Dr. Rajib Dasgupta, chairperson, Centre of Social Medicine & Community Health, JNU, Delhi, and member, National Adverse Event Following Immunization (AEFI) Committee talks about the move to open schools following a current drop in the number of COVID-19 cases being reported in the country.
At this point in the COVID-19 pandemic, keeping schools open and keeping them closed both have their pros and cons. Which one do you think has more merit?
There is continuing evidence from across the world that schools can function safely. However, schools certainly need to put mitigation measures in place.
Not going to schools and other care centres such as Anganwadis is having immense detrimental effects on mental and physical development of children, apart from educational attainments. India is one of those exceptions that has had schools closed for anything between 600 to 650 days. Taking all these into account the broad recommendation is to keep schools open.
However, schools will need to put a slew of preventive measures before that and the advisory of World Health Organisation (WHO) should be consulted based on which the final decision should be taken on whether to open school in a locality, which includes the status of COVID-19 in that area.
Assuming most schools do open, what are the precautions that should be taken on the part of the school and parents?
At the first level, schools should consider the three Cs as risk elements — closed spaces with poor ventilation, crowded spaces with many students and close contact.
At the second level, there are administrative changes that are now quite ‘standard’ for schools to adopt. These include attendance and entry rules, staggering times, cohorting that is keeping students and teachers in small groups that do not mix, taking decisions on alternate days or alternate shifts depending on their infrastructure and imperatives.
The third aspect is about strengthening the infrastructure that include hand washing facilities, identifying separate entries and exits etc. Maintaining a clean environment is crucial.
Do we need to connect the decision of school-opening with vaccinations? What are some of the lessons we can draw from some of the countries?
India has made good progress with adult vaccination particularly in urban areas. Students are, therefore, in a much more immune-secure situation today.
From other countries, we can learn that the ‘stay at home when sick’ policy works. Close engagement between the school administration, teacher/staff associations, parents and the community group is crucial to build a shared understanding. Third, we have not seen outbreaks in communities that have spread from schools. Finally, the experience of using self-testing kits to pick up infections early is vital.
Is hybrid schooling — a mix of online and offline — more feasible for contexts particularly where physical infrastructure doesn’t allow precautionary measures?
Even while we can encourage in-person attendance, the hybrid mode perhaps cannot be given up immediately. In fact, the advisory from the WHO on school-opening is mainly based not on the physical infrastructure of the school, but on the epidemiological situation of where the school is located.
Emerging evidence from schools state that it is difficult for teachers to do justice to both groups. It is, therefore, important that education and health authorities work collaboratively on these issues.
Should vaccination of children under 15 years be anywhere linked with the opening of schools?
Vaccination is not a prerequisite for reopening schools. Indian sero-surveys have shown children also have had a very high natural infection rate. Children are thus protected to a great extent already without suffering severe disease and their risk for severe disease is miniscule at this point. A lot depends on how we are able to communicate to assure parents that children are safe even without vaccination, and that schooling is both safe and necessary.
