WHO’s guidelines for reopening of schools

In response to Covid-19, countries around the world have implemented several public health and social measures (PHSM), including movement restrictions, closure of schools and businesses, and international travel restrictions.

As the local epidemiology of the disease changes, countries including South Africa, will adjust these measures according to the intensity of transmission.

According to the WHO, one of these guidelines is considerations for decision-makers and educators on how or when to reopen or close schools in the context of Covid-19.

According to WHO, the decision to close, partially close or reopen schools should be guided by a risk-based approach to maximise the educational and health benefits for students, teachers, staff and the wider community, as well as help prevent a new outbreak of Covid-19 in the community.

WHO advised that decision-makers consider the following when deciding on whether to open or close schools:

• Current understanding about Covid-19 transmission and severity in children.
• Local situation and epidemiology of Covid-19 where the school(s) are located.
• School setting and ability to maintain Covid-19 prevention and control measures.

Additional factors to consider when deciding how or when to partially close or reopen schools includes assessing what harm might occur due to school closure, including the risk of non-return to school, limited access to meals and domestic violence aggravated by economic uncertainties.

WHO: Covid-19 and children:

Data from individual countries and a recent review of Covid-19 in children suggest that children are less often reported as cases than adults, and that the infection generally causes mild disease and that serious illness due to Covid-19 is seen infrequently in children, although there have been rare cases of critical illness.

The role of children in transmission remains unclear and additional data is needed. To date, there have been few educational institutions involved in Covid-19 outbreaks, but from these studies, it appears that disease transmission was primarily related to social events linked to school or university life rather than transmission within classrooms.

These studies also suggest that the introduction of the virus was likely by an adult member of staff.

As part of the guidelines set out by the World Health Organisation (WHO) it is advised that decision-makers choosing to open schools should follow the guidelines below.

Hygiene and daily practices at school:

• Educate everyone in the school about Covid-19 prevention, this includes appropriate and frequent hand hygiene, respiratory hygiene, mask use if mandated, symptoms of Covid-19 and what to do if you feel sick. Non-contact greetings should also be advised. Offer weekly updates on these as the pandemic evolves.
• Create a schedule for frequent hand hygiene, especially for young children, and provide sufficient alcohol-based rub or soap and clean water at school entrances and throughout the school.
• Schedule regular cleaning of the school environment daily, including toilets, with water and soap/detergent and disinfectant. Clean and disinfect frequently touched surfaces such as door handles, desks, toys, supplies, light switches, doorframes, play equipment, teaching aids used by children, and covers of books.
• Assess what can be done to limit risk of exposure, or direct physical contact, in physical education classes, sports or other physical activities and play in playgrounds, wet areas and changing rooms.
• Increase frequency of cleaning in gym and sports facilities and changing rooms, provide hand hygiene stations at entrances and exits, establish one-way circulation of athletes through the facilities and limit the number of people allowed in the locker room at one time.
• Put in place respiratory and hand hygiene and physical distancing measures in transportation, such as school buses, and tips for students on safe commuting to and from school, including those using public transport. Only one child per seat and at least one metre apart in school buses, if possible. This may lead to a need to increase the number of school buses per school. If possible, the windows of the bus should be kept open.
• Develop a school policy on wearing a mask or a face covering in line with national or local guidance. If a child or member of school staff is sick, she/he should not come to school.
• Provide sufficient medical masks for those who need them, such as school nurses and children with symptoms. Screening and management of sick students, teachers and other school staff.
• Enforce the policy of “staying at home if unwell” for students, teachers or school staff with symptoms. If possible, connect with local organisations to provide home care support and ensure communication between home and school.
• Create a checklist for parents/students /staff to decide whether students /staff can go to school, and with due consideration for the local epidemiology of Covid-19.

The checklist could include:

• Underlying medical conditions and vulnerabilities, to protect the student/staff.
• Recent illness or symptoms suggestive of Covid-19, to prevent spread to others.
• Special circumstances in the home environment, to tailor support as needed.
• Special considerations regarding school transport as needed.
• Waive the requirement for a doctor’s note to excuse absences when there is community transmission of Covid-19.
• Consider daily screening for body temperature, and history of fever or feeling feverish in the previous 24 hours, on entry into the building for all staff, students and visitors to identify people who are sick.
• Ensure students who have been in contact with a Covid-19 case stay home for 14 days. The school officials should notify public health authorities in case of a positive Covid-19 case.
• Establish procedures for students or staff who have symptoms of Covid-19 or are feeling unwell in any way to be sent home or isolated from others.

The World Health Organisation (WHO) has offered a number of considerations for the reopening of schools during the Covid-19 pandemic through a supporting policy offering the following guidelines to help decision-makers, to help schools monitor the situation once they reopen:

As protective school measures are applied, it is important to monitor a range of factors such as:

• Effectiveness of tele-schooling interventions.
• How well has the school been able to develop tele-schooling strategies?
• What proportion of children were reached?
• What is the feedback from students, parents and teachers?
• The effects of policies and measures on educational objectives and learning outcomes.
• The effects of policies and measures on the health and well-being of children, siblings, staff, parents and other family members.
• The trend in school drop out after lifting the restrictions.

Inclusive and early collaboration between the school and the community is needed to develop and implement necessary measures. It will be important to maintain flexibility and modify approaches as needed, and to ensure learning and sharing of good practices.

Completely closing schools without putting in place context-appropriate distance learning methods, wherever possible, and adaptive strategies to reduce potential harm may not be the best or only solution and should only be considered when alternatives are not available.

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