Very High Risk and Pregnant Teachers FAQs

The HSE lists the following groups of people as being at Very High Risk from COVID-19:

The HSE lists the following groups of people as being at Very High Risk from COVID-19:

• are over 70 years of age – even if you’re fit and well
• have Down Syndrome
• have cancer and are being treated with chemotherapy or similar drugs other than hormone therapy
• have lung or head and neck cancer and are having radical surgery or radiotherapy
• are having radical radiotherapy for lung cancer or head and neck cancer
• are having certain complex cancer surgery, for example, surgery for lung cancer, head and neck cancer or oesophageal cancer
• have advanced cancer or cancer that has spread to another part of the body
• are on dialysis or have end-stage kidney disease and an eGFR less than 15
• have a condition affecting the brains or nerves that has significantly affected your ability to breathe, meaning you require non-invasive ventilation (such as motor neurone disease or spinal muscular atrophy)
• have unstable or severe cystic fibrosis, including people waiting for a transplant
• have severe respiratory conditions including Alpha-1 antitrypsin deficiency, severe asthma, pulmonary fibrosis, lung fibrosis, interstitial lung disease and severe COPD
• have uncontrolled diabetes
• have had an organ transplant or are waiting for a transplant
• have had a bone marrow or stem cell transplant in the last 12 months, or are waiting for a transplant
• have a rare condition that means you have a very high risk of getting infections (such as APECED or errors in the interferon pathway)
• sickle cell disease
• have been treated with drugs such as Rituximab, Cyclophosphamide, Alemtuzumab, Cladribine or Ocrelizumab in the last 6 months
• have certain inherited metabolic disorders (such as Maple Syrup Urine Disease)
• have obesity with a body mass index (BMI) greater than 40

 

Your COVID-19 Health Risk Categorisation Report categorising you as Very High Risk expired on 30 June 2021.

If you are satisfied that you are no longer at Very High Risk of severe illness from COVID-19, there is no requirement to submit a new risk assessment questionnaire and you can attend school at the start of the new year as normal.

If you have not already done so, you should submit a COVID-19 Risk Assessment Questionnaire to the OHS/Medmark as soon as possible.

If your medical situation changes a COVID-19 Risk Assessment Questionnaire can be submitted at any stage during the school year.

You must supply a completed medical report from your treating Consultant. As per Circular 0042/2021 where such a report cannot be obtained from the treating consultant within a short timeframe, a copy of the latest treating Consultant’s report can be obtained from your GP. There is a Report from Treating Consultant available on the OHS website.

Based on HSE Guidance, Medmark will take account of whether you have “significant vaccine protection” when considering your potential risk from COVID-19 at the time of your assessment.

Certain immunosuppressive conditions and treatments may affect the efficacy of COVID-19 vaccines, and this will be considered in the risk assessment.

Per the HSE Guidance, this is currently specified as:

• 7 days after receipt of the second Pfizer-BioNTech dose
• 14 days after receipt of the second Moderna dose
• 14 days after receipt of the Janssen dose (one dose vaccination course)
• 15 days after receipt of the second AstraZeneca dose

Immunosuppressive conditions or treatments which may affect the efficacy of COVID-19 vaccines will be considered in Medmark risk assessments.

*Please note that this definition is subject to change over time.

Individual risk assessments are a matter for Medmark, but under the terms of the HSE Guidance, someone who was previously assessed as very high risk and now has significant vaccine protection may be re-assessed as high risk. Someone who was previously assessed as high risk and now has significant vaccine protection may now be assessed as normal risk or same risk as the general population.

Following the risk assessment, you will be provided with a COVID-19 Health Risk Categorisation Report. You should provide a copy of this report to your employer as soon as possible.

The Report will advise whether you are at very high risk of serious illness from contracting COVID-19.

Where that Report advises that you are in the very high risk category, and cannot attend the workplace, you must fill out the Declaration Form at Appendix E of Circular 0042/2021 and submit to your school. Where you are medically fit for work, you should work from home as to the maximum extent possible. You may be assigned work in supporting children in the very high risk category, or other work assigned by your principal. A substitute teacher will be appointed to carry out your normal teaching duties.

If the OHS/Medmark have assessed you as being very high risk, and you are medically fit for work you will be facilitated with alternative working arrangements, i.e. to work remotely. Please see question and answer on duties which may be assigned to you when working remotely.

The DE has set out duties in Circular 0042/2021 that support the work of the school in developing and delivering its programmes of teaching and learning for pupils for teachers who are working remotely which may include:

• Liaising closely with and supporting the work of the substitute teacher(s), which may include engaging directly with pupils/students.
• Taking part in online teaching of classes.
• Supporting and engaging, using online technology, the work and progress of very high risk or extremely vulnerable pupils/students who are unable to attend school.
• Participating in staff meetings, team/subject planning meetings and all other normal meetings using online technology.
• Participating in relevant professional development through emergency remote teaching technology online media.
• Developing aspects of the school’s teaching resources or teaching plans.
• Reviewing and developing whole-school policies, in line with the school’s priorities and in light of the current context.
• Undertaking administrative or other tasks associated with a post of responsibility (provided they hold the post of responsibility in line with relevant Department of Education publications) to the greatest extent possible using online technology.

You should discuss arrangements for working remotely with your principal, or for principals this should be discussed with your Board.

Where a principal teacher is in the very high risk category and is working remotely and in view of the many roles required of a Principal and the need for the presence of the Principal in the workplace to carry out certain of these roles, the Department has again for the 2021/2022 school year, on an exceptional basis, agreed to sanction the filling of an Acting Principal working in collaboration with the Principal in the very high risk category.

The remote working arrangement will be recorded on the OLCS as “COVID-19: very high risk” and the school will be able to appoint a substitute teacher.

Your COVID-19 Health Risk Categorisation Report may include an expiry date, based on your individual assessment.

As per Circular 0042/2021, your categorisation report may be reviewed at any stage during the 2021/2022 school year, due to a change in:

• HSE advice on the higher risk group
• Your medical diagnosis or treatment
• Your vaccination status

If HSE guidance on your health condition changes, Medmark will make contact with you, inviting you to re-submit an assessment questionnaire.

If your diagnosis or treatment changes, or your vaccination status changes, you must submit a new assessment questionnaire to Medmark, and your risk status may be re-categorised.

If you are fit to work, and Medmark have advised that you are High-Risk, you are expected to attend the workplace, with appropriate risk mitigation measures in place.

A workplace risk assessment should be carried out by your employer. You should take extra care to practice social distancing and hand hygiene. Where maintaining social distancing is difficult face coverings and personal protective equipment should be used.

If your doctor or consultant feels you are unfit to attend the workplace, you may provide a medical certificate to remain absent, in which case the conditions of the sick leave scheme (as per Circular 54/2019) will apply to your absence.

If you or your treating doctor believe you have been incorrectly categorised as High-Risk, you may seek a review by emailing cork@medmark.ie. The OHS will re-evaluate the medical evidence, and you may provide additional evidence to support your re-categorisation at this stage.

If the result of the review is that your risk categorisation is unchanged, a further review will not be possible unless there has been a change to your medical condition or the HSE guidelines for the High-Risk group. This process is set out at part 4.2.3 of Circular 0021/2021.

Duties that support the work of the school in developing and delivering its programmes of teaching and learning may be assigned to you.

Please note that the DE intends to publish a revised circular within the next month detailing arrangements for any education staff being facilitated to work remotely for the coming school year.

In the meantime, the DE has confirmed that Circular 0021/2021 still applies.

The remote working arrangement will be recorded on the OLCS as “COVID-19: very high risk” and the school will be able to appoint a substitute teacher.

The HSE advice on the High Risk group includes people who:

• • • • • • are over 60 years of age
          • have a learning disability other than Down Syndrome
          • are being treated for cancer but are not very high risk
          • have been treated in the past 5 years for a cancer of the blood or bone marrow (such as leukaemia, lymphona or myeloma)
          • have been treated in the past 1 year for a cancer that did not start in the blood or bone marrow
          • have chronic heart disease (such as heart failure)
          • have chronic kidney disease with an eGFR below 30ml a minute
          • have chronic liver disease (such as cirrhosis or fibrosis)
          • have a condition affecting the brain or nerves (such as Parkinson’s disease or cerebral palsy) that affects their breathing or ability to protect or clear their airway
          • have clinically stable cystic fibrosis
          • have a serious lung condition but are not at very high risk, for example, moderate COPD, severe asthma, emphysema or bronchitis
          • have diabetes
          • are taking medicine that makes you much more likely to get infections(such as high doses of steroids)
          • have a condition that means you have a high risk of getting infections (such as HIV, lupus or scleroderma)
          • have an inherited metabolic disorder but are not very high risk
          • have obesity with a body mass index (BMI) between 35 and 40
          • have a severe mental illness (such as schizophrenia, bipolar disorder, severe depression)

If you are fit to work, and Medmark have advised that you are high-risk, you are expected to attend the workplace, with appropriate risk mitigation measures in place.

You should take extra care to practice social distancing and hand hygiene. Where maintaining social distancing is difficult face coverings and the personal protective equipment should be used.

If your doctor or consultant feels you are unfit to attend the workplace, you may provide a medical certificate to remain absent, in which case the conditions of the sick leave scheme (as per Circular 0054/2019) will apply to your absence.

If you or your treating doctor believe you have been incorrectly categorised as High Risk, you may seek a review by emailing cork@medmark.ie. The OHS will re-evaluate the medical evidence, and you may provide additional evidence to support your re-categorisation at this stage.

If the result of the review is that your risk categorisation is unchanged, a further review will not be possible unless there has been a change to your medical condition or the HSE guidelines for the High-Risk group. This process is set out at part 4.2.3 of Circular 0042/2021.

A pregnant teacher who has any of the medical conditions as listed on the HSE website under very high risk groups (extremely vulnerable) should follow the process as detailed at paragraph 4.1 of Circular 0042/2021, with regard to obtaining a COVID-19 Health Risk Categorisation assessment.

Due to an increased risk of severe illness from COVID-19-19 in pregnancy and the risk of COVID Placentitis after fourteen weeks gestation, the HSE guidance recommends that all pregnant teachers should submit a risk assessment questionnaire to Medmark before the end of their first trimester.  Pregnant teachers including those who consider themselves to be very high risk of serious illness from COVID-19 should complete this questionnaire.

Please note, although the Department of Education invited the submission of risk assessments by 16 July 2021, this process will remain open beyond that date. In addition, if your medical situation changes during the school year, you can submit a risk assessment questionnaire at any stage.

You should supply a medical report from your treating Consultant. As per Circular 0042/2021 where such a report cannot be obtained from the treating consultant within a short timeframe, a copy of the latest treating consultant’s report may be obtained from your GP.

Medmark will consider your medical condition.

Based on the HSE Guidance, Medmark will also take account of whether you have “significant vaccine protection” as a pregnant employee when considering your potential risk from COVID-19.

Immunosuppressive conditions or treatments which may affect the efficacy of COVID-19 vaccines will also be considered.

Per the HSE Guidance, this is currently specified as:

• 7 days after receipt of the second Pfizer-BioNTech dose
• 14 days after receipt of the second Moderna dose
• 14 days after receipt of the Janssen dose (one dose vaccination course)
• 15 days after receipt of the second AstraZeneca dose

Immunosuppressive conditions or treatments which may affect the efficacy of COVID-19 vaccines will be considered in Medmark risk assessments.

*Please note that this definition is subject to change over time.

Teachers who were previously categorised as being very high risk teachers should arrange a review by Medmark following vaccination or any other significant changes to their medical status.  A pregnant teacher who was assessed as very high risk may be reclassified as high risk following vaccination and may be able to safely return to school with risk mitigation measures in place.

Following the risk assessment, you will be provided with a COVID-19 Health Risk Categorisation Report. You should provide a copy of this report to your employer as soon as possible and in advance of the 2021/2022 school year.

• A teacher who is more than 14 weeks pregnant, does not have significant vaccine protection and has no underlying medical condition will be categorised as high risk. Per Circular 0042/2021 she must attend the workplace, following a workplace pregnancy risk assessment, if she is medically fit for work.
• A teacher who is more than 14 weeks pregnant, does not have significant vaccine protection and has an underlying medical condition will be categorised as either high risk or very high risk based on the most up to date HSE advice. Per Circular 0042/2021, a teacher categorised as ‘High Risk’ must attend the workplace, following a workplace pregnancy risk assessment, if she is medically fit for work. If a teacher is categorised as very high risk the employer will facilitate alternative working arrangements.
• A teacher assessed as Very High Risk and has significant vaccine protection will be categorised as high risk. She will be required to attend the workplace following a workplace pregnancy risk assessment, if she is medically fit for work. A teacher categorised as high risk and working in certain special education settings may be facilitated to work remotely. Further information is provided on this in a later question in these FAQs.
• A teacher assessed as high risk and has significant vaccine protection will be categorised as normal risk. She will be required to attend the workplace following a workplace pregnancy risk assessment, if she is medically fit for work.

The current position based on the updated HSE guidance is that a pregnant teacher up to 14 weeks gestation who is medically fit for work can safely attend the workplace, unless categorised by the OHS/Medmark as “very high risk” due to an underlying medical condition unrelated to their pregnancy.

A workplace risk assessment should be carried out by your employer. You should take extra care to practice social distancing and hand hygiene. Where maintaining social distancing is difficult face coverings and personal protective equipment should be used.

Under HSE Guidance vaccine protection is not a prerequisite for a pregnant teacher who does not have serious underlying health conditions to attend the workplace.

A workplace risk assessment should be carried out by your employer. You should take extra care to practice social distancing and hand hygiene. Where maintaining social distancing is difficult face coverings and personal protective equipment should be used.

If you or your treating doctor or Consultant believe you have been incorrectly categorised as High Risk, you may seek a review by emailing cork@medmark.ie. The OHS will re-evaluate the medical evidence, and you may provide additional evidence to support your re-categorisation at this stage.

If the result of the review is that your risk categorisation is unchanged, a further review will not be possible unless there has been a change to your medical condition or the HSE guidelines for the high risk group.

If your doctor feels you are unfit to attend the workplace, you may provide a medical certificate to remain absent, in which case the conditions of the sick leave scheme will apply to your absence.

For a non-COVID-19 related high risk pregnancy, where a teacher is medically unfit for work, the terms and conditions of the Sick Leave Scheme will apply, i.e. pregnancy related illness provisions.

Circular 0042/2021 acknowledges that different workplace risks may arise in special education settings, and that certain settings may warrant additional care.

For the purpose of this information note, the following definition applies:

“(a) A Special Education setting which means a special school or a dedicated special class within a mainstream primary or post primary school; with

(b) the presence of three or more employees in a single room, throughout the working day; and

(c) where social distancing between the employees in the special education setting is not consistently possible.”

If the criteria set out above apply to the working environment of a High Risk teacher who is more than fourteen weeks pregnant,  they will be temporarily excused from working in this special education setting.

If you are at or over 14 weeks gestation, have been classified as High Risk, and are and working in a special class in a mainstream school, the employer should prioritise your re-assignment within the school, into a role outside the special education setting.

If you are at or over 14 weeks gestation, have been classified as High Risk, and are working in a special class in a special school the employer must prioritise your re-assignment to a role within the school, outside of this special education setting if possible.

If the employer can demonstrate that appropriate re-assignment is not possible, the High Risk pregnant teacher can be facilitated to work from home, and the employer will be able to appoint a substitute teacher.  If this is the case for you, you will need to complete Appendix F of Circular 0042/2021

You should discuss this with your GP, Consultant or Obstetrician.

The DE has set out duties in Circular 0042/2021 that support the work of the school in developing and delivering its programmes of teaching and learning for pupils for teachers who are working remotely which may include:

• Liaising closely with and supporting the work of the substitute teacher(s), which may include engaging directly with pupils/students.
• Taking part in online teaching of classes.
• Supporting and engaging, using online technology, the work and progress of very high risk or extremely vulnerable pupils/students who are unable to attend school.
• Participating in staff meetings, team/subject planning meetings and all other normal meetings using online technology.
• Participating in relevant professional development through emergency remote teaching technology online media.
• Developing aspects of the school’s teaching resources or teaching plans.
• Reviewing and developing whole-school policies, in line with the school’s priorities and in light of the current context.
• Undertaking administrative or other tasks associated with a post of responsibility (provided they hold the post of responsibility in line with relevant Department of Education publications) to the greatest extent possible using online technology.

You should discuss arrangements for working remotely with your principal, or for principals this should be discussed with your Board.

Where a principal teacher is in the very high risk category and is working remotely and in view of the many roles required of a Principal and the need for the presence of the Principal in the workplace to carry out certain of these roles, the Department has again for the 2021/2022 school year, on an exceptional basis, agreed to sanction the filling of an Acting Principal working in collaboration with the Principal in the very high risk category.

The remote working arrangement will be recorded on the OLCS as “COVID-19: very high risk” and the school will be able to appoint a substitute teacher.