THE BIG QUESTION THIS WEEK: SHOULD SCHOOLS REOPEN

Under the Centre’s Unlock-5 guideline students will be permitted in schools on voluntary basis and with a consent slip from their parents. The onus is on schools to make the environment safe, by setting up teams for emergency care support, support/response, hygiene, then planning the seating by maintain social distancing and even have staggered entry and exit timings or separate exit and entry gates where possible. Simultaneously, preventive measures - social distancing, use of mask, washing or santising hands are to be strictly followed, while managements will have to clean, sanitise the entire campus, while also having thermal scanners to screenthe body temperature of students and staff. 

But, while these are guidelines from the Centre, one needs to also look at a series of frequently asked questions (FAQs) from the World Health Organisation (WHO) that has made some very relevant observations on the starting of schools during the COVID-19 pandemic. This column is based mainly on what WHO has to say about reopening of schools. To be clear, WHO states that considering that many countries are starting to slowly lift restrictions on activities, the longer-term effects of keeping schools open on community transmission are yet to be evaluated. There are studies to suggest that re-opening of schools might have a small effect on wider transmission in the community, but this is not fully understood. We are therefore at an experimental stage in this. 

According to WHO, data on the pandemic shows that 8.5 per cent of the cases are that of children under the age of 18 years, and the number of deaths in this segment are relatively few compared to other age groups. It states that the children have usually shown mild symptoms, though there have been cases of critical illness reported and that as with adults, pre-existing medical conditions are a risk factor.It further states that the role of children in transmission is not yet fully understood and further studies are underway to assess this. The updated FAQs point out that there have been few outbreaks involving children or schools reported, however, these among the teaching or associated staff suggests that spread of COVID-19 within educational settings may be limited.

It is pertinent to note that WHO also states that children generally have a milder illness and fewer symptoms, and so cases among them may sometimes go unnoticed. It is clear that a child going to school depends on his or her health condition, the current transmission of COVID-19 within the community, and the protective measures the school and community have in place to reduce the risk of COVID-19 transmission. The latter two are what schools in the State and the government have to list to assure parents that their children will be safe, whenever schools are reopened – whether it be now or sometime later. 

According to WHO, the decision to close, partially close or reopen schools should be guided by a risk-based approach, to maximise the educational, well-being and health benefit for students, teachers, staff, and the wider community, and help prevent a new outbreak of COVID-19 in the community. What it suggests be considered in taking that decision are the following: 

s Epidemiology of COVID-19 at the local level which may vary from place to place

s Likely benefits and risks to children and staff, including consideration of transmission intensity in the area where the school operates

s Overall impact of school closure on education, general health and wellbeing; and on vulnerable and marginalised populations

s Effectiveness of remote learning strategies

s Ability of local health authorities to act quickly on detection of cases

s Capacity of schools/educational institutions to operate safely

s Collaboration of school with local public health authorities

s Range of other public health measures being implemented outside school

While the above would be what need to be considered, WHO recommends a number of measures, many of them being those already in place such as detection, testing, contact tracing and quarantine of contacts, physical distancing, frequent hand and respiratory hygiene in the schools. It suggests necessary resources, policies and infrastructure in place to protect the health and safety of all school personnel. Very pertinently, it asks that the age and capacity of students to understand and respect measures put in place be taken into consideration, as younger children may find it more difficult to adhere to physical distancing or appropriate use of masks. It is to be therfore considered whether in the small classrooms that are a feature of our schools, physical distancing will be possible and how will school managements ensure this outside classrooms during breaks. The decision on reopening schools is definitley not going to be easy to take. 

Where the use of masks is concerned, WHO recommends their use in schools in areas where the transmission is intense and where physical distancing cannot be achieved. Given that Goa has a higher rate of cases per million than the rest of the country, the State could fall under the intense transmission area. Here too there are guidelines, where WHO recommends that children aged 5 years and below should not be required to wear masks and for children between six and 11 years of age, a risk-based approach should be applied considering the intensity of transmission in the area and evidence on risk of infection and transmission in this age group, along with several other factors. However, children above 12 should follow the national guidelines on masks. 

While the wearing of masks would be the simplest of guidelines, it will be maintaining physical distancing that will be a major issue in all schools in the State. At the current juncture can Goa risk reopening schools? That is the big question that has to be decided this week.