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Review: World Bank advocates for Reopening of Schools as countries begin vaccinating Adolescents & Children

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Millions of Children around the world have been kept away from schools because of the COVID-19 pandemic. As many countries have vaccinated a significant proportion of the population, the call for reopening schools has gathered steam. The World Bank, in a recently published document advocated for the reopening of schools citing multiple studies which conclude that Children below 10 years are less vulnerable to COVID-19. 

With the outbreak of the COVID-19 pandemic, educational systems worldwide faced sudden closure with schools, colleges, and universities closed for long periods. Schools in more than 188 countries were shut down and over 1.6 billion (75% of enrolled students) were out of school. The closure was sudden and there was not enough time to switch to distance/digital learning for many children especially in countries like India where the digital infrastructure is not equally available & accessible. In India, the COVID-19 pandemic-induced disruption in education is the largest in history and over 32 crore students were affected.

The World Bank has recently published a document advocating for the physical opening of schools. The document draws from evidence using multiple studies about COVID-19. The document touches on various aspects related to COVID-19 infection. Here is a review. 

Duration of school closure in India is among the longest in the World

As schools remained shut for a significant period, the existing education disparities across the country further got exacerbated by the pandemic. The learning loss has also been significant. On one hand, online education/remote learning is not accessible by all. Even among those who accessed, learning has been substantially lower than what would have been if in-person instruction had continued. On the other hand, there has been a disruption in providing a nutritious meal to children. The Mental health of children has also been affected. Millions of children are also at the risk of being pushed into child labour

In 2020, at least 463 million school children across the globe were unable to access remote learning during school closures according to UNICEF. Further, it was seen that by March 2021, children across the world had lost an average of 74 days of school due to school closures and lack of access to remote learning. As per the UNESCO’s monitoring of school closures, it is observed that lengthy closures have been reported in Latin America and the Caribbean, the Middle East and North Africa, as well as much of South Asia and parts of East Asia Pacific. The duration for which there were full and partial school closures was the highest in Uganda where schools reported closure for 77 weeks. India reported the third-longest closure of 73 weeks. 

Some states in India have resumed in-person classes

According to the COVID-19 Global Education Recovery Tracker, as of July 2021, 80% of schools worldwide were in the regular sessions of which 54% were back to in-person instruction, 34% relied on mixed or hybrid instruction while 10% continued with remote instruction and 2% offered no instruction at all. While schools have opened fully in countries like Canada, Russia, China, Italy, and Japan, schools have opened only partially in the USA, Australia, Brazil, Pakistan, and India. In India, educational institutions including schools started resuming physical in-person operations in September 2021 on the basis of guidelines and safety protocols issued by respective states. Most states started have resumed in-person classes in a phased manner starting with higher secondary students followed by secondary school students. To ensure adherence to safety protocols, classes are being divided into batches to limit the number of students in class. Students are given the option to continue taking classes online. 

Pre-primary and primary school students are relatively less vulnerable to contract COVID-19 

Multiple studies suggest that young children, especially those aged below 10 years (pre-primary and primary school students), are relatively less vulnerable to contracting COVID-19 infection and much less likely to transmit the disease as compared to adolescents and adults. Data-based evidence from studies in Spain, Italy, Iceland, South Korea, and the US point towards the very low incidence of infection among young children. Even among those children who got the infection, severe illness and death were rare and occurred among those children who had other underlying conditions such as obesity, diabetes, and cardiac conditions. Children with complex chronic diseases were almost eight times more likely to be hospitalized and three times more likely to have a severe disease as compared to children without any chronic diseases.

Studies show children are less likely to transmit compared to adults

Unlike in the case of other diseases such as influenza or the common cold which are easily spread by children, the transmission of COVID-19 to adults was found to be less effective. Studies carried out in Finland, Sweden, and the UK confirm this. A study in Germany identified that when children over age ten were physically distanced (more than 1.5 metres) in school and children under ten had no distancing, an infected student led to an average of 0.04 secondary cases in teachers, while an infected teacher-led to an average of 0.56 secondary cases. 

Considering the low vulnerability of children and their limited transmission of infection, teachers and other staff are more likely to contract the disease from their colleagues than from children. In Australia, the findings of a contact-tracing study found that the staff-to-staff transmission rate was 4.4% whereas the child-to-staff transmission rate was 1%. Thus, if staff adhere to the safety protocols, infections in schools can be curtailed to a large extent. Now that vaccines have become more easily available as compared to the times when most of these studies were conducted, the risk is further reduced. However, if schools are kept closed for the fear of infection, children’s future will be at stake, and more is lost in the bargain. 

Countries have begun administering the COVID-19 vaccine for those aged above 12 years

Many countries are working on providing emergency authorization of COVID-19 vaccines for children. USA’s FDA expanded the emergency use authorization for the Pfizer- BioNTech vaccine to include adolescents aged 12 to 15 years as early as May 2021. Soon, the European Union followed suit. Moderna’s vaccine has been given approval by European Union for usage among 12 to 17 years old adolescents. Since then, Spain has vaccinated close to 80% of the young adults aged 12 to 19 years with at least one dose while Switzerland has vaccinated over 27.5% of individuals in the 12 to 15 years age group as of 10 October 2021. As of 11 October 2021, France had completely vaccinated close to 68% of the 12-17 age group.  

China gave emergency use approval to Sinovac’s vaccine for children & adolescents between 3 and 17 years as early as June 2021. Pfizer has submitted a request to the FDA, for emergency approval for using a lower dose in younger children aged 5 to 11 years. Results of trials on children aged 2 to 5 years, and for the youngest age group of 6 months to 2 years old are expected later this year. 

India has given emergency use approval for young adults, but vaccination is yet to start

In India, the Drugs Controller General of India (DCGI) gave Emergency Use Authorization for Zydus Cadilla’s DNA Vaccine- ZyCoV-D for adults as well as adolescents in the age group of 12-18 years in August 2021. It is a 3-dose vaccine with the first administered on day zero, second on day 28th and third dose on the 56th day. According to the company, this is the only needle-free COVID-19 vaccine in the world. However, the vaccine is yet to be made available on the market. News reports also state that the Subject Expert Committee has approved the use of indigenous Bharat Biotech’s COVID-19 vaccine, Covaxin, for individuals aged between 2-18 years. However, the final approval is yet to be given by the DCGI. 

Featured Image: Reopening of Schools

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