Seòmar agus comataidhean

Children and Long COVID

Letter from Deputy First Minister and Cabinet Secretary for COVID Recovery, Scottish Government to the Convener on 17 November 2021

Dear Siobhian,

During my evidence to the Committee on 4 November I committed to look into whether the Government had any available data on children and Long Covid.

The COVID-19 Scientific Advisory Sub-Group on Education and Children’s Issues published a summary report of the evidence on children, schools, early learning and childcare settings and transmission from COVID-19 on 12 August 2021. This included a brief summary of available evidence on Long-COVID in children and young people noted below, along with a list of references to relevant evidence which may also be of interest to the Committee.

“If infected with COVID-19, children and young people are more likely than adults to experience mild or asymptomatic infection. Severe illness, hospitalisation and mortality are rare. Over the time of the pandemic, however, concerns have grown about the longer-term effects of infection, known as ‘Long-COVID’. The REACT-2 studies of people in the community in England found that around a fifth of those surveyed reported having had a COVID-19 symptom previously, with over a third of these reporting at least one symptom lasting 12 weeks or more. The prevalence of persistent symptoms increased with age, with a 3.5 percentage point increase in likelihood in each decade of life. The prevalence of long-COVID was higher among women, people who are overweight or obese, who smoke, live in deprived areas, or had been admitted to hospital. These studies did not look at long-COVID in children.”

“Children and young people can experience symptoms associated with long-COVID  including fatigue, followed by dyspnoea and difficulties concentrating. However, the evidence base is incomplete and rapidly developing. The JCVI statement on COVID-19 vaccination of children and young people aged 12-17 years confirms the low risk of prolonged symptoms in this age group, stating:

Concerns have been raised regarding post-acute COVID-19 syndrome (long COVID) in children. Emerging large-scale epidemiological studies indicate that this risk is very low in children, especially in comparison with adults, and similar to the sequelae of other respiratory viral infections in children.”

The committee may also find the recently published CLoCk study of interest. The Sub-Group will continue to review the evidence on acute and prolonged health effects of COVID-19, and will update their advice if required in light of new findings.

Your clerks advised my officials that the Committee, during private consideration of evidence heard at the same meeting, agreed to also ask whether I could provide any information on what work is being done by COSLA and Scottish Government to advise schools on ventilation and on how this issue is being monitored by education authorities.

Scottish Government reached an agreement with COSLA and representatives of the Association of Directors of Education in Scotland (ADES) at the start of August, that local authorities would ensure that all schools and ELC settings had access to CO2 monitoring, whether fixed or mobile. This was to support the goal of assessing the ventilation in every local authority learning, teaching and play space in Scotland using CO2 monitors and/or (where CO2 monitoring was not appropriate) other appropriate means such as airflow digital modelling. Local authorities were asked to complete this work by the start of the October break wherever possible, subject to monitor supply constraints. The policy was agreed prior to the return of schools in August, and updated Scottish Government COVID-19 Guidance was published on 26th August 2021.

Our guidance supported the use of either fixed or mobile monitoring to undertake these assessments. The wording also reflected intelligence that indicated supply constraints could make completion by the target date of October break challenging for some local authorities, while nevertheless retaining that ambitious goal to help drive as much progress as possible ahead of the winter months.

Guidance also asked local authorities to ensure the information they gathered as a result of these assessments was used to inform actions to improve ventilation in schools where required.

Our current guidance on ventilation in schools is well-regarded and has received positive feedback from stakeholders and experts. Previously many local authorities had already reported progress in addressing ventilation issues in the school estate using this guidance, much of which has been in place since last year.

A Scottish Government funding package of £10m to support the delivery of this CO2 monitoring policy was also confirmed with COSLA Leaders at the end of August, against the background of the agreed policy aim.

The Cabinet Secretary for Education and Skills wrote to the Education Committee on Friday 29 October to provide an update on the progress made by local authorities in completing initial assessments of their learning estates. Local authorities have reported significant progress and although there have been challenges with supplies, the significant majority of learning, teaching and play spaces received an initial assessment prior to the October break.

These included:

• 85% of local authority primary school spaces
• 83% of local authority secondary school spaces
• 75% of local authority ASN school spaces
• 72% of local authority ELC spaces

For some local authorities, urgent work continued for a short period after the October break in order to complete initial assessments and the total number of fixed and mobile monitors planned to be deployed across Scotland is around 22,000. The completion rate for the initial assessment of learning, teaching and play spaces across Scotland:

• was at 98.5% by Friday 12 November, with 31 local authorities at 100% complete;
• is now expected to be 100% by Friday 19 November, with all 32 local authorities at 100% completion.

Local authorities have undertaken a significant programme of work to ensure good ventilation in schools and CO2 monitoring has identified where levels of ventilation may be insufficient. Local authorities reported only limited instances of higher-than-expected levels of CO2, and these issues have been capable of being addressed effectively with relatively simple measures, such as freeing stuck windows or providing guidance to staff.

It has been made clear to all local authorities, through ongoing dialogue and through the grant funding being provided, that ensuring longer term best practice and improvement, as well as value for money from this investment, is essential. Discussions are already underway to consider longer-term actions and next steps beyond these initial CO2/ventilation assessments. We are working with ADES, Scottish Heads of Property Services and other partners to ensure that suitable longer-term strategies are in place across all local authorities.

Yours sincerely,

John Swinney
Deputy First Minister and Cabinet Secretary for COVID Recovery,
Scottish Government