HIQA review of international guidance on the identification and management of symptoms of Covid-19 in schools
The Health Information and Quality Authority (HIQA) has today published two reviews of international guidance to support the National Public Health Emergency Team’s (NPHET’s) response to Covid-19.
A new rapid review summarises the public health guidance from 20 countries and two international public health bodies on the identification and management of symptoms of Covid-19 in schools for children and young people.
The review found general agreement across countries that universal health screening, including temperature screening, should not be conducted in schools. There is also agreement that if a child or young person becomes symptomatic, they should be isolated rapidly.
It is widely recognised that decisions to close schools should not be taken without input from public health authorities and that such decisions should take account of local levels of community transmission.
This reflects the guidance most recently published by the Irish Government on the reopening of schools and the guidance from HSE on the management of Covid-19 in schools.
Dr Máirín Ryan, HIQA’s deputy CEO and director of Health Technology Assessment, said: “It is important that Irish guidance is informed by international best practice in the context of rapidly evolving evidence.
“In our review, we found that most guidance documents acknowledged the difficulty of there being no single symptom that is uniquely predictive of a Covid-19 diagnosis and that many of the symptoms are shared with the common cold, which regularly affects children. Additionally, many children who have Covid-19 have no symptoms.
“There has been limited evidence of child-to-child or child-to-adult transmission of Covid-19. While recognising that transmission can occur, international guidance documents identified in our review have highlighted the potential adverse impact of school closures on children’s social, emotional and behavioural health. Therefore, it was important that schools could reopen safely, following Government guidelines.
"The best management of Covid-19 in schools is prevention by ensuring that students and staff who have symptoms suggestive of Covid-19 stay at home, and that everyone practices good respiratory etiquette and performs frequent hand hygiene. Guidelines around physical distancing and face coverings should also be followed, as appropriate.
"As the current pandemic is evolving, and more evidence emerges, guidance on the management and identification of Covid-19 in schools may need to be updated.”
Also published today is HIQA’s review of guidance for the operation of emergency medical dispatch centres in the context of Covid-19. The review examined high-level international documents focused on managing current difficulties, such as increased call volumes, workforce capacity, and staff health and wellbeing. The guidance identified focused more on current planning rather than medium-term or long-term concerns related to the evolving Covid-19 pandemic.
Dr Ryan continued: “Dispatch centres are the first line of defence against Covid-19. From offering information to the public to dispatching services safely, emergency medical dispatch centres have been a vital component of the ongoing response to Covid-19. The wealth of data they have been able to collect during the crisis will be helpful when planning future coordination of services in epidemics.”
These reviews were developed by HIQA following requests from NPHET’s Clinical Expert Advisory Group.
Read the documents on www.hiqa.ie.