The Centre and state governments should refrain from doing so in the light of new studies highlighting COVID-19 cases among children
The novel coronavirus disease (COVID-19) cases in India are spiraling daily and we are a whisker away from overtaking the United States in having the most cases in the world.
The Union government has given the green signal to states to reopen schools and colleges with parental permission and many states are keen to reopen fully. The University Grants Commission has also allowed the reopening of universities.
The move is fraught with several implications for students, parents and society. Until recently, it was believed globally that children were by and large mildly affected by COVID-19 and that their role in the transmission was limited. But now, that perception is changing with new emerging research.
No longer immune
The renowned Science journal from the US recently published a massive COVID-19 epidemiological study in the south Indian states of Andhra Pradesh and Tamil Nadu. A team of medical experts from India and the US were involved.
It reported that over 30 lakh people were infected from 4,35,539 index patients or first-known cases. The study extensively studied the pandemic in the two states, analysing the data available from 575,071 tested contacts arising out of 84,965 patients.
The study concluded that the case fatality rate was 2.1 per cent. Contact tracing found that five per cent of the people accounted for 80 per cent of infections. Most of the patients were young and infected others in similar age groups.
The death rate among patients older than 65 per cent was comparatively lower than the US. The median hospital stay of the patients before death in India was five days, compared to two weeks in the US.
More than 5,300 children infected 2,508 contacts, most likely other children their age. Non-pharmaceutical interventions like social distancing and lockdown might have contributed to reduction of contacts in children.
Children of all ages were infected and their contacts were mostly other children and adults. The study proved the point that children did indeed contract the virus and transmit it.
In the US, there was a recent study by the US Centers for Disease Control and Prevention (CDC) about how a 13-year-old girl infected 11 of her relatives during a three-week family gathering.
In India, there were two outbreaks among children that were reported in the media recently. In the Gantyada and Dattirajeru mandals of Vizianagaram district, Andhra Pradesh, 27 school students from the 9th and 10th grades tested positive ahead of the school reopening.
In another outbreak from Bhatlur village in Guntur district, again in Andhra Pradesh, 14 students contracted COVID-19 from their tuition teacher. Around 25 others, including their parents in the village tested positive.
There have been hundreds of reported outbreaks in schools, universities, day camps and childcare centres from around the world, especially in the US that conclusively shatter the myth that children do not spread the virus.
There are many facets of COVID-19 that are still unknown, especially the Multi Inflammatory Syndrome (MIS) among children, young adults and long COVID-19.
There were several reports of MIS all over the world in children, although on a lower scale. MIS affects the immune system and various organs and is still being studied.
There were studies from the UK reporting neurological conditions among young children recovering from COVID-19. An American study showed Myocarditis in recovered college athletes.
In a large population of COVID-19-recovered patients, there were long-term effects ranging from heart conditions to lung and kidney damages called Long Covid. Research is still ongoing in these areas.
Children under 18 years might suffer mildly in most cases based on available data. However, they could be active vectors for virus transmission, as new research shows, given their interaction with children and adults, especially with co-morbid conditions or the elderly.
A great risk
The opening of educational institutions poses a great risk to students, parents, grandparents, teachers, staff and the public.
The students traveling in public transport and shared conveyances potentially contract COVID-19 from and infect other passengers. The college students preparing for the examinations run from one coaching centre to another and have social interactions, putting many at risk.
The parents care for their children more than themselves. If schools and colleges reopen and outbreaks occur, it will be difficult to manage the frantic rush of students and their parents to the testing centres and hospitals.
No parent would allow their COVID-sick children at home as they would probably do with cough or cold. The pediatric wards and hospitals will be over-crowded, putting excessive pressure on doctors and healthcare workers, especially in rural areas.
We need additional quarantine and isolation facilities as most homes are small. Are we prepared for such burdens?
The US CDC and World Health Organization mandate that if there is an uptick of COVID-19 cases and positivity rate in the community, it is risky to open educational institutions.
The US CDC has acknowledged that the coronavirus can be airborne and that it can linger in the air for a few hours in form of aerosols. The 6-foot distance is not relevant for aerosols as studies have found that virus can travel to about 12 feet.
The social distancing in schools becomes a huge challenge and enforcement of measures is difficult. Crowded classrooms and buildings are potentially risky. Most of the schools and colleges are poorly ventilated.
There are many teachers and staff who are middle-aged, with comorbid conditions. If God forbid some of them were to die, it will be hard for the parents to answer their kids as to how their favourite teacher died. There are many children and young adults with comorbid conditions. Shielding them will be difficult.
In India, there are many multi-generational households, with children living with parents and grandparents in small houses. The reopening of the institutions will put the entire society at risk and would cause superspreading events all over the country.
What should be done
Governments should, instead, continue the online education mode. It is true that there are several challenges in the delivery mechanisms. But then, existing infrastructure like television and internet can be used meticulously and latest technology can be leveraged.
The national broadcaster, Doordarshan, is already beaming educational programmes. The services of private TV networks can also be used. Doordarshan was originally started as Satellite Instructional Television Experiment.
During its formative years, it was used for relaying school and adult education. Such an effort must be revived and education delivery enriched with creative content.
The teachers must be trained to deliver their lessons effectively online or on TV in a way that the students understand and see what they write on the boards. Phone-in facilities should be provided to clear doubts. A special website should be setup to enable downloading of materials.
For low-income groups and rural areas, Chromebook or tablet loaner schemes can be initiated. To enable internet access, WiFi-equipped buses must be stationed in mapped low-income areas to provide internet coverage.
In the US, almost all the schools have the loaner schemes and WiFi buses used in Georgia and California have been hugely successful. We can also try internet balloons as Kenya is doing.
In the light of new studies and case studies highlighting the COVID-19 cases among children and keeping the national interest in view, governments should refrain from opening educational institutions until the curve is flattened and the cases spike downwards.
We are simply not ready to reopen. We must instead leverage technology to ensure that no student is left behind.
Views expressed are the authors’ own and don’t necessarily reflect those of Down To Earth
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