School students could undertake daily Covid tests rather than quarantine at home under a “test to stay” approach being considered by Australia’s state and territory leaders.
The Doherty Institute has released modelling which examines what would happen to infection numbers in a school outbreak under various scenarios.
It finds that incursions into schools would be “inevitable” during rising cases of community transmission, and notes that returning students to in-person learning and keeping schools open safely has been identified as a national priority.
The findings, provided to national cabinet on Friday, recommend surveillance testing to allow for early detection of positive Covid cases in schools, which would reduce the likelihood of an outbreak, and suggests that in the event of a positive case, close contacts should not have to quarantine.
“We compared a seven-day quarantine of classroom contacts to a strategy called a ‘test to stay’ … where for seven days, if there’s a case in a school, their classroom contacts need to have a daily rapid antigen test before attending school, and they can continue attending school provided they keep testing negative,” Dr Nick Scott, who oversaw the schools modelling for the Doherty Institute, said on Monday.
“What we found was that the seven-day quarantine and the seven-day test-to-stay were approximately equivalent in terms of infection outcomes and outbreak risk, but the seven-day test-to-stay strategy had the considerable additional benefit that there were much less days of face-to-face teaching lost.”
Under a class contact “test to stay” regime, an average of 69 face-to-face teaching days would be lost, compared to an average of 256 if all class contacts were forced into quarantine.
Twice weekly testing of students would also markedly increase the chances of “nipping an outbreak in the bud”, the report found, with a small increase in average school days lost, but far fewer large outbreaks.
If symptomatic students were diagnosed and sent home early, there would be an average of only 10 lost teaching days per incursion.
Scott said the modelling found that in the absence of screening or any form of contact tracing or management, between 37 and 47% of incursions would “die out” given the “randomness” of Covid transmission, but between one-third to one-half of cases would result in an outbreak of between 20 and 50 infections.
The report found the greatest benefit for face-to-face learning from the combination of surveillance and a test-to -stay regime would be when community cases of the disease and school incursions were highest.
“Evaluation of the ability to implement school based surveillance and testing strategies is recommended as a priority, to support a safe return to face to face learning,” the report says.
The Doherty Institute was also asked to look at the risks facing Indigenous communities and reported that a “reactive” vaccine approach could also help limit the spread of the disease in the event of an outbreak.
It concludes that in a community of about 1,000 with low baseline vaccine coverage, a reactive vaccination program could reduce ward and ICU admissions by 47%.
The release of the modelling comes as Australia rolls out its booster program to all Australians who were vaccinated at least six months ago, with immunocompromised and other vulnerable groups first in line.
The health minister, Greg Hunt, said 173,000 people had already received a third dose under the booster program.
“GPs, state clinics, commonwealth clinics, Indigenous medical centres, aged care and disability have been vaccinating people with boosters, so it’s a great start,” he said.
The prime minister, Scott Morrison, said the government was still assessing whether to roll out the vaccine to children aged 5 to 11, saying Australian regulators were yet to form a medical opinion based on initial safety data from the United States.
“We need to be very cautious. And I can tell you that we won’t take a further step on this unless there is clear medical advice that it should proceed,” Morrison said.
“We’ll be ready to go if and when the medical experts say it’s safe to do so and we won’t be authorising a vaccination arrangement for children aged 5 to 11 until the medical experts say it’s safe for your children to be vaccinated.”
Morrison said that the risk profile was different for younger children compared to the rest of the population, given the incidence of serious illness was lower.
The prime minister was also asked his view on the indication from the Western Australian premier, Mark McGowan, that the state would not open its borders until 90% of the over-12 population was vaccinated.
Morrison said it was a “scientifically backed-in proposition” that once vaccination rates reached 80%, states could take the “next step”.
“You are actually putting a price on Australians, when you continue to put heavy restrictions on your economy, once you get 80% vaccination rates,” Morrison said.
On Monday, Flight Centre chief executive Graham Turner, said the company was considering a legal challenge against the WA border closure if the state did not open up once the 70% to 80% vaccine coverage was reached.
Under the WA government’s transition plan, the 90% threshold is expected to be reached by late January, with estimates that the higher threshold will result in 250,000 more West Australians getting vaccinated and 200 lives saved.
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