London School of Hygiene & Tropical Medicine

The COVID-19 pandemic has impacted us all in many different ways, but some of the hardest hit were schoolchildren. Many children and families were affected in different ways, and while there’s plenty of anecdotal evidence from the pupils, parents and teachers who experienced the challenges firsthand, we may not know the full implications of this pandemic on children for many years to come.

When COVID-19 first emerged in the UK, scientists and health officials still knew relatively little about the virus. All we knew was that a respiratory virus thought at the time to be similar – flu – circulates rapidly in school networks which helps drive up infection rates more widely.

On 20 March 2020, schools in the UK were told to shut their gates to in-person teaching, apart from children of key workers or those from more challenging home situations classified as vulnerable. Children and their families began remote learning from home, without knowing how long it would last.

Schools reopened for some year groups from June 2020, while others did not go back until September 2020. Unfortunately the situation was repeated again with a second school closure in January 2021 due to the subsequent surge in cases, only reopening in March 2021. A feeling of apprehension accompanied the return, to ensure children resumed normal studies without being at increased risk of infection for themselves and for their community.

One of my friends who had to home school during lockdown (but was not part of this study) told me: “During the first lock down I felt a lot of anxiety. As a parent who was not furloughed I had the double pressure of replanning all my work and supporting my team as well as educating my two primary school age children. It felt like I was doing a lot of different things very badly and nothing well. At first I thought ‘oh well, they can do a little bit of school work when I have time' but as the weeks passed I really started to feel like I was failing them."

To support the pandemic response and recovery, and in an effort to provide the UK government with the most accurate information available, our Schools Infection Survey (SIS) was formed as a partnership between the London School of Hygiene & Tropical Medicine (LSHTM), the UK Health Security Agency (UKHSA), then Public Health England) and the Office for National Statistics, funded by the Department for Health and Social Care.

This study explored factors such as infection rates, antibody prevalence, mitigation measures, mental health and long COVID in schoolchildren, collecting data from school children, their parents and headteachers.

One of the aspects our surveys allowed us to investigate was how different measures implemented by schools to protect their staff and children were received. For instance, many schools were struggling with maintaining air flow in classrooms during the colder winter months, so we used our headteacher questionnaires to explore their experience of monitoring carbon-dioxide to help balance ventilation with sufficient warmth.

One headteacher participating in the SIS project told us: “I understand the desire of the parents to get back to normal, and I’ve understood this the whole way through. But the real challenge is that COVID-19 is still killing people. We never know someone’s home situation. Anyone can put anyone at risk. At a school there is a lot of mixing due to class structures. There was a lack of understanding that we were implementing these preventive measures trying to do our best to keep everyone safe.”

With access to the world leading labs at UKHSA, we were able to measure antibodies in saliva samples given on a sponge ‘lollipop’ – a much less invasive test for the children. This in turn allowed us to uncover key trends in schools.

For example, by February 2022, nearly all children aged 11 and above involved in the study had antibodies against COVID-19 as a result of both natural infection and vaccination. In comparison 60% of children aged five to 11 had antibodies, mostly from natural infection. At this stage children under eleven years of age had not been offered the vaccine.

It was crucial information like this – combined with national data from the pupil school census, vaccination levels and other COVID-19 surveillance – that enabled health officials to monitor the ever-changing situation. This helped schools to stay open in 2022, and inform the vaccination programme to offer younger children the jab. From our headteachers we knew that ventilation and mask use were also actions schools took seriously.

Our survey responses of self-reported long COVID symptoms have increased our understanding of the risks of long COVID among school-aged children, as well as the impact both remote learning and long COVID has on children’s wellbeing and mental health. We hope that this information can continue to build our knowledge of how long COVID manifests itself in different ways, and how best to support those children suffering the effects of physical illness or problems resulting from being away from the classroom for so long.

One of our most poignant statistics is that over half of secondary school students reported ‘struggling with motivation’ as the main barrier to learning at home. This shows the importance of face-to-face learning, not just for their educational progress, but their health and wellbeing.

Overall, we believe that the SIS project has not just influenced how the UK responded to the pandemic to protect our children’s education and those involved in providing it, but it can also be used to inform future best practices to ensure this education is being delivered in the best and safest way possible to support the children. There is still much to learn to help future pandemic preparedness, and current and future analyses of the SIS data will provide additional insight.

We, and the rest of the SIS team, would like to thank schools and their staff, and the children and their families for their brilliant support and contribution to one of the largest collective surveys  globally. It has no doubt contributed to our recovery and resilience so far and provides a framework for educational insights and support for schoolchildren in the future.

When COVID-19 hit, we had no idea where it would lead or how it would affect different parts of society. No one wants to think of another deadly outbreak but emerging diseases are a risk we have to live with so we have to keep our eyes open and be as prepared as possible for the next pandemic.  

Now thanks to research including the SIS, we have knowledge and experience from the UK school closures. Let’s make sure we don’t forget the lessons, but learn from them to make sure we have a resilient system to protect both public health and our children’s education. 

A shorter version of this article was originally published in Schools Week.