Back to school under ‘Delta Level 2’ – Expert Reaction

Public schools outside Auckland will be re-opening tomorrow under revised Alert Level 2 settings, which encourage tamariki over the age of 12 to wear masks, but don’t require it.

Under the Alert Level 2, schools should put extra public health control measures in place to prevent the spread of COVID-19. Students and teachers do not need to physically distance, but parents, carers and whānau who visit the school should try to keep two metres apart from people they do not know.

The SMC asked experts to comment on the role of ventilation in schools and advice for managing the shift back to school.

Dr Julie Bennett, Senior Research Fellow, Department of Public Health, University of Otago, Wellington, comments:

“The virus that causes Covid-19 can spread via airborne transmission, with virus-laden aerosols able to remain suspended in the air for long periods before being inhaled into the airways, triggering new infections. Indoor spaces with low levels of ventilation are high-risk settings for transmission. Aotearoa New Zealand has already experienced several large outbreaks in school communities, most notably that Marist College outbreak, which generated 96 cases.

“Ventilation rates in New Zealand schools have been shown to be inadequate, with a typical Wellington primary school classroom only meeting the building code ventilation standard 38% of the school day. In 2017, the Ministry of Education published a guideline for minimum performance requirements for indoor air quality and thermal comfort in schools. However, these guidelines only apply to new buildings and upgrades. While some ventilation improvements will require structural alterations to school buildings, there are strategies that schools can implement, especially with the arrival of spring.

“These strategies are:

  • Increase natural ventilation – bring as much outdoor air in as possible by opening windows to get across room air-flow.
  • Use child-safe fans to increase effectiveness of open windows by safely securing fans to blow potentially contaminated air out and pull in outdoor air.
  • Consider having activities, classes, breaks outdoors when circumstances allow.
  • Use CO2 monitors in classrooms to indicate when to take action e.g., opening windows, moving outside.
  • Use potable air cleaners – high-efficiency particulate air (HEPA) filtration units for settings were natural ventilation isn’t feasible and in high-risk areas such as sick bays.

“Things to be mindful of are ensuring that classrooms remain warm enough to be healthy for children and staff – additional funding to enable schools to run heating may be required. Practical guidance for staff that minimises their already high burden of responsibility for multiple facets of children’s wellbeing is needed.

“Ventilation strategies should work together with other outbreak control measures such as mask-wearing, cohorting, staying home when unwell, and vaccinating staff and students. Optimising ventilation in schools has multiple co-benefits aside from Covid-19 prevention, including prevention of other respiratory infections that circulate in schools and improving children’s learning and concentration. Optimising ventilation in schools should be a critical component of the New Zealand Covid-19 response to keep children safe and schools open, as schools do far more than provide formal education.”

No conflict of interest

Dr Mikael Boulic, Senior Lecturer, School of Built Environment, Massey University, comments:

“In 2020, workshops and webinars from two ventilation expert associations (AIVC and ASHRAE) showed that ideally schools should be mechanically-ventilated with at least 10 litres of fresh air/second/per child and HEPA filtration (to capture but not kill the virus). This could be the best solution. However in New Zealand, natural ventilation (opening windows and external doors) is the preferred ventilation method in most classrooms.

“Our ‘He Wharekura Oranga’ research has shown that only around 40 per cent of teachers open class windows during teaching time, so there is not much ventilation at the end of the day for our New Zealand classrooms. If the windows stay closed, there is no ventilation and as a result particles, droplets and potential virus could stay around.

“So, good ventilation will be needed to reduce the level of respiratory particles. In addition to New Zealand government recommendations (social distancing, mask wearing and hand washing to lower the risk), when the weather is fine (spring season starting!) a couple of windows on both sides of the class – for cross-ventilation – could be kept open during teaching.

“Then when the kids have a break outside, teachers could try the ‘flush effect’: all windows and doors open at the same time for 10-15 minutes to efficiently ventilate the classroom. This will also help with cognitive performance, as a high level of CO2 (low ventilation) is connected to poor cognitive performance at school.”

No conflict of interest

Dr Jin Russell, Developmental Paediatrician, Starship Children’s Hospital and PhD Student, School of Population Health, University of Auckland, comments:

“Children are returning to school tomorrow for all regions at Delta Level 2. I welcome the news that the delta outbreak is controlled outside of Auckland to enable students to return to school safely. Schools provide so much more than formal education.

“Parents and children may feel both relieved and anxious at the same time to be returning to school. While we do need to be cautious about the delta variant and ensuring we are following public health advice closely, parents and students can feel reassured that when there is very low likelihood of community transmission, students are at very low risk of catching Covid-19 in schools.

“The majority of children who are infected with Covid-19 experience a mild or asymptomatic infection, however the risk to children are not zero, and rarely, severe disease can result. This is why is so important for children over the age of 12 to be vaccinated, and for school staff to be vaccinated as well.

“Schools will be working hard to make their environments safe for students and staff. Evidence shows that by implementing combinations of interventions, such as universal masking, improving ventilation, increasing activities outdoors, cohorting, distancing, hygiene, and staying at home if any symptoms, schools can significantly reduce potential transmission of the virus and keep everyone protected. There has been a lot of focus on masking, however improving ventilation is a critical measure as well.”

No conflict of interest.

Dr Dougal Sutherland, Clinical Psychologist, Victoria University of Wellington and Umbrella Wellbeing, comments:

“Whilst Alert Level 2 may bring a sense of freedom for some, for others it may bring a sense of worry and anxiety. This worry may be especially so for parents and whānau as children return to school. Parents and teachers will be well aware of the difficulties of enforcing physical distancing between children, whether they be five or 15 years old, and this may raise the concern of COVID-19 spreading, especially given the apparent speed of the Delta variant.

“Anxiety may be compounded for some families if parents remain working from the relative safety off home whilst children are out and about. The ambiguity of rules for children over the age of 12 could also cause confusion and worry for both whānau and teachers alike. Children over 12 are now able to be vaccinated, yet they are not required to wear masks at school nor on school buses, which often resemble sardine cans. In such times of uncertainty, focusing and acting on factors within an individual’s control (e.g., wearing a mask, washing hands, and getting vaccinated) can alleviate some of this worry.”

No conflicts of interest declared.

Jacqui Maguire, Registered Clinical Psychologist, comments:

“It’s important to first acknowledge how resilient our little people are. When children have a stable home base, and at a core level feel loved and safe, they are able to manage many challenges. As a parent, it can be helpful remembering this. This allows our mindset to be ‘how do we support our children to navigate the rapid changes’ instead of coming from a position of concern that they won’t be able to cope.

“Some helpful tips before returning to school:

“1. Talk to your children about the big day:

  1. Ask them how they are feeling about their return to school?
  2. What are they looking forward to? What will they miss about lockdown?
  3. Pre-empt the changes that they might notice. E.g. explain about masks and why people are wearing them. Remind them of the covid safety measures (washing their hands, coughing into elbows).
  4. If your child is 12+, ask their opinion on if they want to wear a mask or not? Discuss the pros and cons with them.

“Communicating (which includes listening) in an age appropriate manner with our children enables them to feel seen, heard and understood. Factors that promote resilience and wellbeing.

“2. If your child is expressing concerns about returning to school, get a very clear picture of their worries. Be a curious scientist by leaving assumptions at the door, and naively enquiring about their thought process. Once you can understand their worries, you have the ability to validate their concerns and derive a plan to manage those.

“3. If you as a parent are concerned about the return to school, discuss your worries with another adult, which may include discussing these with the school if required. It’s important we avoid transferring our thoughts onto our children.

“4. Use this afternoon to get ready. Get clothes ready, pack school lunches, have an end of lockdown celebratory dinner tonight. Your family unit made it through three weeks at home together, and that is worth acknowledging.

“Again, remember that children are resilient. If they feel like the adult has the logistics and concerns under control, it provides them the optimal opportunity to be a child. Good luck, and I hope all our young people enjoy being back in the classroom with their friends.”

No conflict of interest

Dr Melanie Woodfield, The Werry Centre, Department of Psychological Medicine, University of Auckland, comments:

“It’s become a cliché, but lockdown experiences are different for everyone – some children will be desperate to get back to school or kindy, and some will be devastated. Parent experiences might also vary – perhaps ambivalent, conflicted or utterly relieved.

“Often, small children navigate change well. They can surprise us with their ability to ‘pivot’. And there also are practical things that the adults around them can do to support children in this time of transition. Just to say – it’s easier for parents to meet their child’s needs when they’re well rested and supported. And this might not be the case if they’re struggling with job insecurity, or their own anxiety about lowered alert levels.

“Here are some practical ideas for parents:

“Just to say, if you do find yourself upset, stressed or snappy in front of the kids, it’s not the end of the world, but it can be useful to remind them that it’s not their job to look after you. That adults look after adults, and kids don’t need to look after adults. Young children are developmentally egocentric – if an adult is upset, they tend to think it’s because of something they have done or said. So they need to be told simply that you being upset is not their fault. That you’re thinking about something which makes you sad or worried, but you’ll have a talk to your friend and feel better soon. Acknowledge your own worries, but communicate a sense of calm, and an ability to cope.Children feel contained and secure when things are predictable and familiar. Try to keep the family routine the same, those reassuring rhythms of daily life.

“Smoothing the transition might involve laying out their school clothes, sourcing the shoes and popping lunchboxes out on the bench the night before. In the midst of lots of things they can’t control, giving children age-appropriate control over the small things can help. Perhaps what they’d like on their sandwiches, or which socks they want to wear.

“In the morning, try to set the tone from wake-up time. Something fun, unexpected and distracting if possible – maybe upbeat music on the playlist or smiley face toast. It’s less likely to be helpful for young kids to listen to the news or overhear a fraught ‘discussion’ between parents on a morning that might already feel big. Kids will have gaps in their understanding of the situation, that they may fill with ideas that are even worse than the reality.

“Some children will be full of worries: ‘but what if…?’. We’ve all been tempted to reply with ‘don’t be silly’ or ‘it’ll be fine!’ But it is often helpful to reflect back their concern, to validate their emotion and help them feel heard, before moving on and distracting. Perhaps something like ‘it makes sense that you’re worried that your teacher will tell you off for not doing that poem. Knowing her, I think she’ll understand. Let me know after school how it goes.’ Perhaps think of, and mentally rehearse, a couple of key statements that are honest, but reassuring and developmentally appropriate. Short statements, then distract and move on.

“Remember that concepts like germs and infections are abstract. Developmentally, young children do better with concrete or literal concepts, so a long explanation might sail over their heads. Keep it simple, perhaps ‘some people get very sick when they have Covid, but most people get just a little sick. But we’re going to (wash hands / wear masks / stand back) to help keep everyone stay healthy and well.’

“Perhaps anticipate some curly questions after the first day. Maybe why their friend wasn’t wearing a mask, while they had to (or vice versa). These sorts of scenarios can involve concepts around morality, judgment – right/wrong, bad/good – and there can be a discomfort with dissonance – he’s my friend but he’s doing the ‘wrong’ thing. It might be helpful to explain that different people have different ideas, ‘and in our family we…’. And it’s possible to be friends with someone, but have different ideas about things.

“Overall, try to relax expectations and go easy on yourself. You may feel distracted or preoccupied, thinking about how they’re doing. Understand (and accept) that you won’t be as productive, and that thousands of other parents will be in the same situation. These are unusual circumstances. A time for self-compassion and kindness to self and others.”

Conflict of interest statement: “Dr Melanie Woodfield is employed part-time as a Clinical Psychologist in government-funded Child and Adolescent Mental Health Services. She receives research funding from the Health Research Council of New Zealand.”

Dr Kirsty Ross, Senior Clinical Psychologist and Senior Lecturer in Clinical Psychology, Massey University, comments:

“Tomorrow marks the return for school for our young people. I am sure there are caregivers across Aotearoa New Zealand who are gleefully looking forward to waving their tamariki and rangitahi off in the morning, and having the house to themselves again – or returning to work themselves and having some contact with people who are not family members! There will be children and teens who will be feeling excited about seeing their friends again and getting back to some normality with sports, activities and even schoolwork. However, there will also be some young people really  nervous about returning to school, just as there will be parents and whānau who will have some worries about how their children will cope going back to school (and about their health and safety) and who will miss the time they have had as a whānau. The full range of emotions is totally normal  and important to acknowledge right now.

“Lockdown for some young people meant a respite from anxiety, busyness and pressures, especially for our rangitahi at high school. Stress around friendships and social situations, schoolwork,  assessments and preparation for exams, decisions around courses and career plans may have been able to be partly shelved for a few weeks. And so may return with full force over the next few days and weeks. For other young people, lockdown has meant missing out of free school lunches, routines, warm classrooms, and not having access to learning resources so missing out on learning. As I saw in a meme recently, we have all been in the same storm, but we have not all been in the same boat. So young people will be returning to school with a variety of experiences during lockdown and different starting points for learning and engaging with teachers and peers. Returning to school always means a transition period for everyone concerned – parents and caregivers, youth  and educators. And that means riding the wave of emotions for all concerned.

“When you are at home with someone for 24 hours a day, seven days a week, you are exposed to their every thought, feeling and behaviour. For parents and caregivers, that can mean a chance to connect with their young people in different ways; but it is also mentally and physically tiring to be carrying the responsibility for your loved ones’ wellbeing without a break. For many young people, their family and whānau are the safe people to ‘let it all hang out’ with; that can mean that families get the full brunt of emotions as young people experience them. What I would say is that this is actually a good thing (though can be challenging in the moment!) if you understand that you don’t have to fix these feelings, but rather, can help your young person tolerate their feelings and learn  how to regulate and cope with them.

“The first thing you can do to help them as they manage their emotions about returning to school is to validate and normalise their emotions and create the time and space for them to talk about their feelings. There is no emotional response right now that is ‘wrong’; by allowing space for all emotions to be expressed (appropriately, without harming anyone physically or emotionally), these emotions will reduce, settle and pass, and young people will realise they can cope with them. Once the emotions feel more manageable, problem solving and looking at choices in how to manage a situation can begin. But please parents, know that all the emotions you see in your young people at home right now does not mean they are going to fall apart when they get back to school. In fact, it is not unusual for educators to talk about how well young people manage their feelings at school, before they let them out when they get home to their families. This means that young people often do have a way to manage their feelings at school (in front of others) but also that they know that they can select the time, place and people to let those feelings out so that they can receive support, understanding and advice (if needed).

“So, expect and allow for a full range of feelings tomorrow and in the days ahead. Talk about how to make time and space for those feelings as a family. Make time each day to talk about how you have felt, with no expectation of ‘fixing’ those feelings, but just a time to share. Then you can look at whether these are feelings and situations that will improve with time by themselves, or whether there are actions needed and additional support that needs to be put in place. Remember that when you haven’t done something for a while, it loses its familiarity and our feeling of competence and confidence in that situation may have temporarily reduced. Having not been at school or work for a while may mean feeling anxious walking back into the school grounds or workplace again; it can mean feeling nervous about whether you will remember the morning routine and the order of showers that needs to occur for everyone to get out of the house on time! But that doesn’t mean that you won’t remember the rhythm and routine with time, and that these places, people, and  activities won’t become familiar again. Just give yourself and your loved ones time to remember the familiar, and get used to new processes like mask wearing.

“And lastly, please remember that your schools and educators put a huge amount of thought, planning and consideration into ensuring that schools and young people are safe and will be prioritising wellbeing. Many educators are parents themselves, and your young people are precious to them too. They will also be nervous about wanting to get it right; have faith in their decisions, but ask questions to alleviate your concerns if there are things that are not clear. We are all in this together. Good communication between home and school means that parents can reiterate the messages from school, and provides reassurance for young people that the adults in their world are working together and can be relied on to ensure their health and wellbeing is taken care of. Then they can relax and trust in those processes and decisions, and get on with the big job of being a young person in these challenging times.”

No conflicts of interest declared.