The Indian Council of Medical Research (ICMR) in its latest study suggested that schools should be reopened gradually.
The study also indicated that schools should be allowed to remain open and safe with the appropriate implementation of mitigation measures at multiple levels where children’s participation remains essential.
âIt is essential to realize the impact of prolonged school closures during the COVID-19 pandemic on the overall development of children. Therefore, schools should be reopened in a phased manner (starting with primary schools, then secondary schools) and allowed to remain open and safe with appropriate implementation of mitigation measures at multiple levels where child participation remains essential, âexplains the ICMR study.
Published by ICMR, the Indian Journal of Medical Research is a peer-reviewed open access publication authored by ICMR Executive Director Dr Balram Bhargava, Samiran Panda and Tanu Anand.
The study observed that school closures in India for more than 500 days affected more than 320 million children, according to the UNESCO report.
Another schoolchildren online and offline learning survey conducted in 15 states across the country, among children from 1,362 sampled households from relatively disadvantaged hamlets and bastis (slums) in August 2021, found that only 8 percent of students in rural schools and 24 percent in urban areas studied regularly while almost half of those surveyed were unable to read more than a few words.
âAnother survey reported that while students and parents ‘lacked social interactions,’ lacked physical activity, and ‘felt they were losing ties with their friends due to prolonged school closures’ during the COVID-19 pandemic, teachers believed the pandemic had caused irreparable damage. damage to the overall development of the future generation (personal communication), âhe noted.
According to the study, there is ample evidence to suggest that children between the ages of 1 and 17 have similar susceptibility to a mild form of SARS-CoV-2 infection as in adults. However, the risk of serious illness and death in children compared to adults is much lower. This can be attributed to a variety of factors, including a lower density of angiotensin-2 converting enzyme (ACE-2) receptors lining the airways of children that provide the site of the protein binding domain. SARS-CoV-2 peak.
The ICMR noted that the fourth cycle of the national HIV positive survey for COVID-19 held in June 2021 in India found that more than half of children between the ages of six and 17 were HIV positive, which implied that a considerable proportion of children were exposed to and infected with SARS-CoV-2 infection and infection was not confined to adults only.
“Treatment centers did not witness a greater frequency of critically ill children infected with SARS-CoV-2 during the second wave of COVID-19 in May and June 2021 compared to the previous year, while adults were being treated in inpatient facilities in considerable proportions, numbers nationwide coinciding with the rapid spread of the delta variant in 2021, âaccording to the study.
Referring to data from the UK, the ICMR paper noted that reopening schools with younger children was unlikely to push the reproduction number (R) above one, while the reopening of secondary schools resulted in a greater number of cases as older students also infected their respective family members. , while another school setting in Ireland reported no secondary transmission.
An article by DG Bhargava interestingly points out that it should also be noted that global evidence suggests that schools are ‘non-drivers’ of the transmission of SARS-CoV-2 infection into the community.
According to the study, the benefits of reopening the school in India’s current COVID-19 scenario (post-second wave) must therefore be weighed against the associated risks. Evidence indicates that restoring the functioning of the education system to the way it was in the pre-COVID era, as soon as possible, seems prudent in the current Indian context. However, it would be necessary to examine state and district specific data on previous waves of infection and the status of adult immunization coverage to project any plausible third wave and its potential intensity in order to shed light on such decisions related to the re-education of schools. opening.
The ICMR document advised steps to bring physical and social distancing, with a staggered schedule, alternating day schools, blended learning with online classes for compromised children. Alternative classroom arrangements in well-ventilated areas, ballrooms and open gardens are advised.
âAir conditioners should be avoided while exhaust fans should be installed in classrooms to create negative pressure to limit potential spread. Children should be advised not to share meals or spend long hours in canteens or mess rooms. Visible billboards with innovative behavior change messages generated through the active engagement of schoolchildren and teachers on school premises, could do a lot in this regard, âICMR said in its study. .
The ICMR also suggests that frequent testing of school staff and students for the early detection of cases is essential to prevent outbreaks.
âTesting strategies for SARS-CoV-2 infection in schools should act as a supplement and not a substitute for other organizational and behavioral interventions. Routine temperature or symptom checking in schools should be avoided due to limited evidence of their usefulness. It is also recommended that schools should have access to on-site testing facilities in accordance with existing country-specific guidelines. Temporary or localized closures of a classroom or school may occur depending on levels of transmission in the local community or if COVID-19 indicators worsen, âthe study adds.
In the solution proposed by the ICMR, teachers, staff and those involved in transporting children must be vaccinated urgently, alongside the adoption of the use of the mask after vaccination and said, âThis Combined intervention is essential because vaccination against COVID-19 does not prevent the acquisition or transmission of infection, which is true for both adults and children. Opening schools as part of this combined intervention will not only ensure continuity of in-person learning, but will also give parents confidence that schools are safe for their children. “
The ICMR study also indicates that currently, COVID-19 vaccine trials for children and adolescents are still ongoing in India and available evidence suggests that children aged 12 and over are at high risk. contracting the infection and should therefore be given priority for vaccination over younger children.