Coronavirus: Jury out on fever checks at schools

Victorian students returning in term three are having their temperatures checked daily.

Victorian schools are being obliged to carry out time-­consuming daily temperature tests on thousands of students despite a lack of evidence that widespread screening is effective in detecting the coronavirus.

Barely a month before the state government announced mandatory temperature screening for students attending schools in restricted areas, the official health advice to school principals was that such a policy was not warranted.

“Schools should not conduct wide-scale temperature checking of students as there is limited evidence to demonstrate the value of such checks,” Victoria’s Chief Health Officer Brett Sutton wrote in a guidance note dated June 5 and seen by The Australian.

That advice echoed an early statement from the Australian Health Protection Principal Committee. Yet on July 9 state Education Minister James Merlino issued a directive that, on the advice of the Chief Health Officer, daily temperature checks be carried out in schools across Melbourne and Mitchell Shire.

Mr Merlino did not specify the basis for the new advice and the Department of Health and Human Services declined to comment when asked about the policy change on Wednesday.

The value of temperature screening in schools has been the subject of international research, including a recent Lancet paper examining school closures and management practices during coronavirus outbreaks including COVID-19.

It found that school temperature monitoring did not contribute to control of infection transmission during the 2003 SARS outbreak. “A review of the 2003 SARS outbreak in Singapore noted that twice daily, mandatory temperature screening of all children aged 6–16 years in schools was part of the containment measures instituted,” it said. “Although there were schoolchildren diagnosed with SARS in Singapore, none of them were identified through temperature screening.”

The South Australian Health and Medical Research Institute says the predictive value of temperature screening is limited because more than half of all adults tested do not present with fevers and the prevalence of fever is even lower among children.

“In most settings, the limitations of general screening for temperature are unlikely to be outweighed by the benefits,” says a COVID-19 evidence update issued by the institute in May.

A spokeswoman from the federal Department of Health said the AHPPC considered there was little benefit to be gained from checking temperatures in schools, because those checks would “not tell you whether a person has COVID-19, [only] if the person has a raised temperature”.