The reopening of schools in the middle of a pandemic is considered to pose a high risk of Covid-19 transmission because children are vulnerable to contracting and transmitting the coronavirus that causes the disease.
By
KOMPAS TEAM
·7 minutes read
KOMPAS/SUCIPTO
A child cries as a health worker in PPE takes a nasopharyngeal swab sample during a mass testing program on Thursday (30/7/2020) at Rapak Market in Muara Rapak village of North Balikpapan district in the city of Balikpapan, East Kalimantan.
JAKARTA, KOMPAS – The number of Covid-19 cases in young people is increasing globally. Recent studies have shown that children under the age of five have greater levels of genetic material of coronavirus in their respiratory tract, which causes Covid-19, compared to older people. The finding should be taken into consideration in the plan to reopen schools.
"The latest data show that more and more children are suffering from Covid-19. This must be taken into account in the decision to reopen schools. Moreover, the Covid-19 infection rate in children in Indonesia is higher than the global average, " Yogi Prawira, head of the Covid-19 task force of the Indonesian Pediatric Society (IDAI) said in Jakarta on Thursday.
According to a study of the World Health Organization (WHO), of around 6 million Covid-19 infection cases found globally, the percentage of people aged 15-24 years who contracted the disease rose to 15 percent by July 12 from 4.5 percent on Feb. 24, while for children aged 5-14 the percentage rose to 4.6 percent from 0.8 percent previously.
A number of countries, such as the United States, Spain, France and Japan, reported that many of the new cases detected recently were young people.
The latest data issued by the Covid-19 task force on Thursday (6/8) showed an additional 1,882 new cases of Covid-19, bringing the total number of cases in the country to 118,753. Of the total, 75,645 patients have recovered and 5,521 patients have died.
The Covid-19 infection rate in children in Indonesia is higher than the global average
Of the total number of Covid-19 cases, the number of the children aged 0-5 years infected with the disease accounted for 2.3 percent, while those aged 6-18 years accounted for 6.8 percent, aged 19-30 years (23.3 percent), aged 31-45 (31.4 percent), 46-59 years (24.5 percent) and over 60 years (11.6 percent).
While cases of infants aged 1-5 years who died of Covid-19 in Indonesia accounts for 1 percent. Infants under one year of age are more vulnerable to death with a fatality rate of 4 percent, compared to those aged 1-18 years whose fatality rate is only 1 percent. The number of cases of children aged 6-18 years who died due to Covid-19 accounted for 1.1 percent of total Covid-19 deaths, aged 19-30 years (5.1 percent), aged 31-45 years (15.3 percent), aged 46-59 years (38.7 percent) and over 60 years (38.8 percent).
A teacher of tidies up a stack of homework folders containing student assignments on Wednesday (5/8/2020) at a drop-off point in front of SDIT Ibnu Sina Duren Sawit Islamic integrated character-building school in East Jakarta. The school holds online classes and assigns homework every two weeks for distance learning (PJJ) during the large-scale social restrictions (PSBB) in Jakarta, which still does not allow in-school classes.
The child fatality rate due to Covid-19 in Indonesia is high. Ourworldindata.org data managed by Oxford University and the team said that in South Korea, China, Spain and Italy, no children aged 0-9 have died from Covid-19. Meanwhile, children aged 10-19 years who died from Covid-19 in the four countries accounted for 0-0.2 percent of Covid-19 deaths.
"The proportion of children (5-14 years) infected with Covid-19 globally is less than 5 percent while in Indonesia the number of is 6.8 percent, meaning that children in Indonesia are more vulnerable. In fact, children mostly stay at home. What will happen if many schools are reopened? " Yogi asked.
Likewise, the child fatality rate in Indonesia is higher than those in other countries. "This is because we already had child health problems even before the pandemic, including malnutrition and obesity. Pneumonia is the main cause of the child death in Indonesia, “he said.
With the consideration of child health and safety, IDAI opposes the government\'s plan to immediately reopen schools. "The peak of the first wave is not yet visible. The number of new cases is still rising, including those of children. I treat children who suffer Covid-19 and 80-90 percent of them were infected by the adults around them. Some of them are in critical condition, "he said.
The epidemiological requirement – such as that Covid-19 transmission be under control – is a must for reopening schools. "We do not agree with the zoning system. Does the zoning system guarantee that children or teachers from the red zone are not allowed to go to schools in the green zone areas? As long as there are no restrictions on people’s movement from one to other regions, the zoning system is meaningless,” said Yogi.
Children wear masks and a face shield on Thursday (6/8/2020) as they study outdoors on the bank of Ciliwung River in Kampung Kebonjukut of Babakan Pasar village in Central Bogor, West Java. The students headed to the riverbank to get a good mobile signal outside the dense settlement, so they can download their schoolwork, and then headed back to one of their houses to continue studying together. Many students study in small “pods” like this one, as not all have digital devices or internet access.
Susceptible to infection
Apart from being susceptible to infection, children can also transmit Covid-19 to other people. "WHO emphasizes that children can be infected with Covid-19 and transmit the disease to other people," said Dicky Budiman, an epidemiologist from Griffith University.
Many studies show that the closure or opening of schools has a relationship with the infection and fatality rates. This is detailed in a study conducted by Katherine A Auger of the University of Cincinnati, Ohio and her team and published in The Journal of the American Medical Association (JAMA) on July 29, 2020. According to the study, school closures in the US on March 9 to May 7 reduced the number of cases and deaths due to Covid-19. The number of cases fell 62 percent per week and deaths decreased 58 percent per week.
The latest study carried out by Taylor Heald-Sargent from Northwestern University Feinberg School of Medicine, Chicago and his team showed that children who tested positive for Covid-19 with mild to moderate symptoms had viral loads or concentrations of the SARS-CoV-2 virus in the respiratory tract as high as adult people. In fact, children under five have higher viral loads than older children and adults.
The study, published in the journal JAMA Pediatrics on July 30, 2020, states that children have the potential to drive the spread of SARS-CoV-2. In addition to the implications for public health, the early childhood population needs to be taken into account for immunization targets when a SARS-CoV-2 vaccine becomes available.
The deputy for education and religious coordination at the Office of the Coordinating Human Development and Culture Minister, Agus Sartono, said that the reopening of schools would begin in areas that have limited access to online learning. About 450,000 schools do not have access to electricity and the internet. It must be ensured that these regions have a low risk of the Covid-19 transmission.
According to the plan, the technical procedures for the reopening of schools will be announced on Friday (7/8). "If the health protocols for Covid-19 prevention can be strictly implemented, the schools can be reopened, not only areas categorized as green zones, but also in the yellow zones in the smallest unit of territory, namely the village, "he said.
Students use their mobile devices to complete their schoolwork online on Thursday (6/8/2020) in Jambu district of Semarang regency, Central Java.
However, there are challenges in the reopening of schools, especially related to the risk of the Covid-19 transmission to children on the way from home to school.
For that, school reopening must undergo a strict evaluation. The reopening of schools must start from a higher level of education, namely SMA senior high schools and SMK senior vocational high schools. Early childhood education is not recommended for opening. "Student learning hours and the number of students will be limited to 25 percent seating capacity. Make sure the health protocol, from the use of masks to the provision of hand washing facilities, is implemented, "Agus said.
The secretary general of the Association of Home Schools and Alternative Education, Anastasia Rima, said many parents and teachers misunderstood online learning or distance learning (PJJ). According to the Education and Culture Ministry’s Circular No. 4/2020, teachers and parents should not focus on academic achievement in online learning but on life skills.
Student learning hours and the number of students will be limited to 25 percent seating capacity.
According to Agus, the government’s policy to impose sanctions against violators of health protocols has helped prevent Covid-19 transmission during the transition period for the full reopening of schools. The sanctions are stipulated in Presidential Instruction No. 6/2020 concerning the improvement of discipline and law enforcement related to health protocols in the prevention and control of the Covid-19 transmission.
The chairman of the Indonesian association of public health experts, Ede Surya Darmawan, said the Home Affairs Ministry needed to ensure that each regional head immediately issued implementing rules for imposing sanctions against health protocol violators. Without the rules, sanctions cannot be imposed.
Meanwhile, the phase III clinical trials for the Covid-19 vaccine candidate produced by Sinovac from China will be held in Bandung starting Tuesday. (11/8). (AIK/ TAN/ TAM / MED)
/https%3A%2F%2Fkompas.id%2Fwp-content%2Fuploads%2F2020%2F08%2F20200730CIP06_1596727501.jpg){kind=logo}
