WHO tells schools to maintain 3-feet distance and move classes outdoors when they reopen amid coronavirus
Experts recommend daily screening for body temperature, allowing only 1 child in each seat in school buses and waiving requirement for doctor's note to excuse absence when there is community transmission of Covid-19
Maintaining a distance of at least 1 meter or 3 feet between everyone present in class, moving lessons outdoors, ventilating rooms as much as possible, increasing desk spacing (at least 1 meter between desks) and staggering recesses/breaks and lunch breaks are part of a slew of recommendations issued by the World Health Organization (WHO) for reopening schools.
The advisory says that decision-makers should consider some critical factors while deciding on whether to open or close schools. This includes current understanding about Covid-19 transmission and severity in children, local situation and epidemiology of coronavirus where the schools are located, and school setting and ability to maintain prevention and control measures.
Additional factors to consider in deciding how or when to partially close or reopen schools include assessing what harm might occur due to school closure (such as risk of non-return to school, widening disparity in educational attainment, limited access to meals, domestic violence aggravated by economic uncertainties), and the need to maintain schools at least partially open for children whose caregivers are “key workers” for the country.
Schools have been asked to create a schedule for frequent hand hygiene, especially for young children, and provide sufficient alcohol-based rub or soap and clean water at school entrances and throughout the school. The guidance also calls for developing a school policy on wearing a mask or a face covering in line with national or local guidance. "If a child or school staff is sick, she/he should not come to school. Provide sufficient medical masks for those who need it, such as school nurses and children with symptoms," says the WHO.
The agency suggests that schools must assess what can be done to limit risk of exposure or direct physical contact, in physical education classes, sports or other physical activities and play in playgrounds, wet areas and changing rooms. "Limit mixing of classes for school and after-school activities. For example, students in a class will stay in one classroom throughout the day while teachers move between classrooms."
"Classes could use different entrances, if available, or establish an order for each class to enter and leave the building/classroom. Create awareness to ensure the students do not gather and socialize when leaving school and in their free time. Expand high-school timetable, with some students and teachers attending in the morning, others in the afternoon, others in the evening," says the WHO.
It asks schools to consider increasing the number of teachers, if possible, and to allow for fewer students in each classroom (if space is available). Experts say schools should advise against crowding during school pick-up or daycare, and if possible avoid pick up by older family or community members, for example, grandparents.
The guidance recommends putting in place respiratory and hand hygiene and physical distancing measures in transportation such as school buses, and tips for students on safe commute to and from school, including those using public transport. Only one child per seat should be allowed, and at least one metre apart in school buses, if possible. "This may lead to a need to increase the number of school buses in each school. If possible, windows of the bus should be kept open," it says.
The WHO says that schools should enforce the policy of "staying at home if unwell" for students, teachers, or school staff with symptoms, and if possible, connect with local organizations to provide home care support and ensure communication between home and school. Experts advise creating a checklist for parents/students /staff to decide whether students /staff can go to school while considering the local epidemiology of Covid-19.
The checklist could include underlying medical conditions and vulnerabilities, to protect the student/staff, recent illness or symptoms suggestive of Covid-19, to prevent spread to others, special circumstances in the home environment, to tailor support as needed, and special considerations regarding school transport as needed.
"Waive the requirement for a doctor's note to excuse absences when there is community transmission of Covid-19. Consider daily screening for body temperature, and history of fever or feeling feverish in the previous 24 hours, on entry into the building for all staff, students, and visitors to identify persons who are sick. Ensure students who have been in contact with a Covid-19 case stay home for 14 days. School officials should notify public health authorities in case of a positive Covid-19 case. Establish procedures for students or staff who have symptoms of COVID-19 or are feeling unwell in any way to be sent home or isolated from others," say guidelines.
Communication is critical and accordingly, the WHO asks schools to Inform parents about the measures the school is putting in place and ask for cooperation to report any cases of Covid-19 that occur in the household. "If someone in the household is suspected to have Covid-19, keep the child home and inform the school. Explain to the students the reason for school-related measures, including discussing the scientific considerations and highlighting the help they can get through schools (for example, psychosocial support)," experts recommend.
The WHO also suggests initiating or continuing tele-schooling or similar methods wherever necessary and possible. "If tele-schooling is not possible, invite students to take text-books home or arrange to deliver assignments. Consider radio or television broadcasts of lessons, arrange a buddy system for homework with older siblings at home, or with friends by telephone," says the advisory.
The agency says that as protective school measures are applied, it is important to monitor a range of factors such as the effectiveness of tele-schooling interventions, how well has the school been able to develop tele-schooling strategies, what proportion of children were reached, and what is the feedback from students, parents, and teachers. "Other factors include the effects of policies and measures on educational objectives and learning outcomes, as well as on the health and well-being of children, siblings, staff, parents, and other family members, besides the trend in school dropout after lifting the restrictions," says WHO.
CDC checklists to help reopen schools, businesses
To help decide whether it is safe to reopen during the coronavirus pandemic, the US Centers for Disease Control and Prevention (CDC) has issued one-page checklists each for schools, child care programs, youth programs, workplaces, restaurants and bars, and mass transit. The advice is less detailed than draft recommendations the agency sent to the White House for review last month.
As far as schools are considered, it tells them to asks three questions: will reopening be consistent with applicable state and local orders, is the school ready to protect children and employees at higher risk for severe illness, and if the school can screen students and employees upon arrival for symptoms and history of exposure. The CDC says that schools should not reopen if the answer to any of these questions is a "no".
"The purpose of this tool is to assist administrators in making (re)opening decisions regarding K-12 schools during the Covid-19 pandemic. It is important to check with state and local health officials and other partners to determine the most appropriate actions while adjusting to meet the unique needs and circumstances of the local community," it says.
The CDC recommends promoting healthy hygiene practices such as hand washing and employees wearing a cloth face covering, as feasible, and intensifying cleaning, disinfection, and ventilation. It encourages social distancing through increased spacing, small groups, and limited mixing between groups, if feasible, and training all employees on health and safety protocols.
"Develop and implement procedures to check for signs and symptoms of students and employees daily upon arrival, as feasible. Encourage anyone who is sick to stay home. Plan for if students or employees get sick. Regularly communicate and monitor developments with local authorities, employees, and families regarding cases, exposures, and updates to policies and procedures. Monitor student and employee absences and have flexible leave policies and practices," suggests CDC, asking schools to meet these safeguards first.
The "decision trees" are very similar, with small adjustments to account for the differences between schools, and other workplaces, for example. Guidelines for workplaces include encouraging social distancing and enhancing spacing between employees, including through physical barriers, changing the layout of workspaces, encouraging telework, closing or limiting access to communal spaces. It also calls for staggering shifts and breaks and limiting large events, when and where feasible.
Restaurants and bars have also been advised to practice social distancing, and increasing spacing at establishments by encouraging drive-through, delivery, and curb-side pick up. The CDC asks these establishments to meet safeguards such as spacing of tables/stools, limiting party sizes and occupancy, avoiding self-serve stations, restricting employee shared spaces, and rotating or staggering shifts if feasible.