Closing schools and childcare centres probably had only a minimal effect on reducing Covid-19, but is causing major social damage, the Ministry of Health says.
The ministry has released a 16-page document dated April 13 to explain why it supported this week's Cabinet decision to reopen schools and early childhood education (ECE) from April 29 for children whose parents need to go back to work under level 3 of the coronavirus alert system.
"Recently emerging evidence suggests closure of education institutions has a limited role in reducing Covid-19 morbidity and mortality," the report said.
"Best case scenario modelling, which may not apply to New Zealand (because it was mostly based on the UK experience), suggests it may reduce Covid-19 by 2 to 4 per cent."
Against this, it says: "Educational institution closures come with significant and enduring adverse impacts on health, education, economic and social inequities."
"Given the emerging evidence of uncertainty of benefit of education closures in reducing Covid-19, coupled with certainty of increased inequity from the closures (even with mitigation in place), consideration should be given to lifting of mass restrictions on all levels of education and moving towards a more targeted approach," it says.
"The lack of evidence suggests taking a cautious approach and monitoring / evaluating as we proceed."
The Early Childhood Council, which opposes reopening childcare centres because of the risk of spreading the virus, has challenged statements by Health Ministry director-general Dr Ashley Bloomfield that children and teenagers "have low infection rates, they don't become that unwell if they do get infected, and they don't tend to pass the virus on to adults".
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Bloomfield pointed to a World Health Organisation investigation into the origins of the virus in the Chinese city of Wuhan where, "of all the people they interviewed for that report, not one could recall any instance of a child passing infection to an adult."
The April 13 ministry document cites an Australian official update dated April 5 on cases in schools and childcare finding "low onward transmission among children, with 1.9 per cent of close contacts who were children testing positive for the virus".
The document says any widespread outbreak of Covid-19 "would have inequitable impacts on Māori and Pacific peoples (higher levels of mortality in all age groups, higher disease burden in all ages)".
But it adds: "While Māori and Pacific peoples have much to gain from pandemic control, the impacts of the control measures deployed to reduce Covid-19 will themselves disproportionately impact Māori and Pacific peoples. This is due to existing inequities in health status and in the broader determinants of health (economic position and educational
achievement) as a result of the process of colonisation.
"For example, closing of schools is likely to more severely impact groups of children already disadvantaged by the education system such as Māori and Pacific children and children with additional learning needs," it says.
"Replacement options such as online learning have the potential to further disadvantage these groups who have the least access to technology devices and internet access that allows learning to be delivered this way.
"The consequences of control measures are also likely to have long term health impacts if they adversely impact the determinants of health for Māori and Pacific peoples."
The document recommends that the Government should consider "staged reopening of primary schools and secondary schools" with controls such as:
• "Physical distancing strategies in place within schools. e.g. staggering start and end times of schools for different years, cancellation of all school events or those that mix classes, partial weeks for different classes, preventing mixing in breaks (perhaps through staggering them)."
• "Greater hygiene requirements around cleaning."
• "Suspension of other activities that involve children mixing, e.g. before and after school care, assemblies, sports, etc."
• "Redeploying staff to protect those in high-risk groups Covid-19."
• "Where possible (e.g. primary schools) consider restricting cross community schooling so children are not moving between neighbourhoods."
"Starting with primary schools might be most appropriate, as children are more supervised by parents than secondary school students (to ensure less out of school social contacts)," the document says.
"Moreover, early primary education may be the most difficult to transition to an online environment. We note starting with primary schools is the approach Denmark is taking to reopen their education system.
"ECE reopening needs further consideration as there are limited options in some settings for interventions to reduce social contacts. However, delays in reopening ECE centres will have adverse impacts on the ability of parents of young children to return to work, and mitigating the financial impact of this on low income families will be a key consideration for the duration of closure."
The document does not include detailed rules that the Ministry of Education later announced on April 17, including keeping children at schools and ECE in small groups of 10 or less and staggered start and finish times and break times so that groups can be kept apart from each other.
However the rules are generally consistent with the general principles outlined in the document.
• Education level 3 rules: covid19.govt.nz.