Daily lateral flow testing of pupils who have been in contact with a Covid-19 case, could be just as effective in controlling transmission in secondary schools as asking them to self isolate, according to a major new study.
A new report also found that using lateral flow tests on contacts every day rather than sending bubbles home can reduce Covid related absences by almost 40 per cent.
The findings of a study into the use of daily contact testing in schools published today by Oxford University have been described by the head of NHS Test and Trace as a “major breakthrough” in keeping pupils in schools.
Need to know: School Covid restrictions are relaxed
Trial: Scientists call for the daily testing pilot to be paused
Background: Daily contact testing in schools is halted amid Covid concerns
Although it is unclear what the government will do with the findings as it already has plans to relax self isolation rules for people under 18 from next month.
Around 200 secondary schools and colleges across England took part in a trial this year. One group followed the national guidance of isolating contacts of positive cases for 10 days, and the other allowed contacts to stay in school if they took daily Covid tests which produced negative results
The findings come after the latest Department for Education data revealed that more than one million children in England were out of school last week for Covid-19-related reasons - this amounts to around one in seven students (14.3 per cent).
This included 934,000 children who were self-isolating after possible contact with a Covid-19 case.
Current rules say that children have to self-isolate for 10 days if they are identified as a contact of someone who tests positive for Covid-19. This has resulted in entire bubbles in schools being sent home
However this won’t apply from the start of the Autumn term as rules change on August 16 so pupils identified as Covid contacts will instead be asked to take a PCR test and can continue attending schools.
The government had planned to use daily testing to replace the need to self isolate this year but abandoned it over concerns about rising Covid cases at the beginning of the year. Instead it launched this trial study.
The study analysed data from more than 200,000 students and 20,000 staff between April and June 2021. It invited close contacts to provide “a research PCR test for Covid-19 on day two and seven following contact, in order to determine how many close contacts became infected.
Researchers have estimated that there were slightly fewer infections among pupils and staff when daily Covid-19 testing was used in schools, compared to among the group who were isolating at home for 10 days.
The findings suggest that 1.5 per cent of the contacts who attended school to do daily lateral flow device tests tested positive or indeterminate for Covid-19, compared to 1.6 per cent of students and staff staying at home.
The study, which was sponsored by the Department of Health and Social Care and supported by the Department for Education and Office for National Statistics, suggests that 1.8 per cent of available school days were lost due to Covid-19 in the group who continued the self-isolation policy, compared to 1.5 per cent of available school days being lost in those who took part in daily testing.
In the preprint study, which has yet to be peer-reviewed, researchers estimate that school-based contacts taking part in daily coronavirus testing can reduce Covid-related school absences by 39 per cent.
Tes approached the Department for Education and the Department of Health and Social Care for a comment.
Education secretary Gavin Williamson said last month that he would be looking at “the outcomes of the daily contact testing trial, as we consider a new model for keeping children in education.”
Susan Hopkins, chief medical adviser for NHS Test and Trace says: “This is a major breakthrough, showing that daily contact testing can keep young people in classrooms instead of making them isolate at home.
“Children and parents have made enormous personal sacrifices throughout this pandemic by isolating when needed, and we all know the disruption it has caused in their lives.
“We’ve been trying to find safe alternatives, and this study gives us evidence of safe alternatives to isolation for school contacts. So far, self-isolation has been one of the most effective tools at our disposal against Covid-19 - stopping isolated cases from becoming major outbreaks. To have another potential tool like this is great news.”
Bernadette Young, clinical lecturer in infectious diseases at the University of Oxford and an investigator on the study, said they had expected daily testing to improve transmission control due to the “social penalties” attached to the 10-day self-isolation policy.
Dr Young said asking pupils to carry out asymptomatic testing twice a week, as well as naming friends they have been in close contact with, could prevent secondary students from being “more upfront”.
She said: “Now if the consequence of you testing positive is that all your friends are put in isolation, there’s a social penalty that goes with that.
“And so the hypothesis was, or the theory was, that if that penalty is lessened because your classmates will still be allowed to attend school, your motivation to testing will change.”
Dr Young added: “By offering daily testing, you identify more of those who are truly positive and isolate specifically those who are positive, and they’re more likely to withdraw from [social] mixing and decrease the number of infectious cases present in the wider context. So it makes sense that it could happen.”
The study, which was sponsored by the Department of Health and Social Care and supported by the Department for Education and Office for National Statistics, suggests that 1.8 per cent of available school days were lost due to Covid-19 in the group who continued the self-isolation policy, compared to 1.5 per cent of available school days being lost in those who took part in daily testing.
