COVID-19, Immunodeficiency and School Attendance

30 July 2020 Update

This information has been developed for parents and carers, to guide decisions about school attendance for children with primary immunodeficiency (PID) during the COVID-19 pandemic. Public health measures implemented by Australian and New Zealand governments have been successful in controlling the spread of SARS-CoV-2, the coronavirus that causes COVID-19 in most regions. This means that most regions have re-opened schools for face to face learning.  However, in regions where there are outbreaks, some students may be required to temporarily return to remote learning.

pdfASCIA PCC COVID-19 Immunodeficiency School Attendance 2020 July Update177.45 KB

For parents of more vulnerable children, including those with PID, the decision to send their children back to school during or after an outbreak is complex. The type and degree of immunocompromise varies widely between children with PID, so it is important to ask your child’s clinical immunologist if you have specific questions.

Schools in Australia and New Zealand should have measures in place to reduce the spread of COVID-19 (and other respiratory infections), so we recommend that many children with PID can return to school, in regions where there are no outbreaks.

This advice is based upon the following facts:

We understand there will be questions about this advice and will attempt to answer some questions here.

What evidence suggests that children with PID don’t have an increased risk of severe COVID-19?

ASCIA has been following reports and liaising with colleagues from countries that have been much more severely affected by the pandemic than Australia or New Zealand. An international survey is underway to document how many patients with PID have COVID-19. As of early May 2020, only a small number of patients with known PID have been diagnosed with COVID-19 and there is currently no evidence that children with PID are at increased risk of severe COVID-19.

What is the evidence that transmission of COVID-19 in schools is rare?

There have been a number of studies which have shown that the risk of transmissions in schools is low:

What is the Government advice regarding children with complex medical conditions?

Are there any groups of patients who should not return to school?

The type and degree of immunocompromise varies widely between children with PID, so it is important to ask your child’s clinical immunologist if you have specific questions. Advice may differ depending upon the child’s circumstances, infection transmission rates in their community and possibly the state or country they live in.

Is the risk different for primary or secondary school aged children?

There is a slight increase in risk of contracting COVID-19 in secondary school aged children, compared to primary school aged children, and the risk of transmission at school appears to be slightly higher in older teenagers. However, this slight increase in risk is not sufficient to make different recommendations regarding returning to school for these two groups.

Do children have to practice physical/social distancing at school?

Returning to school does not mean that everything will return to normal. There will be an increased focus on handwashing, other hygiene measures and physical/social distancing measures, where practical  

We understand that physical/social distancing is not practical for younger children, and in regions where there is low community spread it does not appear to be necessary, due to low risk of transmission in this age group.

Older students are generally more capable of complying with physical/social distancing recommendations and have a slightly higher risk of contracting the virus from other students. Therefore, older children should make every effort to follow recommendations regarding regular handwashing and physical/social distancing.

The greatest risk for school outbreaks remains adults. Therefore, it is very important that parents comply with restrictions to minimise contact they have with other parents, teachers and students in the school environment

Should children wear masks at school?

The role of masks has attracted a lot of attention in the media. The use of masks has mostly been recommended in countries and regions where there is widespread community transmission, to reduce spread of the virus.

It is understood that the potential benefit of widespread use of masks is to reduce the risk of asymptomatic adults spreading the virus, rather than protecting someone from contracting the virus. Therefore, wearing a mask at school is unlikely to provide any additional protection for your child.

However, in regions where there are outbreaks, the wearing of masks is recommended when physical/social distancing is not possible. 

Further information

This information has been adapted with permission from the Australian & New Zealand Children’s Haematology/Oncology Group (ANZCHOG) oncology and bone marrow transplant (BMT) advice.

The ASCIA COVID-19 webpage www.allergy.org.au/members/covid-19 is regularly reviewed and updated.

© ASCIA 2020

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.

ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice. The content of ASCIA resources is not influenced by any commercial organisations.

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