‘A Car Crash Waiting To Happen’Staff Worried Schools Not Ready for Mass COVID Testing
Staffing costs, pressure on resources and inaccurate tests are all prompting worry about mass testing when schools reopen in March, reports Sian Norris
School staff have raised numerous issues about the return of mass testing in schools – including worries about staffing, costs and the reliability of the tests themselves.
With the Government planning for all pupils to return to schools and colleges on Monday 8 March, there are concerns about whether the ‘pause button’ on the carrying out of mass lateral flow tests will be lifted to coincide with classrooms re-opening.
The Department for Education first proposed mass lateral flow testing in schools in December, asking schools to be ready to launch the programme on 11 January 2021. However, when the third lockdown required schools to close their doors to most pupils on 5 January, the Government paused the roll-out.
Sarah*, who works at a sixth form college and has been given responsibility for organising mass testing for students when lockdown ends, told Byline Times: “It’s a car crash waiting to happen.”
Staffing and Resource Pressures
Back in January, Sarah set-up a small-scale testing centre within the college to cater for students and staff on-site.
“That was challenging enough,” she said. “Because we aren’t clinicians. We’re teachers, admin staff, lab technicians. When the Government first announced the plans I thought they would provide military personnel but we’re having to ask staff or even parents to volunteer.”
The Government has provided training videos and guidance on how to conduct mass lateral flow testing in schools, as well as a calculation of how many testing centres each school or college would require for the amount of students and staff. Sarah’s college has more than 2,000 students and 200 staff members – necessitating 10 testing centres on-site.
“Each centre requires a swab assistant, a person to process the test, and a person to monitor and record the test,” Sarah says. “Then you also have someone to manage reception and cleaners. We just haven’t got the staff.”
Testing more than 2,000 students across 10 stations would also take around two-and-a-half weeks – and that, Sarah acknowledges, is if staff worked flat-out with no breaks offering 90 testing slots a day.
“We’ve got other stuff to do but this is a full-time job in itself,” she added.
The impact on staff was raised by the National Association of Head Teachers (NAHT), the General Secretary of which, Paul Whiteman, released a statement in January expressing concern with how the Government “is delivering testing kits to secondary schools without the staff, the training or the clinical supervision to carry them out effectively”.
Whiteman went on to say that “removing school staff from the classroom and retraining them to administer clinical tests is a deeply flawed proposal. Schools and parents alike will want every education professional focused on supporting pupils to catch-up on lost learning throughout the spring term”.
In guidance published on 23 December, the Department for Education said they it did not expect teachers to administer the tests and that their “expectation is schools and colleges will make their own decisions on how to deliver this through a mix of existing staff, agency staff and volunteers”.
Sarah has received emails from security companies offering their professional support to administer the tests once schools return. “I’ve worked out the cost to our college to bring in external support would be around £26,000 to £30,000 for two-and-a-half weeks,” she told Byline Times.
The Government has made £78 million available to be paid to schools retrospectively to help cover additional costs incurred by mass lateral flow testing, including staffing costs. The amount of funding available to a school or college will depend on its size. The department estimates that a “mainstream secondary outside London, with 2000 pupils and staff will receive around £28,000”, while “a mainstream secondary in inner London, with 1000 pupils and staff will receive around £20,000”.
Test Accuracy
The logistics of setting up the testing provisions aren’t the only issue facing school staff, pupils and parents.
Concerns about the accuracy of lateral flow tests raise questions about the efficacy of the policy and whether the testing regime will, in fact, inspire confidence and keep people safe.
The Government has spent £800 million on procuring lateral flow tests from the company Innova and it is now in the process of awarding another £900 million worth of contracts for lateral flow devices – which Innova will be in prime position to bid for.
However, an article in the British Medical Journal (BMJ) claims that “studies have shown that in symptomless people [the test] misses the SARS-CoV-2 virus in a substantial proportion”. In a Liverpool pilot study, 60% of infected, symptomless people went undetected, including one-third of those with high viral loads. In a second pilot in Birmingham, only 3% of those who would have tested positive with a PCR (polymerase chain reaction) test were detected using a lateral flow test.
The lateral flow tests are more accurate when administered by a healthcare professional. One study found that the tests delivered 77% accuracy when conducted by a trained nurse or laboratory scientist on those with symptoms.
This makes the Innova test “not fit for the purpose” of mass testing, according to the BMJ, as it will be delivered by volunteers on people who are not showing COVID-19 symptoms.
In schools, the conditions required for the higher rates of accuracy will be absent. Even if Sarah called in the private security firm to help fill her staffing shortfall, it won’t be nurses and scientists administering, monitoring and processing the tests. Teenagers taking the tests will also be asymptomatic as any pupil with symptoms should be isolating at home.
“The students will be swabbing themselves and they don’t all do it properly, obviously,” Sarah said. “PCR tests are a lot more accurate. But these lateral flow tests, you know they’re not very accurate. So, even if you get a negative test, you’re not going to rely on that.”
Writing in the BMJ, Jon Deeks, Angela Raffle and Mike Gill have expressed concern that the roll-out of mass lateral flow testing in schools is because “hundreds of millions of Innova testing kits were purchased before it was known how they would perform in people without symptoms and when administered by less than expert hands” and that the “message has gone out that ‘they have to be used,’ or ‘as long as testing detects otherwise unknown cases, the whole exercise will be worthwhile’”.
It’s a suspicion Sarah shares: “They’ve got all these tests and they obviously feel they need to use them.”
She continues to have grave concerns about the programme. “I am convinced that many schools and colleges will either fail to do it at all, or will do it badly, and at considerable financial cost,” Sarah said.
The Department for Education did not respond to Byline Times‘ request for comment.
*Name has been changed to protect anonymity