Schools across the UK reopened in August and September, and have mostly remained open. While the UK Government has provided guidance about measures that should be put in place to make schools as safe an environment as possible, we understand that there are questions and concerns that people have regarding attendance of their child/children at school, or about working at schools themselves.
On 4 November, the Government updated its guidance for the clinically extremely vulnerable in England. The guidance states that as there is a very low risk of children becoming very unwell from COVID-19, even for children with existing health conditions, most children originally identified as clinically extremely vulnerable can attend school. However, those children whose doctors have confirmed are still clinically extremely vulnerable are advised not to attend school while the current national lockdown (from 5 November to 2 December) is in place. After the lockdown, tier-specific guidelines for people who are clinically extremely vulnerable will apply. In all tiers, children should continue to attend school unless specifically advised not to by their doctors.
This is mirrored in the latest guidance from the UK CF Medical Association (CFMA) here.
Children who live with someone who is clinically extremely vulnerable, but who are not clinically extremely vulnerable themselves, should still attend school.
When the widespread reopening of schools across the UK was announced this summer, we put together the following information which includes advice from the UK CF Medical Association (UKCFMA) and Royal College of Paediatrics and Child Health (RCPCH), which is still relevant.. If you are unsure about what is right for your child, speak to your CF team who will be able to provide individual advice according to their particular healthcare needs.
Advice from the UKCFMA
The UKCFMA has reconfirmed their advice that the vast majority of parents should plan for their child or children with cystic fibrosis (CF) to attend school.
There may be a very small number of individual children with CF who might be advised not to go to school because of the severity of their cystic fibrosis. If you think that your child might be in this category, discuss this with your CF team.
Advice from the RCPCH
The Royal College of Paediatric and Child Health advised that after shielding was paused across most of the UK at the end of July and 16 August in Wales, all children previously identified as ‘clinically extremely vulnerable’ should be revaluated over the summer period. Their guidance was that the vast majority of children with underlying medical conditions, including those with cystic fibrosis, should no longer be listed as ‘clinically extremely vulnerable’ and would not need to shield should such measures need to be re-introduced at some future date. All such children should return to school.
This updated information was produced in response to reassuring data about the much lower risks of severe COVID-19 infection among children.
We know that in early November, many children remained on the shielding list as the process to officially remove them had not been completed. This means families in England may still receive a letter to update them on the new guidance for those who are clinically extremely vulnerable. We understand that this letter will explain that children should only follow the guidance if specifically advised to by their own specialist CF team.
You can read the full guidance on the RCPCH website.
So far, few people with CF have been diagnosed with COVID-19. Details about the number of cases reported to the UK CF Registry can be found here.
The Cystic Fibrosis Trust coordinated an international project reporting the outcomes in 40 people with CF and COVID-19 infection. and the CFMA have provided a brief overview of this in their latest statement.
Children with CF have been attending school in countries such as Holland, Sweden and Denmark since early summer. Schools have reopened across the UK. A small number of children with CF in England returned to school at the end of the Summer term, on the advice of their CF teams, and schools across the UK have reopened for the Autumn term with the vast majority of children with CF advised to attend as normal. So far, school attendance has not resulted in any new concerns about COVID-19 infection among the CF population.
We know this can be a difficult decision for many families who are trying to meet the educational and social needs of their children while minimising the possible risks.
If you have concerns, talk to the school about them to understand the measures that they have been put in place to minimise contact between individuals and maintain social distancing. The school will have carried out a risk assessment for the return of pupils, including those who have been shielding.
Since the start of the Autumn term, school attendance has been compulsory in England, and strongly recommended elsewhere in the UK. Compulsory school attendance means parents could theoretically face fines or prosecution if they choose to take their children out of school. However, where a clinical team advise that a child shouldn’t attend school due to the risk of COVID-19, the school should support the child to stay home and learn remotely.
If you are concerned about your child being at school, we advise you to talk to your CF team. If you and they agree that it is not in your child’s best interests to attend school, ask them to provide written confirmation for the school and ensure that the school makes provision for your child to learn at home.
Parents with CF might have concerns about their own children attending school and potentially bringing the virus home. If you have CF and are concerned about your child returning to school, speak to your CF team.
You may also want to discuss these concerns with the school as their risk assessments should have included consideration of children living in households with someone who has been shielding (see below). You could ask to see a copy of the risk assessment. There will be differences between schools in the specific measures in place to minimise risks according to their types of buildings and their lay out.
It is important for children to be able to attend school and balancing this against risk of transmission will depend on your own health status, your child’s needs, and the measures the school has put in place. There is no one-size-fits-all solution to this issue, which is why it’s important to discuss this with your CF team. With the appropriate infection mitigation measures in place in schools and at home, most children of CF parents should be able to attend school, attend school, and across the UK guidance suggests they should attend as normal.
In line with Government advice, schools across the UK have taken measures to minimise the risk of transmission of COVID-19 to ensure school environments are as safe as possible for pupils and staff.
- ensuring that people who are ill stay at home;
- robust hand and respiratory hygiene;
- enhanced cleaning arrangements;
- active engagement with NHS Test and Trace; and
- minimising potential for transmission of COVID-19 as much as possible, e.g. reducing contacts and maximising distances between children in schools.
Specific guidance for schools in each of the four nations is available online:
If you are an adult with CF who works in a school, you will have discussed your return to work with your employer and may also have sought advice from your CF team. We are regularly updating our information about employment rights in relation to COVID-19 and our helpline team are available to support you if needed.
Returning to school can be an anxious time, even without COVID-19. Schools have a duty to support the emotional wellbeing of their pupils. If you are concerned that your child is particularly anxious or worried having returned to school, you can raise this with your child’s teacher or the school’s pastoral care team.
We have a number of videos and information resources that might also be helpful.
If there is a psychologist available in the CF team, it might be helpful to speak to them about these issues.
There are a number of things you can do to support your child to feel settled and happy at school. See our information resources for pre-school and primary school, and secondary school.
In our pre-school and primary school pack, you can download or order your own individual healthcare plan (IHP) for either primary or secondary age children, in which you can include information about your child’s health, CF care and how their condition affects them. This can be shared with your child’s teacher to help them understand what support is needed. Your CF nurse or another member of the CF team will liaise with your child’s school as needed.