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Last week, the NSW government announced that schools are expected to reopen in October. While face-to-face learning undoubtedly has benefits for children and parents alike, the announcement left a series of important questions unanswered about how it can be done safely.
By the time NSW lifts restrictions (estimated around October), only 60-70% of the population in NSW – and possibly fewer in Australia – who are 16 years of age and older can be fully vaccinated.
The Australian Technical Advisory Group on Immunization (ATAGI) has recommended immunizing children 12 years and older, but most of these children will not be fully immunized by October and children under 12 will not be immunized. for the moment.
In New South Wales, with well over 1,000 cases per day and increasing, there will still be significant community transmission when schools open. It’s unclear when schools in Victoria (where cases are also on the rise) will open, but there may still be transmission in the state when they do.
So what do we need to do to make sure children are as safe as possible in school?
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1. Vaccinate adults around them
In California, an outbreak in an elementary school occurred when an unvaccinated teacher, who came to work despite symptoms, read to students without their masks. Most of the children who were infected were more than 2 meters from the teacher, confirming that the 1 to 2 m distancing rule is not effective for an airborne virus.
Every child and teacher in a classroom or daycare with an infected person is at risk. Shared air is the primary means of spread of SARS-CoV-2 – the virus that causes COVID-19.
Children often contract the virus from the adults around them, so vaccinating adults in a child’s household and teachers can help protect them.
Vaccination is now mandatory for teachers in NSW, but about 67% have received a dose. This probably corresponds to less than 40% of the fully vaccinated New South Wales population.
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One dose of vaccination confers approximately 31% protection and two doses confer 67% (AstraZeneca) to 88% (Pfizer) protection against the Delta variant. Most children still won’t be immunized if schools in the two largest states reopen for the last quarter of the year. This means that it is even more important to make sure adults are vaccinated.
2. Compulsory masks for teachers and students
We can enforce masks in schools for teachers and students, and strongly recommend the use of masks for young children in daycare.
The American Academy of Pediatrics recommends masks for children two years of age and older; children over this age can wear masks without too much problem.
Since mask use in schools is more common overseas, there are now many toolkits (including translated versions) and recommendations available to help children wear a mask. For example, your child is more likely to wear a mask if they are wearing their favorite color, sports team, character, or special interest.
It is important to note that a DIY fabric mask can be designed to fit your child’s face and be of high quality if key design principles are followed. It is important to make sure that children have choices and understand why they are wearing a mask (eg, “When we wear a mask, the virus cannot pass from person to person.”
Read more: Can’t get your child to wear a mask? Here are 5 things you can try
3. Ventilated classrooms
Classrooms can be ventilated by opening windows (ideally two windows at opposite ends of the room). If there is only one window, a fan can help exhaust the dirty air. If the windows can’t be opened, luckily there is a cheap solution: portable air purifiers, which dramatically reduce the viral load in classrooms.
Read more: Poorly ventilated schools are a super-propagating event waiting to happen. It can be as easy as opening windows
There are also DIY methods for making air purifiers.
4. Reduce the number of people inside
Reducing the number of people crammed into a classroom can reduce the risk of COVID. For example, during times of high epidemics, if the decision is made to open schools, a group of children can come every other day and learn online every other day.
We have shown that this approach, combined with masks, reduces the risk of transmission on college campuses.
Using outdoor spaces for classes is also a good idea as the weather warms. Although Delta can transmit outdoors, the risk is likely much lower.
5. Test the schoolchildren
Finally, rapid point-of-service tests in schools will help reduce transmission, and self-test kits (when approved in Australia) can help.
Saliva tests are also a convenient way to test children. These tests are now available in official health facilities, so governments could make them available to schools.
What about daycares?
We must also think about daycare centers. Contrary to popular accounts, a new study shows that children up to three years old transmit more than older children. Thus, the vaccination of nursery nurses and parents of young children is also essential.
All of the above measures, with the exception of masks for 0-2 year olds, can easily be used in child care settings.
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A record number of children are hospitalized with COVID-19 in the United States. It remains unclear whether the high number of sick children is mainly due to the increased transmissibility of Delta, or whether it also causes more severe illness in children, as is the case in adults. Although the risk of serious illness remains much lower in children than in adults.
Read more: People under 12 are increasingly catching COVID-19. How sick do they get and when can we vaccinate them?
One thing we do know is that as vaccination rates increase in adults, the unvaccinated groups, the most important of which are children, will be at greater risk proportionately. The 70-80% targets for vaccinating eligible adults for the easing of restrictions correspond to 56-64% of the general population, leaving plenty of room for Delta to spread like wildfire among adults and unvaccinated children. So there are good reasons to protect children if we open schools.
In addition, lost productivity due to blockages is a significant component of the estimated daily economic cost of A $ 220 million in New South Wales alone. Sick children make it more difficult for their parents to work productively, if at all. And they increase the risk that the parents themselves will get sick and be unable to work.
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