Recovery, Renewal, Resilience

As schools begin to re-open, it is important to consider the wide range of needs and emotions of young people and staff whose lives and education have been disrupted by the pandemic. Pupils and staff may be anxious or hesitant about returning to school and may require additional support. Consider:

• Encourage schools to identify learning of what went well and what could be improved based on their experience of previous lockdowns - and use this learning to improve planning
• Identify the current capacity of services and forecast potential demand for social services to which schools may refer children and families. Create additional capacity where forecasted demand exceeds current capacity
• Work closely with schools to monitor school attendance and identify children who have not returned or are showing signs of distress:
  • Encourage school staff to reach out to families to understand the challenges that they are facing in returning to school
  • Enhance partnerships between schools and social services, to ensure any child who needs additional support is identified and appropriate support is offered
  • Ensure schools refer families who are identified as struggling or in need of additional support to specialist services
• Assess the impacts of further disruption and change for children with special educational needs and disabilities (SEND) and their carers/specialist teachers/support staff in mainstream schools:
  • Staff illness or self-isolation may mean that schools do not have adequate levels of staff with vital specialist training - schools should inform local authorities to discuss alternative arrangements for vulnerable children in this event
  • Encourage schools to complete risk assessments and begin to plan for how one-to-one specialist teaching will take place safely and potential disruptions identified and actions taken to mitigate their occurrence
• Allocate funding to provide additional mental health support in schools for pupils and staff who may have experienced trauma, separations from or loss of loved ones or whose family may be struggling financially, e.g. due to job loss
• Encourage schools to prioritise children's wellbeing especially in the first few weeks, avoid rushing to reinstate routines or adding pressure on teachers and students to catch up
• Request a temporary suspension of school inspections to give staff time to implement and adjust to new procedures that may be required, such as health and safety protection measures

Concurrent emergencies such as disruption to water supply or contamination of water resources can have serious impacts on healthcare facilities and the health of individuals, which may be amplified during a pandemic. Water outages or contaminated water can disrupt clinical procedures, e.g. maintaining a sterile environment in hospitals. Protecting water supply is also crucial during a pandemic, as poor hygiene is a catalyst for the rapid spread of infectious disease. Consider:

• Early scenario planning to consider different types of water shortages alongside the pandemic, and assess potential impacts on health facilities and public health
• The need to establish new systems to provide immediate support to communities in the event of water supply disruption or contamination during COVID-19:
  • Evaluate emergency response measures (e.g. mass water distribution) to determine if they are COVID-safe, and make necessary amendments if required
  • Plan for the need to construct and install handwashing stations in affected communities, to prevent rapid spread of the virus
• The potential for water stagnation to occur in buildings that have been unoccupied over the last year, which may lead to contamination
  • Identify buildings that have been unoccupied and plan for maintenance contractors to test and repair water systems before allowing the building to re-open

Previously, employers in the USA have supported influenza preparedness by providing on-site clinics to administer flu shots for their staff. It may be possible for organisations to use previous arrangements and infrastructure for flu vaccination to support the COVID-19 vaccination programme. If organisations do not have such infrastructure, developing it could help support COVID-19 vaccination programmes and expedite employees return to work. This may be dependent on the type of vaccinations available and requirements for their storage. When a COVID-19 vaccine is widely available and accessible consider:

• Making vaccination a part of worksite wellness programmes whereby staff can be vaccinated at an onsite clinic provided by their employers
• How employers can provide supplementary support in tackling COVID-19 transmission, alongside the vaccine, through educational material on preventative measures e.g. mask wearing, to promote long-term public health compliance

Business continuity of transport systems is critical while ensuring safe conditions for staff and passengers. IAPT provide early advice to considering:

• Preparing - follow their recommendations for all public transport networks
• Personal protection - increase personal protection and hygiene measures to reassure both staff and passengers
• Reduced service - may be required in outbreak areas
• Reduced contact - reduction of contact measures for affected areas

A collaboration between primary, secondary and special schools in the UK has developed some examples from practice on how to maintain social distancing. These are not exhaustive and may be adapted and implemented alongside other protective measures in schools. Actions to consider:

For primary and secondary schools

• Stagger lunch and break times of students and, where possible, start and finish times
• Mark the playground in a way that allows for separate 'bubbles' of children to play and for staff to walk round the space safely
• Adjust seating plans to recognize that some children may have had low levels of engagement with others during lockdown and may need to sit nearer the teacher for further support
• Ensure specialist or support staff who may be at risk from COVID-19 can continue providing support e.g. install protective screens and allocate a specific classroom for that staff member
• Negotiate with transport companies to bring children to school in their specific COVID-19 groups (bubbles). This may be especially relevant for children from special schools who have additional health and safety needs

For special schools

• Ensure specialist staff and therapists have the resources to write their reports from home to limit staff meetings
• Find ways to integrate various therapies to limit the use of specialist rooms and facilities

These concerns relate to opening infrastructure and maintaining infrastructure.

Opening infrastructure

• Schools - the reopening of schools is a hugely complex issue that requires consideration of health and safety, staffing, finances, building capacity and facilities. Reopening schools also has socioeconomic implications related to rights to education, safeguarding children, feasibility of adults to work and the economic impacts of this
• Public transport - reopening public transport services, increasing service capacity, and public trust in transport use is vital to keep cities and regions moving. Ensuring safe and sustainable mobility support local economies and the environment

Maintaining infrastructure

• Supply chains - special attention should be paid to the flexibility and resilience of supply chains as supply chain failures can have devastating impacts on capacity to respond and recover. Supply chains should be prepared for a second wave of the pandemic; critical and alternative suppliers should be identified so supply chains can be modified
• Internet access and cyber security - ensuring safe and secure connection and reliable internet access is crucial in keeping people, government and economies running. It also forms an important role in safe and trustworthy risk communication at all levels of society

TMB Issue 10 brings together the reflections of our learning from the first 10 weeks of gathering lessons on recovery and renewal from COVID-19. Follow the source link below to read all of the reflections from our team (p.9-15).

The impact of school closures, especially nursery and primary schools, carries high social and economic costs as learning is interrupted, parents are unprepared for home schooling and for the impacts this has on childcare. Working parents may have no choice but to leave children alone when they have to work, or to miss work to take care of their children. This can impact child nutrition, social isolation and increase children's exposure to violence and exploitation. Schools in Denmark, China, Korea and Taiwan, have begun to open. In Korea, the government has incorporated the concept of digital classrooms into current educational legislation to develop a 'future-orientated' approach to online education.

A number of measures for adjusting the school day have been identified:

• Consider staggering the school day so children arrive in different time blocks. In Demark the start and end of the school day is split into three 15-minute windows, and the day finishes at 2pm to reduce risk of new rules feeling oppressive. This helps reduce crowding at the school gates
• Parents are not allowed inside the building and must collect their children at outside while observing social distancing rules- consider marking lines, and creating one-way systems for parents to collect children in playgrounds
• Consider rotating year groups into schools for a week at a time
• Consider changes to lesson delivery e.g. restrict movement of teachers one teacher per class. Consider how this may impact which classes teachers will need to deliver and how this can be effectively timetabled. Also consider making class sizes smaller by splitting classes in two and have taught rotas between staff
• Limit handling of children's books through increased self-marking activities
• Provide allocated desks to each child with social distancing requirements in place. Be pragmatic and realistic about how to ensure social distancing when children are not at their desks, e.g. how they will traverse corridors or stairways, how to manage behaviour at break times
• Consider reducing creative activities such as art, and 'carpet time' for primary school children. Or requesting personal supplies i.e. scissors or paintbrushes are brought in. Consider how creative classes can be taken outdoors to make learning fun, and safer
• Stagger lunch breaks and class times to avoid the risk of too many people moving through the school at one time

Alongside restructuring the school day, re-opening of schools requires attention to infrastructure. This may include:

• Installing additional handwashing facilities so children have to wash hands before entering school and then throughout the day - in Denmark children wash their hands six to eight times a day
• Measure temperatures before students are allowed on site. In China some schools have installed a system at the entrance of the school to record temperatures. Any person displaying a temperature above 37.3 degrees is taken for further temperature checks
• Installing hand sanitisation stations and bins for discarded masks in and around the school site. China also has isolation areas should anyone be taken ill during the course of the day
• Utilising additional buildings such as church halls or community centres if the school does not have the required space to maintain social distancing and its cohort of students
• Accounting for reduced workforce availability due to illness, and PPE requirements

There is an urgency to return pupils to schools to support their health and well-being and to relieve pressures on working families who may be experiencing increased financial hardship as a result of having children at home. It is important that robust scientific evidence is used to make such decisions; a study from Germany found children were as likely to spread coronavirus as adults which suggests caution is required. However, lessons from Denmark, China and Taiwan could provide useful insights into practical adaptation and innovation to support a safe return to school.

To read this case study in its original format with references etc., follow the source link to TMB Issue 7 p.16-17.

Consider measures to ensure safe return to social activities.

As tents do not provide long-term solution to surges in patients and are no suitable for longer periods of disease in winter. Instead develop "shadow" or auxiliary hospital wards as a spatial reserve for disasters and pandemics. Auxiliary wards would build resilience into the healthcare system for pandemics.

Reference: Expert in Civil Contingency, Germany

Also consider that experts within education have stated that social distancing within schools will not be possible at primary or secondary level.

Consider the redeployment of government staff and volunteers can help at the homes and for domiciliary care. Testing of staff and available PPE is essential for these support services to work.

Reference: UK County Council

This should include people who are part of the wider working society e.g. municipal waste workers, those involved in food production and distribution, as well as the more obvious workers (health related and response). This would support both the reopening of key services and the economy.

Reference: Chief Resilience Officer, USA

Measures should prevent the entry and spread of COVID-19 by students and staff. Students and staff should not be stigmatized if they become affected and schools should continue to be welcoming, respectful, inclusive, and supportive.

Reference: Chief Resilience Officer, USA

Local government should continue moving their services to online delivery where possible to help those who are working from home, by strengthening digital infrastructure, network coverage in their areas and should consider developing cyber security campaigns. Out city "is trying to design a new digital routine, shaping work, events, meetings and initiatives on new online formats" for foreseeable future.

Reference: Chief Resilience Officer, Italy; and the American Red Cross, USA

Local government should identify where to source, pre-position and warehouse resources for disasters that may happen during the response and recovery to Covid-19. This will seek to mitigate the cascading impacts of simultaneous events e.g. PPE and other resources needed if homes flood and people are to be evacuated from their homes and temporarily housed.

Reference: American Red Cross

Local government should coordinate procurement between government and voluntary sector to anticipate the long-term provision of services i.e. foodbanks (in US Feeding America had their orders cancelled by suppliers as government bought stocks).

Reference: Feeding America, USA