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Q&A: Schools and COVID-19
Post date:
2020/08/28
A new school year has begun! Find out here what precautions should be taken to keep children, teachers, other staff and the wider community safe.
Q: Are children at lower risk of COVID-19 than adults?
Children are less often reported as cases when compared with adults, and the illness they experience is usually mild. From data reported to WHO, children and adolescents up to 18 years of age represent 1 to 3% of reported infections, even though this age group makes up 29% of the global population.
While children may be less affected, they may also have a greater number of contacts in school and community settings. Further studies are underway to assess the risk of infection in children and to better understand transmission in this age group.
Q: What is the role of children in transmission?
The role of children in transmission is not well understood. To date, few outbreaks involving children or schools have been reported. However, the small number of outbreaks reported among teaching or associated staff also suggests that spread of COVID-19 within educational settings may be limited.
As children generally have milder illness and fewer symptoms, cases may sometimes go unnoticed. Importantly, early data from studies suggest that infection rates among teenagers may be higher than in younger children. Some modelling studies suggest that school re-opening might have a small effect on wider transmission in the community, but this is not well understood.
Further studies are underway on the role of children in transmission in and outside of educational settings. WHO is collaborating with scientists around the world to develop protocols that countries can use to study COVID transmission in educational institutions, which will soon be available at this link.
Q: Should children with underlying health conditions (asthma, diabetes, obesity) return to school?
Whether a child should go to school depends on their health condition, the current transmission of COVID-19 within their community, and the protective measures the school and community have in place to reduce the risk of COVID-19 transmission. While current evidence suggests that the risk of severe disease for children is lower overall than for adults, special precautions can be taken to minimize the risk of infection among children, and the benefits of returning to school should also be considered.
Current evidence suggests that people with underlying conditions such as chronic respiratory illness, obesity, diabetes or cancer are at higher risk of developing severe disease and death than people without other health conditions. This also appears to be the case for children, but more information is still needed.
Q: Should teachers and other staff with underlying health conditions return to school?
Adults 60 years and older and people with underlying health conditions are at higher risk for severe disease and death. The decision to return to a teaching environment depends on the individual and should include consideration of local disease trends, as well as the measures being put in place in schools to prevent further spread.
Q: What is the incubation period for children?
The incubation period for children is the same as in adults. The time between exposure to COVID-19 and when symptoms start is commonly around 5 to 6 days, and ranges from 1 to 14 days.
Q: What should be considered when deciding whether to re-open schools or keep them open?
Deciding to close, partially close or reopen schools should be guided by a risk management approach to maximize the educational, well-being and health benefit for students, teachers, staff, and the wider community, and help prevent a new outbreak of COVID-19 in the community.
The local situation and epidemiology of COVID-19 may vary from one place to another within a country, and several elements should be assessed in deciding to re-open schools or keep them open:
1. Benefits and risks: what are the likely benefits and risks to children and staff of open schools? Including consideration of :
- Disease trends: are COVID-19 cases being reported in the area?
- Effectiveness of remote learning strategies
- Impact on vulnerable and marginalized populations (girls, displaced, disabled, etc.)
2. Detection and response: are the local health authorities able to act quickly?
3. Collaboration and coordination: is the school collaborating with local public health authorities?
In addition to the local situation and epidemiology, a careful assessment of the school setting and ability to maintain COVID-19 prevention and control measures needs to be included in the overall risk analysis.
Q: What benefits would school re-opening provide?
The decision to open schools should include consideration of the following benefits:
- Allowing students to complete their studies and continue to the next level
- Essential services, access to nutrition, child welfare, such as preventing violence against children
- Social and psychological well-being
- Access to reliable information on how to keep themselves and others safe
- Reducing the risk of non-return to school
- Benefit to society, such as allowing parents to work
Q: What are the prevention and control measures to be prepared and put in place in schools?
There are several actions and requirements that should be reviewed and put in place to ensure the safety of children and school staff while at school. Special provisions should be considered for early childhood development, higher learning institutions, residential schools or specialized institutions.
WHO recommends the following:
Policy, practice and infrastructure: Ensure the necessary resources, policies and infrastructure are in place that protect the health and safety of all school personnel, including people at higher risk.
Behavioural aspects: Consider the age and capacity of students to understand and respect measures put in place. Younger children may find it more difficult to adhere to physical distancing or the appropriate use of masks.
Safety and security: School closure or re-opening may affect the safety and security of students and the most vulnerable children may require special attention, such as during pick-up and drop-off.
Hygiene and daily practices: Hand hygiene and environmental cleaning measures should be in place to limit exposure. Schools should consider training of staff and students, a schedule for daily cleaning, availability of hand hygiene facilities and national/local guidance on the use of masks.
Screening and care of sick students, teachers and other school staff: Schools should enforce the policy of “staying home if unwell”, waive the requirement for a doctor’s note, create a checklist for parents/students/staff to decide whether to go to school (taking into consideration the local situation), and consider options for screening on arrival.
Communication with parents and students: Schools should keep students and parents informed about the measures being implemented to ensure their collaboration and support.
Additional school-related measures such as immunization checks and catch-up vaccination programmes: Ensure continuity or expansion of essential services, including school feeding and mental health and psycho-social support.
Physical distancing: Physical distancing of at least 1 metre between people should be implemented in the school premises and in the classrooms. This includes increasing desk spacing and staging recesses, breaks and lunchbreaks; limiting the mixing of classes or age groups; considering smaller classes or alternating attendance schedules, and ensuring good ventilation in classrooms.
Remote learning: Tele-schooling and distance learning options such as delivering assignments, broadcasting lessons on radio or television and frequent follow-up support should be adapted to the situation.
Q: What are the risks during transportation to and from schools?
The following adaptations to transport to and from school should be implemented to limit unnecessary exposure of school or staff members.
- Promote and put in place respiratory and hand hygiene, physical distancing measures and use of masks in transportation such as school buses, in accordance with local policy.
- Provide tips for how to safely commute to and from school, including for public transportation.
- Organize only one child per seat and ensure physical distancing of at least 1 metre between passengers in school buses, if possible. This may require more school buses per school.
- If possible and safe, keep the windows of the buses, vans, and other vehicles open.
Q: Does WHO recommend staff and children to wear masks at school? And if yes, what type of masks?
The decision to wear a mask depends on the assessment of risk. For example, how extensive is COVID-19 in the community? Can the school ensure physical distance of at least 1 metre from others? Are there students or teachers with underlying health conditions?
Fabric masks are recommended to prevent onward transmission in the general population in public areas, particularly where distancing is not possible, and in areas of community transmission. This could include the school grounds in some situations. Masks may help to protect others, because wearers may be infected before symptoms of illness appear. The policy on wearing a mask or face covering should be in line with national or local guidelines. Where used, masks should be worn, cared for and disposed of properly.
It is important that anyone feeling unwell should stay at home and call their health provider.
Q: Are there any specific recommendations on school ventilation and air conditioning use?
Clean, natural ventilation should be used inside buildings where possible, without re-circulating the air. If air re-circulation is necessary, filters and duct systems should be cleaned regularly and routinely changed according to the manufacturer’s instructions. Heating and cooling systems should be well maintained.
Q: What should be monitored after re-opening of school?
Monitoring of the following should be considered through a range of mechanisms:
- Detection of new COVID-19 cases in educational institutions and success of contact tracing
- Implementation of and adherence to recommended public health measures in school settings
- Information on school drop-out, disaggregated for sex, age, disability and socio-economic status
- Effectiveness of remote education strategies
- Effects of policies and measures on educational objectives and learning outcomes
- Effects of policies and measures on the health and well-being of children, siblings, staff, parents and other family members
Based on what is learned from this monitoring, further modifications should be made to continue to provide children and staff with the safest environment possible.
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