The prevalence of coronavirus (COVID-19) in the UK has decreased, test and trace measures are up and running and the UK Government has provided clear advice about measures that should be put in place to make schools as safe an environment as possible. As a result of these measures, the Government has advised that all schools should be fully re-opened from autumn 2020.
We understand that while many families will feel very positive about these developments, others will feel anxious and will have many questions and concerns.
To help address these issues, we have provided the following information which includes advice from the UK CF Medical Association (UKCFMA) and Royal College of Paediatrics and Child Health (RCPCH) to help you plan your child’s return to school. 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 health care needs.
Advice from the UKCFMA
The UKCFMA has advised that the vast majority of parents should plan for their child or children with cystic fibrosis (CF) to return to school.
There may be a very small number of individual children with CF who might be advised not to go back to school yet 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 has 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.
You can read the full guidance on the RCPCH website.
So far, very 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. These were adults. All survived and outcomes were similar to people without CF of a similar age. A further publication is planned including data from 180 cases. Outcomes are consistent with the first report. The report includes 51 children. Some of the children required additional oxygen but none of them needed any further levels of respiratory support while recovering from their illness.
Children with CF have been attending school in countries such as Holland, Sweden and Denmark since early summer. In the UK, schools have reopened in Scotland and are due to reopen across the rest of the UK in August and September. 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. 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.
Talk to your CF team. If you and they agree that returning to school should be delayed for longer, ask them to provide written confirmation for the school and ensure that the school makes provision for your child’s continued learning at home.
Parents with CF might have concerns about their own children returning to 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 return to education 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 return to school.
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 need to discuss your return to work with your employer as well as seeking advice from your CF team. Government guidance on the reopening of schools in the four nations (see links above) also sets out whether and how staff who have been shielding should be supported to return to work at school. 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, 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 prepare your child’s return to school and settling back in. 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), 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. We are producing an equivalent healthcare plan for secondary school students, which will be available shortly.