Public health experts seek graded reopening of schools

Public health experts from three medical associations have written to Prime Minister Narendra Modi suggesting that schools and other educational institutions should be reopened in a graded manner.

The statement issued by the Indian Public Health Association, the Indian Association of Preventive and Social Medicine and the Indian Association of Epidemiologists stated that the closure has had a significant impact on the teaching-learning system and mental health of the children.

"It is time now to move towards normalcy. The opening of schools and other educational institutions could be started in a graded manner. There should be a pragmatic approach, especially in areas where a sufficient population is already infected," the experts said.

Twenty members of the joint Covid-19 task force went on to say that schools may be opened with due safety measures with social distancing, alternate work days and with adequate surveillance even in low infection areas.

In the Unlock-4 guidelines issued by the government, schools and educational institutes have been directed to remain closed. The experts said that the impact of school closure is higher on the children of lower socio-economic strata, who do not have social capital for alternatives like digital platforms.

"Sufficient evidence is available that infected, young children are at an extremely low risk of developing morbidity," the public health experts said.

They requested the government to discontinue the imposition of lockdown as a strategy to control the spread of coronavirus infection and said that limited restrictions should be imposed in epidemiologically-defined clusters for short periods.

The three health associations said that even cluster restrictions should be imposed only after weighing its impact on the livelihood of the population.

They added that creating containment zones and aggressive testing for Covid-19 offers little advantage in large cities where the infection has already spread wide. "The focus should instead be on preventing deaths from Covid-19 and not containing the infection."

The experts said that containment zones should be revamped with a clear roadmap and timelines for periodic review by an expert committee, with the aim to test all suspects, isolate all infected individuals for proper treatment and that they should be de-contained in 14 days.

Asserting that "pragmatic testing" should be adopted as a control strategy, they said that universal scaling up of testing at the current community transmission stage of the pandemic may not be an optimal strategy and will divert attention and resources from control measures.

"With the availability of sufficient understanding of the natural history of disease and at-risk population, testing should be used with due diligence. Targeted testing of high-risk individuals, healthcare workers, elderly with comorbidities, screening prior to surgical procedure is recommended," the experts said.

The associations further said that it must be assumed that an effective vaccine against the novel coronavirus "would not be available in the near future" and any false sense of hope that this panacea is just around the corner must be avoided

The public health experts include Dr Sujeet Kumar Singh, Director at the National Centre for Disease Control (NCDC), Dr AC Dhaliwal, Former Director, National Vector Borne Disease Control Programme and NCDC, Dr DCS Reddy, Former Professor and Head, Community Medicine at BHU in Varanasi, Dr Sanjay K Rai, National President of IPHA and Professor at AIIMS in New Delhi and several others.