Dr Illona Duffy started working this week with a crisis call from a mother working in the health department whose child was close contact with a Covid-19 case.
“There is no one to look after her child, she is going to have to stay home and there is no sick leave for her to do that,” Dr Duffy said.
Starting Monday, contact tracing protocols for schools, nurseries and children’s extracurricular activities are expected to change dramatically.
Public health experts, including Chief Medical Officer Dr Tony Holohan, believe it is clinically safe to relax the majority of testing and tracing protocols for children 12 and under, provided that they have no symptoms of Covid-19.
While we will see fewer healthy children forced to stay home from school and less frantic parents, as a result of these changes, that doesn’t mean that navigation will be smooth.
In reality, the next headache for families, nurseries and schools will be to get through the rest of the term into winter, with less contact tracing and less formal communication.
More than ever, the primary defense of schools and nurseries against the pandemic is that children with even the mildest symptoms stay at home. But to what extent is our system set up to support parents in this area?
For Dr. Duffy, the decision to relax protocols for schools seems to be the right one.
Since its inception, contact tracing within schools has been managed directly by public health teams.
“But it just didn’t work because in reality, public health doctors are already so overworked,” Dr Duffy said.
“It took days and days and in some cases the parents were never contacted and it was up to the school that had to advise them to keep their child at home, to organize the test.”
Parents have a responsibility to keep their child at home if they have any symptoms, she said.
The advice to anyone with symptoms of Covid-19, including children, is pretty clear.
If you have symptoms, isolate yourself by staying in your room and get tested. Children should not go to school or nursery.
But for children, there is confusion when it comes to advice on what constitutes “symptoms.”
At the Oireachtas Education Committee this week, the topic of runny and stuffy noses in children was raised directly with Education Minister Norma Foley, potentially for the first time in a public forum.
Donnchadh Ó Laoghaire, education spokesperson for Sinn Féin, highlighted advice from the Ministry of Education that lists runny nose and nasal congestion as a potential symptom of Covid in children.
But according to separate HSE advice, it’s okay to send children to school if they only have nasal symptoms.
“Runny noses are a scenario like tens of thousands of situations families could face,” said Laoghaire, before correcting himself immediately. “Okay, maybe not tens, but certainly thousands.”
It will be the ‘snuffly’ children, who are otherwise doing well, who can pose challenges for nurseries and schools.
Dr Duffy said: “We get calls from parents saying ‘you know they just sniffed but they’re fine otherwise there’s nothing else’.
“The first question we always ask them is’ Did you need to give them Calpol? And if they say “yeah, they just sounded a little quirky” then you know – get them tested. “
“We don’t want symptomatic children to go to school. I think there is a huge parental responsibility with this.
“If your child is showing symptoms of Covid you shouldn’t have sent him. We have to realize now that this is not acceptable, if you have a sick child you have to keep him at home.
The speed at which the decision to facilitate contact tracing and testing for asymptomatic children has taken many by surprise.
More Frequently Asked Questions (FAQs) were posted on Friday morning, along with more tips on managing change.
From next week, in the vast majority of cases, directors and nursery directors will not be notified by public health officials if a child with Covid-19 has attended a classroom while he is was contagious.
At the same time, they were told there was no clinical need to notify parents of cases within a school if they were brought to their attention.
“No sharing of health data is therefore undertaken on the advice of public health and under the Infectious Disease Regulations, as has been the case to date. ”
In the same set of FAQ documents, the sharing of information through certain groups, such as “WhatsApp etc” is noted, and the FAQs reiterate “the importance that the privacy of an individual is not violated by others, in accordance with the normal GDPR requirements ”.
“It is also important that children and families do not feel targeted or pressured into disclosing information. ”
With formal communications to cut down, you can see the potential for panic in some cases if a child is sent home from a sick class.
A child improperly sent home is a fairly regular occurrence during any normal school week, but now even more so during Covid, and with other viruses, noroviruses and flu circulating.
Rumors tend to grow in a vacuum, and in the absence of official communication from public health experts, principals fear that parental angst and stress may be directed against them.
But one thing the FAQs make clear is the importance for families to be aware of the need to make sure children are not sent if they show new symptoms of Covid-19.
In these circumstances, “they must observe their child and contact their general practitioner if necessary”.
However, it has been well reported that the lack of paid leave specifically to cope with these circumstances is an obstacle for many families.
Dr Duffy said: “For people who can work from home, that’s okay, but if you’re working in a hospital as a nurse or caregiver it’s not an option.”
Asking a family member as a grandparent is also not an option for all families.
“We always want to minimize the exposure of people to people most at risk, so it’s very difficult. I don’t know what the answer is.
When schools returned in September 2020, employment expert Richard Grogan was one of the first to point out the lack of support under the law for parents in case they needed to take time off while still keeping symptomatic children outside of school.
Little has changed since then, he believes.
There is “force majeure” leave, but it is emergency leave, designed for circumstances where the immediate attention of a parent is required.
“It doesn’t really cover a child who has to stay out of school,” he said.
“Force majeure is about things like an accident or when a person has to be taken to hospital. ”
It is not intended to cover situations where a child has to stay home from school due to suspected Covid.
“A child with a runny nose and cough is not an emergency, in law.”
If a parent finds himself in a situation where his child has a mild temperature and is not himself, there is no entitlement to paid leave that covers him if he cannot work from home.
“Difficulty is likely for people who are not in this situation. These will likely be lower paid workers or those whose work cannot be done remotely. ”
We haven’t figured out how to handle this, he added.
“There is no coordinated plan. They should be on welfare, but that’s something the government doesn’t want to address. There will be parents who say ‘the child is going to school. ‘. ”