By Dr Despina Demopoulos a paediatric intensivist at the Wits Donald Gordon Medical Centre
 
In the lead up to the start of the academic year for 2021, conflicting views regarding schooling during Covid were expressed. Government, teacher trade unions, political parties, civil society organisations, school governing bodies and parents each had different views. This led to increased parental, caregiver and child anxiety.
 

What does the evidence REALLY say?

The South African Paediatric Association (SAPA) and Paediatric Management Group (PMG) strongly recommend children return to school as soon as is safely possible. They recently published a statement with the latest evidence which also considers the implications of the new virus variant (501Y.V2).
As of 2nd January 2021, individuals aged ≤19 years made up 9.2% of laboratory-confirmed COVID-19 cases and 3.9% of all COVID-19-associated admissions in South Africa, while comprising 37% of the total population of SA.
 
 

FAQ’s regarding schooling during Covid

1. Do children have a high risk of acquiring SARS-CoV-2?

  1.  Children are less likely to acquire SARS-CoV-2 than adults. They account for 1-3% of reported cases. Children and young people have lower susceptibility to SARS-CoV-2, with 56% lower odds of acquiring infection following contact with a confirmed case.
  2. Children and adolescents younger than 20 years have 44% lower odds of acquiring SARS-CoV-2 from a close contact compared with adults 20 years and older; this finding was most marked in those younger than 10 to 14 years.
  3. Current SA statistics show that although the new virus variant, present during the second wave, has increased virus transmission compared to the first wave, children are not at higher risk of being affected by the new strain compared to adults.

2. Do children transmit less?

  1. The ability of children to transmit SARS-CoV-2 is dependent on their susceptibility, symptoms, viral load, social contact patterns and behaviour.
  2. Younger children are less likely to transmit the virus to each other and staff compared to adolescents and adults.

3. Severity of Disease

  1. In general, children have much less severe disease than adults. When children and adolescents are infected, they are more likely to have only mild disease.
  2. Children are more likely to have an asymptomatic infection than adults.
  3. There are no differences in the proportion of children admitted to public hospitals, admitted to ICU, or dying in hospital during the first and second COVID-19 waves in South Africa.

 

schooling during Covid

 

4. What is the risk to our teachers?

  1. Teachers and non-teachers have similar Covid-19 infection rates. This goes to show that learners are not superspreaders and teachers are therefore relatively safe.
  2. While teachers are less likely to be infected by learners, they are at higher risk of contracting the virus from other adults, e.g. colleagues in tearooms, at home or in the community (outside school). 
  3. Older teachers and those with comorbidities should be more cautious, just as they would be in any working environment.

5. Have there been transmissions in schools?

  1. As schools have reopened internationally and in South Africa, some school-related cases of COVID-19 have been reported, but there is little evidence that schools contribute significantly to community transmission.
  2. There has been no noticeable effect (including number of cases, admissions, and deaths) associated with the timing of opening or closing of schools in South Africa.
  3. Most positive cases resulted from close contact with infected persons, gatherings with persons outside the household and lack of consistent mask use in school- and NOT from schooling during Covid. 

6. Risk-benefit analysis

The major benefits of sending children to school should be balanced against the relatively small risk of COVID infection:
  • Children who attend school are able to complete their studies and progress in their learning.
  • Only 20% of South African school children have access to online learning.
  • Children who attend school also have access to other services including nutrition and child welfare and the support they receive makes them less likely to be abused at home.
  • Children at school have more of their psychological and social needs met and are less likely to suffer from mental illnesses like depression and anxiety.
  • Children are also more likely to access mental and therapeutic services if they attend school.
  • They are able to form relationships with peers and adults and have opportunities for play, which stimulates their development.
  • At school, children can receive education on how to keep themselves and their families safe from COVID. This in turn benefits society.
  • Poorer children are particularly vulnerable to the impact of missing school as they are less likely to have online learning, are more dependent on the school nutrition program and are more reliant on the stimulation that school provides.
  • Families struggle with child care which can impact the family’s source of income and the security of the child.
Schools provide so much more than just education in terms of providing nutrition and food security, physical and psychological safety which should be maintained at all costs in the face of potential COVID collateral damage to children.
 
 
Read Part 2 of this series which deals with how to make schools as safe as possible.
 
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