This advice updates the advice from BSA to members on January 22 and is issued in the context of a rapidly changing situation and is on behalf of BSA and our partners, AEGIS and BAISIS.
While it covers areas such as travel, communication and medical issues, BSA would remind members that it is NOT a medical authority, nor is this guidance intended as legal advice, and any decisions by a school in this area should involve its own medical staff in conjunction with local GPs.
1. What is Coronavirus?
According to https://www.fitfortravel.nhs.uk/ “Coronaviruses are a family of viruses that can cause a range of illnesses, from the common cold to more severe infections like MERS-CoV and SARS (severe acute respiratory syndrome).”
On January 24, the World Health Organisation said: “not enough is known about the epidemiology of 2019-nCoV to draw definitive conclusions about the full clinical features of the disease, the intensity of the human-to-human transmission, and the original source of the outbreak”.
More recently, however, Chinese authorities have confirmed that the disease is infectious before patients are symptomatic.
2. Where is the outbreak?
The outbreak started in Wuhan in Hubei Province, China. Cases have also been confirmed in Hong Kong, and the USA, France, and Australia, among others. Hong Kong has declared a state of emergency and shut all schools and universities until February 17. Several people have been tested for the virus in the UK but as yet there are no confirmed cases.
3. Is it safe to travel to China?
The Foreign and Commonwealth Office currently advises against travel to Hubei Province. BSA would, therefore, counsel schools to:
- Confirm all overseas pupils have appropriate guardian arrangements in place in accordance with the relevant school policies and procedures. BSA recommends schools use Aegis-registered guardians (https://aegisuk.net)
- Advise parents, carers and guardians of any pupils proposing to travel to China and Hong Kong over February half-term to consider not travelling. Where possible assist with making suitable alternative arrangements with guardians. In certain circumstances this might include keeping part of the school open for the duration, assuming this can be appropriately staffed and resourced. Please note: AEGIS advises that it will be highly unlikely that homestays arranged by guardians will be able to provide quarantine.
4. What about pupils who travel to China and then return to school?
If students do decide to travel to China, when they return BSA counsels the following:
- Advise those who decide to travel that protective measures could well be in place before they return. Depending on how the virus spreads in that time, this could include the need for returning pupils to be quarantined.
- Work with guardians to develop quarantine procedures. This should not be seen as an over-reaction or ‘scare-mongering’ but is based on experience gained from the progress of previous such diseases. Please note: AEGIS advises that it will be highly unlikely that homestays arranged by guardians will be able to provide quarantine.
- Discuss information relating to any potential vulnerabilities from visitors, such as parents, family members, agents or guardians, who have recently returned from affected areas with local health professionals.
5. What about planned visits to my school from China?
BSA understands that some schools have already cancelled visits from prospective parents, agents and pupils from China. While cancellation may be unnecessary, it is obviously prudent to minimise any unnecessary risk. If schools do decide to cancel incoming visits, they should ensure admissions staff and registrars are given clear information with which they can respond to prospective families.
6. What should we doing medically?
BSA is monitoring advice from Public Health England, Health Protection Scotland and Public Health Wales, as well as other organisations, including MOSA (Medical Officers of Schools Association), and has written to Public Health England and to the Health Secretary. It is also liaising daily with BSA’s lead nursing advisers to try to keep medical advice up to date.
NHS England Wuhan novel coronavirus guidance:
“If you have travelled to Wuhan City in China in the last 2 weeks and feel unwell, call NHS 111 for advice. Do not go straight to a doctor’s surgery or hospital.”
Symptoms usually include:
- feeling tired
- difficulty breathing
- a high temperature
- a cough.
To read the NHS guidance in full: www.nhs.uk/conditions/wuhan-novel-coronavirus
- World Health Organisation
- Public Health England
- Health Protection Scotland
- Public Health Wales
- Department of Health, Northern Ireland
- Health Protection Surveillance Centre, Ireland
- The Lancet. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China.
Based on the current situation, BSA would advise schools to:
- Ensure school medical and pastoral staff are familiar with the relevant symptoms of Coronavirus (https://www.nhs.uk/conditions/wuhan-novel-coronavirus/) BUT for them also to be aware that some of these symptoms are also present in many other conditions, including influenza.
- Ensure senior leaders, medical, reception and admissions staff are advised as part of their planning to consider how the school would respond to a suspected or confirmed case and the need to isolate one or more pupils. Any suspected cases should be reported to the local GP or to NHS/ HPS 111 helplines for advice BEFORE taking the child to a surgery or emergency department. It is advisable to undertake a thorough travel history of affected pupils and their contacts within the past 14 days.
7. Should pupils be quarantined?
The current situation is different from the SARS outbreak in 2003, when many schools had to quarantine pupils. On that occasion, many pupils had already travelled home for Easter before the spread of SARS was identified. However, it is essential that all schools consider appropriate, proportionate and risk-assessed responses based on the circumstances of the individual school, the situation locally and updated advice from the relevant authorities.
8. How should we support students?
It is natural that all students, in particular, those from China, will be concerned. In line with normal pastoral procedures, BSA recommends that schools should:
- Ensure pupils who come from the affected areas are suitably and publicly supported. They will be worried about themselves but more particularly about their friends and families.
- Ensure the school responds sensitively and empathetically to any special circumstances, such as children or staff who need to travel because of family emergencies, bereavements and so on.
- Stay alert for any signs of xenophobia by students towards one another, or by any external audiences, either in school or on social media sites. Such behaviour should not be tolerated and action should be taken against anyone acting in this way.
9. How should we communicate?
Even though there are no confirmed cases in the UK and there is no need for medical alarm at this stage, it is important member schools communicate clearly and regularly about the situation. BSA would recommend creating a clear, common, comprehensive communication that can be used for as many audiences as possible. Wording to include in this communication could include:
I write to update and assure you about the precautions our school community is taking to prevent against the Novel Coronavirus outbreak. We continue to monitor the situation regularly and are taking a dynamic approach to this complex and changing picture, following the advice of Public Health England (PHE) to ensure the health of our whole community, including pupils and staff.
We are mindful that there will be a number of parents who are concerned about the health of their children and would like to assure you that we are assessing any potential risks on a daily basis. The advice we are following is regularly updated and I would encourage you to follow these updates on the PHE website which offers sensible and unbiased information to anyone who may be worried. Based on the current evidence from WHO and PHE there is no immediate cause for concern, however we have taken the following precautions:
- Confirmed no pupil or visitor to the school has been in China, particularly the Wuhan region, since the outbreak
- We are accepting no pupil or visitor from China and affected regions until the outbreak is contained.
- All staff and pupils, particularly medical centre and boarding staff, have been briefed on the signs and symptoms of the Novel Coronavirus.
The latest update from the NHS can be found here (www.nhs.uk/conditions/wuhan-novel-coronavirus).
As half-term approaches, we ask that any pupil or family who intends to travel to, or have direct contact with anyone from, a Novel Coronavirus affected area, to inform us immediately. The Foreign and Commonwealth Office currently advises against travel to Hubei Province.
- Any pupil, parent or visitor who has travelled to or been in direct contact with anyone from a Novel Coronavirus affected area may be asked to remain at home to prevent the potential spread of the virus.
- We ask our international community to speak with their UK guardian to check that emergency cover can be made available and if not to let school know immediately.
The wellbeing of our whole school community is of the upmost importance at this time, especially those from China and other affected areas, and I am sure you will join me in supporting them during this worrying period.
We will continue to keep you informed as the situation and official advice changes. Should you wish to discuss any of the above, please do not hesitate to contact school.
If you would like further advice from the BSA nursing advisors, please email email@example.com.