Children more at risk when not at school

A worker in protective suit disinfects a classroom.

A worker in protective suit disinfects a classroom.

Published Sep 4, 2021

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THERE are concerns that children will be at more risk to Covid-19 infection as schools return to full capacity and with proposals to reduce social distancing in classrooms.

The Department of Basic Education is proposing reducing the distance between primary school pupils from a meter to 0.5m. This is to allow more pupils to attend school.

While parents and teacher unions have raised concern, experts said the situation should be looked at in its entirety.

Don’t panic, know the facts

Professor Mignon McCulloch, chairperson of the South African Paediatric Association (Sapa), said the Delta variant was more contagious for everybody.

“But we also know that this is a virus that is going to make older people with comorbidities really sick and potentially die from this variant. We know that children can be affected by the Delta variant, but on the whole, it remains an adult disease. Children will get sick from it, but only those with severe comorbidities are at high risk.

"And in this case, we don't just mean children, for example, with a touch of asthma. We mean children with leukaemia, other forms of cancer, significant obesity, etc. These are the kids who may be more at risk, but it still remains predominantly an adult condition.”

She said 99% of hospital admissions in South Africa for Covid-19 were still adults.

“What we are seeing that is different is that teenagers from 15 years upwards and young adults are the ones who are not socially distant enough, so they are also getting it. So the 15 years and upwards are obviously behaving more like adults in terms of not social distancing. The Early Childhood Development and primary school kids are the ones who are not that badly affected.”

McCulloch said there were other aspects of schooling that needed to be considered: “Children are falling way behind in academic progress”.

Covid-19’s effect on education

In a press release in July, the UN Children’s Fund (Unicef) said the impact of disrupted education since the outbreak had been devastating. It said South African learners were between 75% and a full school year behind where they should be.

The press release quoted statistics from the National Income Dynamics Study-Coronavirus Rapid Mobile Survey Wave 5, and the Department of Basic Education.

Unicef said rotational attendance, sporadic school closures and days off for specific grades have resulted in schoolchildren losing 54% of learning time. Some 400 000 to 500 000 learners have reportedly also dropped out of school over the past 16 months. This, said Unicef, was most likely for children living in informal urban and rural settings, with household poverty also playing a critical role. The total number of out-of-school children is now up to 750 000.

In a statement, Christine Muhigana, a Unicef South Africa representative, said: “It’s urgent that we get every child back into the classroom, safely, now. Remote learning has been a lifeline for some children but for the most vulnerable in South Africa, even this was out of reach. We need to ensure that we prioritise vulnerable girls and boys in all our efforts to keep children in classrooms."

Unicef said the education system could not afford further shocks, such as the recent unrest. This resulted in more than 140 schools being vandalised in KwaZulu-Natal and Gauteng – on the back of the more than 2 000 schools that were looted and damaged during the hard Covid-19 lockdown last year.

Risk-benefit wager

Experts have said the impact on schooling resulted in the loss of learning, mental distress, exposure to violence and abuse, and missed school-based meals.

McCulloch said it was a matter of looking at the situation via a risk-benefit ratio, including the possible reduction of social distancing.

“The reality is that in schools where there could not be adequate physical distancing, at least the children can get back to school. School is not just about learning. School is also about access to meals. A lot of children are becoming malnourished and going hungry since the pandemic. It's also about psychological safety. When they are with their friends, they feel safer.

“It’s also about physical and sexual safety. When children are left unattended at home while their parents have to go to work, they are at risk of physical and sexual abuse, they are playing in the streets and are open to accidents. They are playing in each other’s homes and they could spread the virus that way. So we want these kids back at school in as contained an environment as possible.”

McCulloch said it was important to realise that there were some schools that could not do 1m social distancing.

“It’s then important to make sure that the teachers are wearing their masks and that teachers are vaccinated. Because we know this illness is predominantly adults-to-children spread, not the other way around. At school, they can hand sanitise and ensure that everybody wears their masks.

“As a risk-benefit ratio, we are not saying that we are happy with the idea, but we know that whether it’s 2m or 1m, it’s probably the same. We know that masking is important. We feel that we are losing a generation of educated kids. We are saying, if we are going to be worrying about the younger kids having a mild infection, we are doing so at the expense of having a population of uneducated children who are also vulnerable to malnutrition, and physical and sexual abuse.

“So it’s a risk-benefit wager and we need to just be sensible about it, not panic, and realise that some of our classes have about 50 to 60 kids in them. But if they wear their mask, open the windows and ensure there is good ventilation in classrooms, then the school environment is probably safer than the children being out in the community at home.”

She said the National Institute for Communicable Diseases had done a study looking at babies, children, teenagers and adults living in the same homes. It was found that the spread was still predominantly from adults to children, not from children to adults.

Vaccinate children?

In the US and the UK, authorities have reviewed their vaccination management strategies where the shift is now to getting children and teenagers vaccinated.

Given the concerns over the Delta strain and the situation with schools in South Africa, McCulloch said those at higher risk need to be vaccinated first.

“The highest risk of the people are over 60, then the people over 50, then the people over 35, then the people of 18, then those between 12 and 18 and then the kids under 12.

“In an ideal world, I would want everybody vaccinated. But it's really important that adults take responsibility and get themselves vaccinated. We will get to the kids, but at the moment we know that the kids are going to get sick from this virus but they won't get as sick as the adults, and a lot of adults have died.”

McCulloch said if people were worried that the vaccine was developed too quickly, they should realise that it had now been around for almost two years.

“In Europe, it was rolled out in December of 2020. By the end of this year, it will be two years. So it’s about a responsibility to each other and to our youth that we get as many adults vaccinated as possible. That's the only way we’re going to get through this.”

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