Dr Illona Duffy began work this week with a crisis call from a mother working in the health service whose child was a close contact of a Covid-19 case.
“There is no one to look after her child, she’s going to have to stay home and there’s no sick leave for her to do that," said Dr Duffy.
From Monday, the contact tracing protocols for schools, creches, and children’s extracurricular activities are set to drastically change.
Public health experts, including Chief Medical Officer Dr Tony Holohan, believe it is clinically safe to ease the majority of test and trace protocols for children aged 12 and under, provided they have no symptoms of Covid-19.
While we will see fewer well children forced to stay home from school, and fewer frantic parents, as a result of these changes, it doesn’t mean it will be smooth sailing.
In reality, the next headache for families, creches, and schools, will be navigating through the rest of the term into winter, with reduced contact tracing and less official communication.
More so now than ever, the main defence for schools and creches from the pandemic relies on children who have even the mildest of symptoms staying at home. But how well is our system set up to support parents with this?
For Dr Duffy, the decision to ease protocols for schools seems to be the right one.
Since its introduction, contact tracing within schools was handled directly by the public health teams.
“But that just hasn’t worked because really, the public health doctors are just so overburdened already,” Dr Duffy said.
“It was taking days and days and, in some cases, parents weren’t ever being contacted and it was up to the school who had to advise them to keep their child home, to arrange to test.”
It is incumbent on parents to keep their child home if they even have the mildest of symptoms, she stressed.
The advice to anyone with symptoms of Covid-19, children included, is pretty clear cut.
If you have any symptoms, self-isolate by staying in your room and get a test. Children should not attend school or creche.
But for children, there is confusion when it comes to the advice on what constitutes 'symptoms'.
At the Oireachtas Education Committee this week, the subject of children’s runny and stuffy noses was raised directly with the Education Minister Norma Foley, potentially for the first time in a public forum.
Donnchadh Ó Laoghaire, Sinn Féin spokesman on education, pointed to Department of Education advice that lists runny and stuffy noses as a potential symptom of Covid in children.
But according to separate HSE advice, it is okay to send children into school if they only have nasal symptoms.
“Runny noses are a scenario like tens of thousands of situations families might face,” Mr Ó Laoghaire said, before immediately correcting himself. “Okay, maybe not tens, but certainly thousands.”
It will be the 'snuffly' children, who are well otherwise, that may pose challenges for creches and schools.
Dr Duffy said: "We are getting calls from parents saying ‘you know they’ve just got sniffles, but they are fine otherwise, there’s nothing else'.
"The first question we always ask them is ‘Did you need to give them Calpol?’ And if they say ‘yeah, they just seemed a bit off’ well then you know – get them tested.”
“We don’t want symptomatic children going into school. I do think there is a huge amount of parental responsibility with this.
"If your child has any symptoms of Covid, you shouldn’t have been sending them in. We’ve got to realise now it’s not acceptable, if you have an unwell child, you have to keep them at home.
The speed at which the decision to ease contact tracing and testing for asymptomatic children took many by surprise.
Further frequently asked questions (FAQs) were published on Friday morning, with more advice on managing the changes.
From next week, in the vast majority of cases, principals and creche managers will not be advised by public health officials if a child who has Covid-19 attended a classroom while infectious.
At the same time, they have been told there is no clinical need to advise parents of cases within a school if it comes to their attention.
“Any sharing of health data is therefore not being undertaken on the advice of public health and under the Infectious Disease Regulations, as it will have been to date.”
In the same set of FAQ documents, the sharing of information via certain groups, like “WhatsApp etc” is noted, and the FAQs issue a reminder of “the importance that an individual’s confidentiality is not broken by others, in line with normal GDPR requirements”.
“It is also important that children and families do not feel targeted or pressured to release information.”
With official communications to be pared back, you can see the potential for panic in some cases if a child is sent home from a class sick.
A poorly child sent home is a regular enough occurrence during any normal school week, but now even more so during Covid, and with other viruses, noroviruses and flu circulating.
Rumours tend to grow in a vacuum, and in the absence of official communication from public health experts, principals are worried that angst and stress from parents will be directed towards them.
But one thing the FAQs make clear is the importance of families being aware of the need to ensure children are not sent in if they have new symptoms of Covid-19.
In these circumstances “they should observe their child and contact their GP as appropriate”.
However, it has been well-flagged that a lack of paid leave specifically to deal with these circumstances is a barrier for lots of families.
Dr Duffy said: “For the people who can work from home, well that’s alright but if you are working in a hospital setting as a nurse, or a carer, it’s not an option.”
Asking a family member like a grandparent isn’t an option for every family either.
“We still want to minimise people’s exposures for those at a higher risk so it is very difficult. I’m not sure what the answer to it is.”
When the schools returned in September 2020, employment expert Richard Grogan was one of the first to point out the lack of support under the law for parents in case they needed to take leave while keeping symptomatic children out of school.
Little has changed since then, he believes.
There is ‘force majeure' leave, but it is emergency leave, designed for circumstances where the immediate attention of a parent is required.
“It doesn’t really cover a child who has to stay out of school,” he said.
“Force majeure is for things like an accident, or where someone needs to be taken to hospital.”
It is not meant to cover situations where a child needs to stay home from school due to suspected Covid.
“A child with a runny nose and a cough is not an emergency, in law.”
If a parent finds themselves in a situation where their child has a slight temperature and isn’t themselves, there isn’t a paid leave entitlement that covers them if they can’t work from home.
“The difficulty is likely for the people who are not in that situation. It will probably be lower-paid manual workers or those whose job cannot be done remotely.”
We haven't worked out how to deal with this, he added.
"There is no coordinated plan. They should be getting social welfare, but that is something the Government does not want to address. There are going to be parents who say 'the child goes to school'."