PHE school Covid outbreaks analysis: 8 things we learned

There were 30 outbreaks of Covid-19 in schools and other educational settings in June 2020, a new study by Public Health England has found.

The research, published yesterday, is based on “enhanced national surveillance” amid the wider reopening of schools from June 1.

However, PHE has warned there are “important limitations” to its findings, given they were gathered while schools were operating “strict protocols for class and bubble sizes” which “may not be achievable when schools opening fully in the next academic year”.

Here’s what we learned.


1. 30 outbreaks, 67 single cases

According to the PHE study, there were 30 “outbreaks” – which involve more than two or more “epidemiologically linked” cases in staff or pupils – in educational settings in June, when schools started to reopen more widely.

The outbreaks affected 121 people. There were also 67 single cases, taking the total number of confirmed Covid-19 cases to 198.

The PHE study concluded that the wider re-opening of schools “was associated with very few outbreaks after easing of national lockdown in England”.


2. ‘Strong correlation’ with regional incidence

According to the report, there was a “strong correlation” between the number of outbreaks in educational settings and the regional incidence of Covid-19.

PHE said this “emphasises the importance of controlling community transmission to protect educational settings”, and said additional interventions “should focus on reducing transmission in and among staff members”.

The report added that “most school children” affected were identified “as part of contact tracing after their parent, often a healthcare worker, was diagnosed with COVID-19”.


3. More staff affected than pupils

Of the 67 single confirmed cases, 30 were in children and 37 were in staff.

Of the 121 people affected by outbreaks, 30 were children and 91 were staff.

Although PHE did not collect information on the source of infection for single cases, it has published what it believes was the “probable transmission direction” for the 30 confirmed outbreaks.

This states that the virus was probably transmitted from staff to staff in 15 outbreaks, staff-to-student in seven outbreaks, student-to-staff in six outbreaks and student to student in two.


4. Primary schools had more cases

Of the 67 single cases, more than two thirds (67 per cent) were in primary schools, while 10 per cent were in early years settings and 6 per cent were in secondary schools.

Of the 30 outbreaks, 60 per cent were in primary schools, 23 per cent were in early years settings and 7 per cent were in secondary schools.

However, PHE said the higher incidence in primary schools was “likely reflecting the larger volume of children and staff returning to these educational settings during the summer mini-term”.


5. One staffmember hospitalised

Of the 67 single confirmed cases in schools in June, one person, a member of staff “required intensive care admission for respiratory support”. None of the children were hospitalised.

According to the PHE report, one secondary school teacher died of Covid-19 after “acquiring the infection from a household member with confirmed infection who had acquired the infection in the community”.

But the teacher “had not attended the school during their infectious period and, therefore, did not have contact with other staff or students within the school”.


6. Pupils sent home, schools closed

The study also recorded how schools and other educational settings responded to cases.

Of the schools with single confirmed cases that provided information, 90 per cent sent the individual and their contact bubble home. Four schools decided to close entirely “because of a perceived risk of onward transmission, although this was contrary to national recommendations”.

In schools affected by the 30 outbreaks, affected contact bubbles were excluded in every case, while 3 per cent of schools also “decided to close either on an interim basis (to allow for deep cleaning or for exclusion periods to elapse) or for the rest of the term”.


7. Local school closures ‘may be necessary’

According to the PHE report, the potential for spread within educational settings “does suggest that school closures may be necessary as part of lockdown in regions with increasing community infection”.

However, the research added that given what is known about the “detrimental effects of lack of access to education on child development”, local closures “should probably be considered only in extremis by comparison with other lockdown measures”.

PHE also its findings indicated “that early detection and isolation of staff and students can prevent progression to an outbreak in most cases, highlighting the importance of the ‘test, track, and trace’ approach”.


8. ‘Be vigilant’, staff told

PHE said the higher risk of Covid among staff highlights “a need to strengthen infection control measures at two levels”.

“Staff members need to be more vigilant for exposure outside the school setting to protect themselves, their families and the educational setting,” the report said.

“Within the education premises, stringent infection control measures between staff need to be reinforced, including use of common staff rooms and crosscovering staff across bubbles.”

But the study also described as “reassuring” its finding of “very little transmission between the students which is consistent with emerging literature for preschool and primary school students”.

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