New Zealand experts call for science-informed approach to COVID-19 in schools

Researchers in New Zealand are calling for a practical, science-informed COVID-19 action plan for schools.

The public health experts from the University of Otago, Massey University, Tū Kotahi Māori Asthma Trust outline seven goals for infection control in schools in a New Zealand Medical Journal editorial. 

The proposed goals include improving air quality, staying home when sick, masks and support for online or hybrid learning during outbreaks. Also, a rights-based approach to health outcomes, and better data and information.

The editorial’s lead author, Dr Amanda Kvalsvig at Otago University tells Cosmos the author group is seeking a more cohesive and equitable approach to schools to address what she calls ad-hoc managing of COVID-19 in 2022. 

Kvalsvig, who has a background in paediatrics and epidemiology, flags a number of concerns with the approach to schools in 2022, including the emphasis on face-to-face learning, the lack of surveillance testing, inconsistent approaches to masks, and delayed access to children’s vaccines.

New Zealand school teachers had the highest rates of COVID-19 by occupation in the country, the editorial says. The paper estimates between February and June 2022, between a third to 46% of school-aged children tested positive to COVID-19, based on official figures or WellKiwis data respectively. By September 2022, the share rose to 66% of 5-19 year olds (WellKiwis data).

Kvalsvig says data and information on COVID-19 in schools has been “patchy”, with some reporting at a national level, but nowhere near what is needed to assess whether control strategies are working. 

“We’re calling for a much more organised public health system from now on, where all schools collect and report baseline information and some schools act as sentinel surveillance sites that collect more in-depth information, including regular testing to detect asymptomatic cases and to monitor rising and falling trends in a consistent way.

“We would also like to see NZ schools piloting new-generation tests that are easier for children to use and can detect multiple infections eg  COVID-19, influenza and RSV, as soon as these are available,” Kvalsvig says.

She adds, the lack of evaluation on the effectiveness of COVID-19 measures in schools has “been a highly frustrating gap. 

“There were hundreds of thousands of COVID-19 cases in school-aged children in 2022 but without information about the contexts of how those infections happened, it’s impossible to learn any lessons from these huge outbreaks about what was working or not working.”

In recent weeks, Cosmos has been reporting on the effectiveness of COVID-19 measures in schools in Victoria and other states, the lack of systematic data collected on the effects of masks on classroom learning, and the failure of governments to include children’s voices in public health decisions affecting them.

Like in Australia, Kvalsvig says in Aotearoa New Zealand children have mostly been almost completely excluded from decision processes about COVID-19 measures in schools.

“We’re calling for children to be given agency in these key decisions that have important implications for their health and education.”

The editorial’s proposed goals for a science-led and whānau-centred (community-centred) approach to infection control in schools include:

1. “Air quality in classrooms is excellent at all times
2. Children, young people and staff are not in school while they are infectious
3. Additional protection via masks is rapidly available during outbreaks (e.g., periods of high COVID-19 transmission and/or seasonal respiratory infection and/or an emerging influenza pandemic)
4. Schools are resourced to provide high-quality teaching and learning and other support online or in a hybrid model during infectious disease outbreaks
5. School-based health outcomes and progress on curriculum aspirations are equitable, rights-based and uphold Te Tiriti o Waitangi [Treaty principles in the context of health include self-determination, equity, active protection, options and partnership]
6. School communities are well-informed and are actively participating in programmes to improve health and wellbeing
7. There is a high level of situational awareness throughout the school system supported with high-quality surveillance of health and the coverage of key interventions.”

Read more Cosmos coverage on COVID-19 schools measures:

• Authorities urged to consult children about COVID-19 and public health measures that affect them
• COVID-19 schools data reveal: Unreleased Victorian data and analysis on masks, RATs and cases
• COVID-19 schools data: State government responses show urgent need for better data management
• How do COVID-19 masks affect children in the classroom?