20 September 2023
- Children and young people place significant importance on school, associating it with future prospects and a return to normality after illness.
- Balancing school demands alongside Long Covid symptoms is challenging and often means sacrifices in other life areas.
- Effective school support is varied, with communication gaps between health and educational professionals posing challenges.
New research from the Nuffield Department of Primary Care Health Sciences, the University of Oxford, and the universities of Stirling and Aberdeen funded by the National Institute for Health and Care Research (NIHR), has shone a spotlight on the profound effect Long Covid can have on children and young people’s school experience and wider lives.
‘I have really bad meltdowns where I just want to be back to normal [...] I do half days at school [...] go in at like 11am, and I come home and I just, I’m crying [and] ‘I just want to be normal again,’ Said Mae, 11 years old, who had Long Covid for eight months at interview.
Published today in BMJ Open, this pioneering qualitative study explored the impact of Long Covid on children and young people’s experiences of school. The researchers carried out narrative interviews over video calls or telephone between October 2021 and July 2022. They engaged with 22 children and young people (aged 10-18) and 15 parents and caregivers of those aged 5-18 years, all dealing with the persistent aftermath of Covid-19 infection – Long Covid.
Participants were recruited through routes including social media, Long Covid support groups, clinicians, and community groups to capture a varied spectrum of experiences. The researchers particularly focused on what interviewees said about the impact of Long Covid on schooling and education.
The insights from the children and young people highlighted the pivotal role of school in returning to a ‘normal life’ after illness. However, returning to school was often a false hope, rather than a genuine return to normality. Extreme fatigue meant full school attendance was often a quick route back into illness. As one 13-year-old boy described: ‘I couldn't really do anything [with friends] at break. I was just resting. I struggled going up the stairs. I can’t do PE. Yeah, I just feel tired after every lesson’.
For those managing to attend school part-time, juggling studies and social activities with enough rest to avoid making symptoms worse was a big challenge. A 16-year-old explained: ‘The hardest part is not being able to go to school or like see people my age, socialise and everything. It’s all like online for me now over like social media or messages [...] seeing other people [...] my age that are going out in school or doing all their exams [and] doing lots of things throughout the summer that I would like to be able to do, but I just can’t. I think that’s quite hard.’
Young people valued education highly but felt cut off from friends and stressed about falling behind due to frequent absences. Parents told of difficulties liaising with schools, particularly around getting validation about legitimate illness from already overburdened healthcare. School support varied drastically, spanning from scepticism to empathy and tailored adjustments.
Dr Alice MacLean, lead author and researcher based within the Institute for Social Marketing and Health, University of Stirling said: ‘This research clearly shows that absence from school due to Long Covid has a stressful and isolating impact on children and young people. The findings highlight the need for greater awareness and understanding of Long Covid in schools, and for tailored support to enable those affected to engage with school in a way that is manageable and not detrimental to their physical or mental health.’
Dr Cervantée Wild, co-author and Researcher based within Nuffield Department of Primary Care Health Sciences, University of Oxford said: ‘The findings highlight how much children and young people value school and education as part of normal everyday life. It is important to listen to the experiences of young people with Long Covid and use their voices to inform practical and achievable recommendations for how educational and healthcare professionals can support them.’
The authors call for the need for greater awareness of Long Covid in schools and targeted support for affected children, young people and their families.
Sue Ziebland, Principle Investigator for the study and Professor of Medical Sociology based within Nuffield Department of Primary Care Health Sciences, University of Oxford, said: ‘Our study provides practical recommendations for how healthcare and education professionals can better support children and young people in managing their Long Covid symptoms alongside school demands. These have the potential to improve experiences for young people with Long Covid and reduce pressures on their caregivers.
Listening to and validating the experiences of children and young people with Long Covid is vital.’
The researchers would especially like to thank all the children, young people and parents who took part in interviews, especially as many were still very affected by their Long Covid symptoms and had limited physical and cognitive resources.
Notes to editors:
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Contact: Please send all request for interview or comment to firstname.lastname@example.org
This work is independent research funded by the National Institute for Health and Care Research (NIHR). The views expressed in this publication are those of the author(s) and not necessarily those of NIHR or The Department of Health and Social Care.
About the University of Oxford
Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the seventh year running, and number 3 in the QS World Rankings 2024. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.
Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.
Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 300 new companies since 1988. Over a third of these companies have been created in the last five years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing £15.7 billion to the UK economy in 2018/19, and supports more than 28,000 full time jobs.
Within the division, the Nuffield Department of Primary Care Health Sciences is the largest centre for academic primary care in the UK and leads world-class research and training to rethink the way healthcare is delivered in general practice and other primary care settings. The department’s main research focus is on the prevention, early diagnosis, and management of common illness, bringing together academics from many different backgrounds to work together to produce benefits for the NHS, for populations, and for patients (www.phc.ox.ac.uk).
About the University of Stirling
The University of Stirling is committed to providing education with a purpose and carrying out research which has a positive impact on communities across the globe – addressing real issues, providing solutions, and helping to shape society. Stirling is 4th in Scotland and 43rd in the UK for research impact, with 87% of its research having an outstanding or very considerable impact on society – and more than 80% rated either world leading or internationally excellent (Research Excellence Framework 2021).
The University of Stirling is ranked among the top 30 UK universities for student satisfaction (National Student Survey) and top 30 in the UK for postgraduate student experience (Postgraduate Taught Experience Survey), and has an overall five-star rating in the QS Stars University Ratings.
More than 18,000 students study with the University of Stirling globally, with over 140 nationalities represented on its scenic central Scotland campus alone. The University – also home to 1,700 staff – is ranked first in the UK and top three in the world for its campus environment (International Student Barometer 2022, wave two). Ranked first in the UK and top five in the world for its sports facilities (International Student Barometer 2022, wave two), Stirling is Scotland's University for Sporting Excellence. Its world-class facilities provide the perfect training environment for the University’s sports scholars – many of whom compete at the highest level, including at the Olympics and Commonwealth Games – and for students, staff, and the wider community.
The University has twice been recognised with a Queen's Anniversary Prize – the first for its Institute for Social Marketing and Health (2014) and the second for its Institute of Aquaculture (2019).
The University is a signatory to the £214 million Stirling and Clackmannanshire City Region Deal and a central partner of the Forth Valley University College Health Partnership.
About the National Institute for Health and Care Research (NIHR)
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
- Funding high quality, timely research that benefits the NHS, public health and social care;
- Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
- Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
- Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
- Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
- Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.