Why Repeat Social Care Mistakes with COVID-19 In Schools?

Back in March, incredulous care workers were listening to their distressed managers coming out of meetings in which plans to 'safely' discharge elderly people from hospital into care homes had been outlined. If regulations and guidelines were followed, there would be minimal danger of transmitting COVID-19 - and, of course, there was all this stuff called PPE everyone expected to see delivered any day.

All our experience of working with the elderly plus our gut instinct told us something was amiss. What was being suggested was risky, dangerous and, to say the very least, taking a capricious liberty with the lives and manner of death of vulnerable people. I am not writing this with the benefit of hindsight. At the time many of us made protests. I wrote to my MP and the CQC. 

Had we known then that patients who might be or were infected with COVID-19 would routinely be sent to care homes where there was no particular expertise in nursing highly contagious diseases, no PPE and no facilities for isolation, we would have shouted a lot louder. Had we known that GPs would not be allowed to visit and no provision would be made for proper palliative care in some cases, we would have swung from the trees and yelled.  We accepted the situation with huge trepidation because we knew these lovely, trusting, vulnerable, elderly people needed to be cared for. We drew up the very best plans we could in the circumstances. Many homes went to extreme lengths with staff voluntarily isolating themselves from family for long periods, living in caravans and tents and making their own PPE.

It was a disaster. We had known it would be.  Although many elderly people have been successfully shielded, on May 15th the BBC reported more than 18,000 excess deaths in care homes in England and Wales during April here. Members of the Social Care work force are twice as likely as the general population (including NHS workers) to have died here.

Now, the government seems to be making a similar miscalculation about schools. With the reproduction rate (R) scarcely below 1 for a few days, this reckless government has issued guidelines for social distancing in schools, keeping children in 'bubbles' which prevent transmission between too many households. These guidelines are being challenged by teachers who say that they are simply not workable. The teachers have powerful representative organisations (unlike carers) to speak up for them. The BMA has lent its support to voices that are saying not, 'we don't want to go back to school' but 'we don't think it's safe to send reception class pupils back to school, in this way, now'. Experience, gut instinct and scientific data are all crying out, 'this is very risky.' 

I am no expert in children's health but I do know that there are a whole range of studies that suggest we do not accurately know the extent to which COVID-19 affects children. Nor do we know the extent to which children transmit the disease. There have been studies in China here and elsewhere here but the research is at an early stage and they mostly show what we do not yet know rather than draw definitive conclusions. A syndrome has been identified where children who have had the disease later develop an inflammatory condition that has landed some in ICU here. 

We all know the extent to which children bring infections home from school, especially the youngest. A friend's family was affected when her sons contracted the virus at school in March. They were, thankfully, not very ill, but Mum and Dad (a doctor and an agricultural scientist) caught it and were off work for weeks. I've just watched a Conservative MP's youtube video describing the approach to distancing that puts children into groups or 'bubbles' of 15 with a teacher. Should someone contract the disease, only the 'bubble' and their families would need to isolate. If each child has even four people in their family, this would result in over 60 people isolating for 7-14 days or perhaps much longer, many of whom could be vulnerable or might be key workers. 

Children have to get back to school but every instinct and a lot of evidence is shrieking '1st June is too soon.' Why experiment with the safety of our youngest children? (In many countries with excellent educational results, they would not be in school until they were 7.) Why not wait until R has been consistently below 1 for weeks rather than days? 

Teachers are not raising objections because they are cowardly, lazy or obstructive. They are raising professional concerns because they instinctively know that we are taking a huge risk with the well-being of children and families. Just as the carers were back in March, they are extremely worried that the regulations and guidelines they are being given are inadequate to contain the infection and, worse, that all the factors relevant to the situation have not been properly considered. They do not want to see unnecessary deaths or the permanent disabling of children or parents who contract the disease. They remember the false assurances given in early March that it was 'very unlikely the virus would be transmitted to care homes' even as care homes were beginning to report that it was being transmitted. 

Teachers and carers have one thing in common. They look after the most vulnerable and the most precious members of society - our children, our parents, those who are abused, those who have dementia, those who have disabilities and are disadvantaged. Most disgracefully, this week, parts of the press have turned on teachers. Regularly, the same parts of the press attack carers who are among the lowest paid and least trained workers in society for alleged dereliction of duty over conditions in care homes. The truth underlying such attitudes is that, as a society, we have become so focused on economic growth and workplace productivity that we have no interest in resourcing and supporting those who do the kinds of work that shore up the quality of our children's and parents' lives. We give lip service to the importance of education and the crucial role of teachers; we clap and call care workers 'heroes' as we send them to look after the dying with no protective equipment. We do not listen to them, we do not take their advice, we do not resource them properly. We allow them to be invisible and disparaged and then we blame them for not overcoming the difficulties our demands place upon them. In failing them, we let down the very people we say we love and value most. A civilised society, at the very least, funds care for its infants and its dying and we have failed the test for the latter. Do not let us fail it for the former.