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There is no doubt that the world we knew in December 2019, bears very little resemblance to the one we find ourselves in in February 2022. The first confirmed case of Coronavirus came into the UK on 23rd January 2020, and we have been fighting it on several fronts ever since. The goalposts have shifted more than once, as a number of new variants took hold. At the time of writing, daily cases of the Omicron variant are approximately 140,000 having topped 200,000 in early January, and the UK was the first European country to surpass 150,000 deaths. But there have been other impacts. Our children’s education has suffered as schools and nurseries closed, exams were cancelled, and many had to resort to online lessons in less-than-ideal home-learning circumstances. And then there are the (as yet unquantified) issues related to mental health and the impact on our children’s social and emotional well-being.

However, it is not all ‘doom and gloom’. As we move forward into 2022, we do so from a very different place to the start of 2021. In December 2020, Margaret Keenan, a nonagenarian grandmother received the first dose of a UK-approved vaccine, and this gave us hope. Vaccines have cut the risk of severe illness and death by over 85% and some are nearer 95%. The booster programme in the UK was rolled out at unprecedented speed in reaction to Omicron, and whilst infection rates have risen sharply, we can take some comfort in the fact that death rates have not followed, as they did at the start of the pandemic

However, this is not the time to let our guards down or become complacent. The infection is still out there and there are people who will die if they contract it. But at some point, as many of our politicians have suggested – we will have to learn to live with the virus. So, what should we all be doing to help our minimise risk and what should we be doing in our settings to help?

There are several things we have now which we didn’t have at the start of the pandemic, such as:

  • More information and data on the virus, how it spreads, what works and what doesn’t
  • New treatments and drugs to combat severe disease
  • Experience of dealing with Coronavirus in the community and in hospitals
  • Experience of how lockdowns, restrictions, and social distancing work
  • Track and trace
  • Lateral flow and PCR tests
  • Short-, mid- and long-term plans, responsive to the current situation
  • Better herd immunity
  • A proven and effective vaccine programme
  • Protocols and procedures on how to deal with cases and outbreaks

Prevention is better than cure

You should already have written risk assessments for dealing with COVID-related infections, but you need to update these regularly in response to changes in data and the law. Recently, for example, the isolation period for fully vaccinated people reduced from 10 days to 7 days, but this was under the proviso that the person could show 2 negative lateral flow tests on day 6 and 7, taken 24 hours apart. This, no doubt, will change again the future.

It is also important to remember that the devolved administrations in Scotland, Wales and Northern Ireland have independent responsibility for healthcare and education in their countries, so different rules apply in each nation. Settings should keep abreast of any changes in the law and be prepared to react quickly. Therefore, check your policies, procedures and protocols to make sure they are in line with your own government’s current guidelines and update them if necessary. Make sure too, that you have communicated these well to your staff, trainees and parents too remembering any translations needed for EAL children/parents.

How to reduce the spread of disease

Whilst we know there are now more positives, we also need to combat real issues like ‘pandemic fatigue’ or ‘vaccine complacency’, which can have a negative effect. This could be ‘forgetting’ to wipe down surfaces as often as we might or being less vigilant with our hand washing. Below are some ways to reduce the spread of infection, and the HSE have a full list on their website:

  • Increase cleaning especially after changes of room or venue
  • Use antiviral products instead of antibacterial ones
  • Spread hand-sanitisers around the venue and ensure they are fully stocked
  • Remove high risk items such as cushions and soft toys, or increase washing, or implement a quarantine system
  • Increase the availability of hand washing stations and improve the effectiveness of hand washing through supervision
  • Think about allocating areas to different groups to minimise contact
  • Social distancing – although not required by law, limiting contacts and seeing fewer people will have the effect of reducing the spread of disease
  • Consider the use of masks, visors, and other PPE which may be relevant to your setting, the needs of your children/staff and current regulations
  • Limit visitors
  • Implement regular testing
  • Increasing ventilation by opening windows and doors
  • Consider bringing a change of clothes

Vaccination

The availability of a vaccine transformed the pandemic and has undoubtedly saved lives. Almost all of the people who are hospitalised or have severe disease in recent weeks are either unvaccinated or not fully vaccinated. In the light of this evidence, vaccination is currently recommended for all people in the UK over the age of 12. Two doses are recommended for children aged 12-15 years, and 3 doses for all those over 16. The recommendations have changed over time as more data has become available. Other countries are vaccinating children as young as 3. Find the most up-to-date UK recommendations on the NHS website, here.

Responding to an infection

If your setting experiences some cases, it is important that you have up-to-date policies and protocols that reflect current guidelines. We have already mentioned changes to the self-isolation period from 10 to 7 days, with conditions, but this may still leave your setting short of staff if you have an outbreak. You should make sure you have:

A protocol for dealing with staff infections and any infections in children and/or their immediate family or close contacts

Contingency plans for low staff levels – consider recruiting temporary staff or re-employing retired staff for cover if needed

A protocol for a temporary closure of the setting including how this will affect parents, how they will be informed, any notice needed, and any adjustments to finances that may result

References

NHS coronavirus website 

https://www.nature.com/articles/d41586-021-03686-x

https://www.reuters.com/business/healthcare-pharmaceuticals/countries-vaccinating-children-against-covid-19-2021-06-29/

https://www.bmj.com/content/376/bmj.o5

 

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