27th May 2020
Guidance for parents of children returning to school in June or July 2020 I know you will be aware that the government has announced plans to return children of certain ages to schools in England this term, and you may be anxious about whether this is safe for your child and for members of your household. GPs are unfortunately not in a position to provide individual risk assessments for neither children, nor letters to confirm their suitability or otherwise to return to school.
Cheshire Local Medical Committee is the statutory body which advises and supports GPs and their clinical teams across Cheshire. We have provided this guidance to answer the questions you may have so that you can make the appropriate decision about whether or not your child returns to school this term.
Should I keep my child at home if they have an underlying health condition or live with someone in a clinically vulnerable group?
1. Children and young people who are considered extremely clinically vulnerable and shielding should continue to shield and should not be expected to attend (see Appendix 1).
2. Clinically vulnerable (but not clinically extremely vulnerable) people are those considered to be at a higher risk of severe illness from coronavirus (see Appendix 2). A minority of children will fall into this category, are expected to attend school with strict social distancing measures in place. Parents should follow medical advice if their child is in this category and is unwell. See https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-in-children/
3. Children and young people who live in a household with someone who is extremely clinically vulnerable and shielding should only attend if stringent social distancing can be adhered to and the child or young person is able to understand and follow those instructions (see Appendix 1).
4. Children and young people who live with someone who is clinically vulnerable (but not extremely clinically vulnerable) as defined in the social distancing guidance and including those who are pregnant, can attend.
We also wanted to reassure you that schools have been instructed as follows: •
- To carry out a risk assessment before opening to more children and young people, and directly address risks associated with coronavirus so that sensible measures can be put in place to minimise those risks for children, young people and staff.
- To make sure that children and young people do not attend if they or a member of their household has symptoms of coronavirus.
- To promote regular hand washing for 20 seconds with running water and soap or use of sanitiser and ensuring good respiratory hygiene by promoting the catch it, bin it, kill it approach.
- To clean more frequently, to get rid of the virus on frequently touched surfaces, such as door handles, handrails, table tops, play equipment and toys.
- To minimise contact through smaller classes or group sizes and altering the environment as much as possible, such as changing the layout of classrooms.
- To reduce mixing between groups through timetable changes, such as staggered break times or by introducing staggered drop-off and collection times.
I sincerely hope you will find this guidance note useful, and that it will also help to alleviate some of your concerns. We ask that parents continue to follow the most up to date national guidance published on this issue, during the Covid-19 pandemic. Further information is available at https://www.gov.uk/coronavirus/education-and-childcare
With very best wishes
Dr Branwen Martin
Medical Director Cheshire LMC
The Weston Centre,
Appendix 1 Who is ‘clinically extremely vulnerable’? Clinically extremely vulnerable people include the following: 1. Solid organ transplant recipients. 2. People with specific cancers: • people with cancer who are undergoing active chemotherapy. • people with lung cancer who are undergoing radical radiotherapy. • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment. • people having immunotherapy or other continuing antibody treatments for cancer. • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors. • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs. 3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD). 4. People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell). 5. People on immunosuppression therapies sufficient to significantly increase risk of infection. 6. Women who are pregnant with significant heart disease, congenital or acquired.
Appendix 2 Clinically vulnerable people If you have any of the following health conditions, you are clinically vulnerable, meaning you are at higher risk of severe illness from coronavirus. You should take particular care to minimise contact with others outside your household. Clinically vulnerable people are those who are: 1. Aged 70 or older (regardless of medical conditions) 2. Under 70 with an underlying health condition listed below (that is, anyone instructed to get a flu jab as an adult each year on medical grounds): • chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis. • chronic heart disease, such as heart failure. • chronic kidney disease. • chronic liver disease, such as hepatitis. • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), or cerebral palsy. • diabetes. • a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets. • being seriously overweight (a body mass index (BMI) of 40 or above) • pregnant women.