The column is written by Dr. Chandrakant Lahariya (MBBS, MD), a Physician-Epidemiologist and a leading expert on COVID-19 disease and vaccines. In this fortnightly column, Dr. Lahariya picks up various topics and gives you tailored solutions, catering to the health needs of your entire family — kids, adolescents, adults, and senior citizens, and all the other members.
The topics he delves into today including school reopening and protection of children from COVID-19 during the third wave.
Is it a good idea to reopen schools now, as there is already a prediction of the third wave?
Schools should be reopened because the risk (of moderate to severe COVID-19 infection and mortality) to children between 6 to17 years of age is very low compared to adults. Also, vaccination is not a prerequisite to reopening schools because children are not superspreaders, and adults are already getting vaccinated.
In my opinion, we shouldn’t keep the schools closed just because there is a prediction of a third COVID-19 wave. If the wave comes, and it seems like a risk to keep schools open, then a decision can be taken to shut them down. Moreover, the daily COVID cases in many states and districts of India are meagre. Therefore, currently, there is no reason to keep schools closed. Children should be allowed to reap the benefits of in-person learning.
What model of schooling should states adopt? Should we go back to education as it was, or should a mix of online and school learning be introduced?
For many months to come, or at least till the world is in a pandemic, the learning will be blended. Many of us in higher economic strata have the right tools (devices and internet connectivity) to continue online learning. However, online learning is widening inequities in the education system.
The children from lower and lower-middle-income strata are worst impacted because they do not have the tools to access education online. In-person schooling is the only option for them. They also need in-person schooling because many of them go to
Indian government schools, which provide not only education but also mid-day meals
However, overall, there will be a significant contribution of online learning in the education system in the years ahead.
What precautions should schools take as they plan for reopening?
There are a few steps that should be taken and facilitated by the schools.
The schools need to sensitize the staff in COVID appropriate behaviour, and strict adherence should be followed.
The COVID 19 Vaccination for all teachers and staff should be facilitated.
The ventilation in the classrooms should be increased, and all other physical modifications should be ensured to allow physical distancing.
Mask wearing should be encouraged. However, children younger than five years are not recommended to wear a mask.
Hand-washing with alcohol-based sanitisers should be encouraged.
Organize talks of health experts for students as well as teachers and parents to alleviate the fear.
Students and staff should be advised to stay home when they are sick.
Sanitization is essential, but we need to remember that the role of contact in virus transmission is minimal.
Finally, occasionally, a few cases may be reported/detected amongst students. However, it should not result in an unnecessary worry amongst parents and schools. The decision on the next step should be taken in consultation with local authorities.
Should vaccination of children be organized at the school level? Should it be made mandatory?
The vaccination of any child is currently not being done in India. In fact, no country is vaccinating children younger than 12 years. In some countries, vaccination of 12-17 years is being done. However, many of those countries are vaccinating only high-risk children in 12-17 years.
One COVID-19 vaccine has been licensed for the 12-17 years age group in India. However, it is not available in government supply yet. The government has not decided on a vaccination approach for 12-17 years of children. Moreover, we need to remember children need not be vaccinated to attend school. As and when the vaccine becomes available, it will be an add on tool.
The COVID-19 vaccine is not mandatory for any age group, including adults, and it will be voluntary for children.
Should children be allowed to play contact sports in school once it reopens?
The approach has to be that contact is minimized and crowding is avoided. At the initial stage, the school opening needs to focus on bringing children for classroom learning. The key is running, and other physical activity should not be done with a mask on. However, outdoor activities such as using the playground in small groups can be encouraged. In addition, playground equipment should be included in the routine cleaning and sanitization activities.
What advice should parents do and advise their children as they start to attend school?
First of all, parents need to be assured that the evidence is that children do not have the additional risk of attending school. If any adult member is going out and coming back to the house, sending a child to school does not alter risk. There is a lot of misinformation and misconception going around. Parents are advised not to get upset and unsettled by information or situation in one particular setting. Expert advice and guidance on school openings should be trusted.
To make sure young children follow COVID appropriate behaviour, parents can explain what coronavirus is, using simple words. Moreover, they should teach kids not to share masks, wash their hands before lunch, and sanitize them.
Should kindergarten kids, who have never attended school before, be allowed to go to school during this pandemic?
The short answer is yes. The scientific evidence is that children in primary school are at the least risk of moderate to severe disease. In fact, all the children have very similar and very low rates of diseases. The available global data on the age distribution of COVID-19 indicates that all children are naturally at low risk from Covid-19. The age distribution of moderate to severe illness and mortality follows a “J” shaped curve, where at the base of the “J” are 10-year-old children at the lowest risk among all age groups. After that, the risk increases every passing year — in both directions––from nine years downwards till one year and 11 years upwards till let’s say 85 years. This makes children around the base of the “J”, the six-year-olds to 14-year-olds, or the age group in the primary and upper primary schools, at the lowest risk of Covid-19. It is amongst other reasons why primary schools must be the first to resume classes, which is safe.
The youngest children are at least risk. But, then, there is an educational and learning perspective as well. The children who have just started schooling need more personalized guidance than older children. When children are learning alphabets and numbers, the role of online teaching is minimal. That’s why we should prioritise the opening of primary schools—the children at the least risk here at a maximum loss due to this pandemic.