aged 20 to 64 years, reported that death rates amongst those in the teaching and educational professions were lower than the national average and significantly lower than some other occupations.  As discussed at the technical panel, these data utilise broad occupational categories which may not be specific to the teaching profession or an individual type of school setting. They were also reported from a period during which schools were closed. Nevertheless, due to the timeline in which serious illness develops, they would likely include deaths from any transmission occurring prior to school closure when circulating virus would be expected to be at much higher levels than we are seeing now.  Therefore, it is true to say that there is no indication currently that the school setting is a greater risk than other settings and a possible signal that it may be safer. ONS published this data on 11th May and therefore it is relatively new information available to your members and to the public. The relevant report can be found at https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/ bulletins/coronaviruscovid19relateddeathsbyoccupationenglandandwales/deathsregisteredu ptoandincluding20april2020.  It is of course important that as the number of students in schools steadily increases, data continues to be closely monitored and staff and students should remain very vigilant.
 
Finally I can confirm to you, as has the Secretary of State I believe, that the DfE guidance on the recommended hierarchies of control have the full endorsement of Public Health England. All elements of advice regarding safe management of the environment and of personal behaviours and protection are based on standard infection prevention and control (IPC) principles and align with advice given for other workplace settings.
 
I would like to express my sincere gratitude for the work of your colleagues throughout this challenging time. Keeping schools open for vulnerable children and children of key workers has been important both in supporting the UK’s response and the life chances of the children you have helped.
 
Yours sincerely,
 
DR JENNY HARRIES DEPUTY CHIEF MEDICAL OFFICER

First published 27 May 2020