Day: 30 August 2021

Gavin Williamson Refuses to Rule Out More School Closures

Education Secretary Gavin Williamson insists we shouldn’t get “carried away with these new freedoms” and has refused to rule out more school closures later this year as a “last resort” if there is another wave of Covid ‘cases’. The Sun has the story.

Mr. Williamson is pleading with parents not to lower their guard and to go on with testing at home.

He said: “It is important not to get carried away with these new freedoms and throw caution to the wind.

“The last thing we want is for schools to partially close again, or for whole classes of pupils to be at home isolating.

“That should be only the last resort. We need to do everything we can to avoid the levels of disruption we saw last year from the pandemic.”

Whitehall officials remain confident fresh school closures are unlikely and say the country is in a very different place to last year.

They point to the success of the vaccine drive and the fact there are detailed plans to squash outbreaks.

But Mr. Williamson insisted schools must still follow Covid precautions, with regular testing a key element.

He added: “Parents, too, have a responsibility to make sure children are tested regularly.

“I know there are many things people would rather be doing, but it’s really important to make time for it.”

Department for Education guidance states that secondary school and college students in England should be checked twice on site on their return, with lateral flow tests between three and five days apart.

Pupils should continue to test twice weekly at home until the end of September, when the policy will be reviewed.

Mr Williamson’s comments came days after experts said it was “highly likely” there would be high levels of Covid infection in schools by the end of September.

Worth reading in full.

The Fatal Flaw in PHE’s New Study Claiming Delta “Doubles Risk of Hospitalisation” Compared to Alpha

A new study from Public Health England (PHE) and Cambridge University was published in the Lancet last week, claiming to find that the Delta variant “doubles a patients’ risk of hospitalisation compared to the Alpha variant”, as the Telegraph reported (as did the BBC).

Reviewing over 40,000 sequenced positive PCR test results from England between March 29th and May 23rd, 2021, the researchers found that 2.2% of Alpha infections (764/34,656) and 2.3% of Delta infections (196/8,682) were hospitalised within 14 days of their first positive test. However, once they adjusted for factors such as age, ethnicity and vaccination status they found the risk of hospitalisation from Delta more than doubled compared with Alpha (a 2.26-fold increase).

The authors took the opportunity to use the results to stress the importance of being vaccinated, noting that only two per cent of those hospitalised were double vaccinated. However, this data is out of date, as more recent data from the main Delta surge suggests that vaccine efficacy against Delta infection may be as low as 15%.

The finding that Delta is more than twice as serious as Alpha is surprising as official data shows that hospitalisations have been much lower with Delta than Alpha. Data in the PHE technical briefings on the variants of concern shows that between February 1st and August 15th, 2.9% of sequenced Alpha infections resulted in an overnight hospital stay, compared with 1.9% of sequenced Delta infections. Technical Briefing 21 (the most recent) acknowledges this but adds that “a more detailed analysis indicates a significantly greater risk of hospitalisation among Delta cases compared to Alpha (see page 50 of Variant Technical Briefing 15)”.

Technical Briefing 15 quotes the findings, then in pre-print form, which are now published in the Lancet study (I criticised an earlier version of the claim here).

March 29th to May 23rd, the study period, is notable for being a period of low prevalence in England, when there were only around 2,000 reported infections a day (compared to a peak of around 50,000). In the over-60s in that period there were only 100-200 reported infections per day.

Another Million Doses of the Moderna Covid Vaccine Suspended in Japan Over Contamination Fears

The recent deaths of two Japanese men in their 30s after being given potentially dodgy doses of the Moderna Covid vaccine was not the end of Moderna’s troubles in the country, with another million doses having now been temporarily suspended following the discovery of contaminants in more batches. Reuters has the story.

The suspension of Moderna supplies, affecting more than 2.6 million does in total, comes as Japan battles its worst wave of Covid yet, driven by the contagious Delta variant, with new daily infections exceeding 25,000 this month for the first time amid a slow vaccine roll-out.

The latest reports of vaccine contamination came from Gunma prefecture near Tokyo and the southern prefecture of Okinawa, prompting the suspension on Sunday of two more lots in addition to the 1.63 million doses already pulled last week.

A tiny black substance was found in a Moderna vaccine vial in Gunma, an official from the prefecture said, while in Okinawa, black substances were spotted in syringes and a vial, and pink material was found in a different syringe.

Japan’s Health Ministry said some of the incidents may have been due needles being incorrectly inserted into vials, breaking off bits of the rubber stopper. Other vials from the lots can continue to be used, the ministry said on Monday.

The contamination cases followed a Government report on Saturday that two people died after receiving Moderna shots that were among lots later suspended.

The Government had said that no safety or efficacy issues had been identified and that the suspension was a precaution. The causes of death are being investigated.

“It is unlikely, in my opinion, that contamination of foreign substances led directly to sudden deaths,” said Takahiro Kinoshita, a Physician and Vice Chair of Cov-Navi, a vaccine information group.

“If the contaminated substances were dangerous enough to cause death for some people, probably many more people would have suffered from some symptoms after the vaccination.

“However, further investigations are definitely needed to evaluate the harm of the particular doses in question.”

Worth reading in full.

New Zealand Woman Dies After Receiving Pfizer Covid Vaccine

The whole of New Zealand was plunged into lockdown following the reporting of a single Covid ‘case’ earlier this month. But the main response to today’s reporting of a death in the country linked to the Pfizer vaccine appears to be highlighting just how safe the jab really is. Sky News has the story.

The Covid Independent Safety Monitoring Board (CV-ISMB) did note that there were other medical issues occurring simultaneously, which may have influenced [the woman’s] death following her vaccination.

“This is the first case in New Zealand where a death in the days following vaccination has been linked to the Pfizer Covid vaccine,” the Ministry said in a statement, without giving the woman’s age.

The Ministry added the vaccine monitoring panel attributed the death to myocarditis, a rare but known side effect of the vaccination.

Myocarditis is an inflammation of the heart muscle that can limit the organ’s ability to pump blood and can cause changes in heartbeat rhythms.

Last month, New Zealand Medicines and Medical Devices Safety Authority (Medsafe) issued a safety alert on myocarditis to raise awareness of the side effect.

All cases of deaths following vaccinations are referred to the CV-ISMB for review.

The board’s Chairman, Dr. John Tait, said: “We want to ensure that the outcomes from this investigation are widely available for others to learn from.

“The Pfizer vaccine is highly effective in protecting against serious illness and death from Covid and we remain confident about using it in New Zealand.”

The Health Ministry has reassured people that the benefits of the jab continue to “greatly outweigh” the risk of Covid and vaccine side effects.

In response, Pfizer said it recognised there could be incidences of myocarditis after vaccinations but such side effects were extremely rare.

Worth reading in full.

Schools Across Europe Must Stay Open, Says WHO

The World Health Organisation and Unicef have said schools in Europe must do everything possible to remain open, in spite of the Delta variant being dominant in the region. The Guardian has more.

“The pandemic has caused the most catastrophic disruption to education in history,” said Hans Kluge, the head of the WHO’s Europe region. “It is vital that classroom-based learning continues uninterrupted.”

Kluge said that while the pandemic continued, “educating children safely in a physical school setting” was of “paramount importance for their education, mental health and social skills”, and must become “a primary objective” for governments.

44 out of 53 countries in the WHO’s Europe region closed their schools nationwide at the height of the pandemic’s first wave in April 2020, and while most reopened that September, surging infection rates sparked new restrictions and more closures in dozens of countries during the autumn and winter.

Mass absences and frequent school closures have continued in several countries through the spring and early summer, with more than one million children, or 14.3% of the age group, out of school for Covid-related reasons – either self-isolating or because their school was closed – in England in late July.

“We encourage all countries to keep schools open, and urge all schools to put in place measures to minimise the risk of COVID-19 and the spread of variants” throughout the new school year, Kluge said in a joint statement with the Deputy Regional Director of the U.N. Children’s Fund for Europe and Central Asia, Philippe Cori.

Worth reading in full.

This is a positive development, save for the fact that Kluge and Cori recommend frequent testing of pupils and staff as a way of keeping schools ‘safe’ without explaining how to avoid pupils who test positive and those in their ‘bubbles’ being sent home for 10 days at a time.

Switch to Remote Learning Caused Large Decline in U.S. School Enrolment

We know that the switch to remote learning caused large increases in school dropout in middle-income countries like Brazil. But what about rich countries like the United States? There you’d expect the switch to be more or less seamless.

Not so, it appears. A new paper documents a dramatic decline in U.S. school enrolment last year, of which around 25% is explained by the switch to remote learning. Thomas Dee and colleagues analysed data on a large sample of K–12 public schools, comprising 17 million students across 34 states. Their main finding is shown in the chart below:

Although school districts that retained in-person learning saw a decline in enrolment, the decline was far larger in those that switched to remote learning. The authors confirmed that this finding held up in more sophisticated multivariate analyses.

Their estimates suggest that “offering remote-only instruction increased disenrollment by 42% (i.e., a change from 2.6 to 3.7%) relative to in-person instruction”. The decline in enrolment was concentrated in kindergarten.

How many students are we talking about? Roughly 57% faced remote-only instruction at the start of the 2020 school year. And about 49 million were enrolled in 2019. This means the switch to remote learning caused about 300,000 additional students to disenroll (49M x 56% x 1.1 ppts).

Interestingly, the disenrollment effect of remote learning was larger in rural areas, which may be due to a lack of high-speed internet access (though the authors were not able to explicitly test this hypothesis).

So where did all the disenrolled pupils go? As the authors note, there are several possibilities. They may have switched to private schools or home-schooling, decided to skip or delay kindergarten, become truant, or dropped out of school altogether.

The study’s findings indicate that a large number of parents did not want their children to participate in remote learning. This ‘revealed preference’, the authors note, is consistent with a report published by the National Academies of Science, Engineering and Medicine last year. It concluded that schools should “prioritize reopening with an emphasis on providing full-time, in-person instruction”.  

Last year’s decline in enrolment, which was exacerbated by the switch to remote learning, may have profound consequence in the years to come. If many students do not return to the school system, they may never gain the qualifications necessary to attend college and advance in the labour market.

And if most students do return, having simply delayed kindergarten (a practice known as ‘redshirting’), they will enter an unusually large, mixed-age cohort. The members of this cohort could face large class-sizes and other challenges throughout their educational careers.

Last year, school districts across the U.S. took the unprecedented step of closing schools and instead providing remote-only instruction. Previous studies have found that the switch to remote learning caused sizeable learning losses – at least in the short run. Thomas Dee and colleagues have shown that it exacerbated disenrollment in the U.S.

Will school closures be judged as a wise policy in hindsight? The answer is almost certainly ‘no’.