Experts recommend the opening of schools, other educational institutions in a graded manner 

The nationwide lockdown induced by COVID-19 in March prompted schools and colleges to move to the virtual world for teaching and learning activities
Representative Image
Representative Image

A group of public health experts has recommended that schools and other educational institutions should be reopened in a graded manner while highlighting that the lockdown should be discontinued as a strategy for control of the spread of coronavirus. The nationwide lockdown induced by COVID-19 in March prompted schools and colleges to move to the virtual world for teaching and learning activities.

The recommendations were made in a report compiled by experts from the Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) and the Indian Association of Epidemiologists (IAE). Recommending that the opening of schools and other educational institutions could be started in a graded manner, the experts said it is time now to move towards normalcy. "There should be a pragmatic approach, especially in areas where sufficient population is already infected with SARS CoV-2 (As assessed by expert committee). Even in low infection areas, schools may be opened with due safety measures (social distancing, alternate work days, etc.), and with adequate surveillance for any outbreaks acceleration due to schools," they said.

The experts said closure of educational institutions, especially schools for children (5-18 years) has had a significant impact on the teaching-learning system as well as mental health of the children. "The impact has been disproportionately 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," they said.

The risk of young children transmitting corona infection to older family members would be the same as adult family members who are permitted to carry out activities outside of home environment, they said. They also said the lockdown as a strategy for control of the contagion should be discontinued. "Geographically limited restrictions for short periods may be imposed in epidemiologically defined clusters. Cluster restrictions should be considered only in areas with no community transmission," they said.

The primary purpose of the lockdown was to slow down the pandemic and gain time for preparedness to fight it, and this purpose has already been achieved, the report said. There is no evidence that any useful purpose would be served by the weekend, intermittent or night time lockdown, banning of domestic flights and large-sized containment zones, the experts noted. "In large cities where already there has been substantial spread (can be assessed by the expert committee) there is no advantage of creating containment zones and aggressive testing," they said.

The group also recommended that primary, secondary and tertiary health care services including outpatient and inpatient services including routine and emergency surgeries should resume as early as feasible, at least in those areas that are progressing towards higher levels of immunity and in towns and districts with no cases. Recommending quarantine and isolation policies, the experts said they should be community-friendly. "The present policies, where houses of all persons who test positive are stamped, isolated by barricades, is creating fear in society. This practice should be abandoned immediately," they said.

"When the majority of states and districts are affected, there is no rationale for quarantine of inter-state travellers who are required to be in mandatory facility (Hotel or health facility) quarantine (for 14 days).

This should be stopped immediately," they said. The experts said citizen-friendly measures like following home quarantine, which has been an effective strategy in many cities and states, should be followed. The experts recommended increasing healthcare expenditure to 5 per cent of GDP.

"Public health care should be significantly strengthened and enhanced with overall public expenditure to be increased to at least 5 per cent of the GDP. The focus of increased health expenditure should be on primary health care and human resource and infrastructure strengthening rather than opening/strengthening tertiary care centres," they said.   The 20-member joint COVID Task Force includes Dr Shashi Kant, Past President IAPSM, and Head of the  Centre for Community Medicine at AIIMS, New Delhi, Dr Sanjay K Rai, National President, IPHA and Professor, CCM, AIIMS, Dr Sujeet Kumar Singh, Director of National Centre for Disease Control NCDC), Dr D C S Reddy, former Professor and Head, Community Medicine, IMS, BHU, Varanasi and Dr.

Rajesh Kumar, former Professor & Head, DCM and SPH, PGIMER, Chandigarh. Dr Singh and Dr Kant are members of the ICMR National Task Force on COVID-19 while Dr Reddy chairs the ICMR research group on epidemiology and surveillance for COVID-19.

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