CONTEXT 

• Schools began opening in a phased manner across several Indian States including the state of Delhi, Uttar Pradesh on September 1.  
• There have been debates about the opening of schools in the midst of a COVID-19 pandemic.
• These have focused on the balance between minimising the risk of disease for children and their family members, and maximising in-person schooling. 

MATHEMATICAL MODELS

• The model used is based upon the various assumptions. It assumes schools as embedded within communities that comprise families of different sizes.  If schools are open, children move between their homes and schools. Children stay at home if schools are closed. Adults go to work at assigned workplaces or stay at home.
• The distribution of ages in the community is based on the age structure of the population in a typical mid-sized Indian city.
• The present model has taken into account non-pharmaceutical intervention including masking and level of prior infection in the community, as measured by serological surveys, possibilities of asymptomatic, mild and severe disease, as well as hospitalisations and deaths which vary across different age groups. 

FINDING OF THE MODELS 

Following are the observations of the model

• an increase in cases in children is expected as schools are opened, relative to keeping them closed.
• However, this will not lead to a new wave under the current epidemic conditions in India as most of the population specifically in the northorth have been already exposed.
• Also Children are at lower risk of severe disease associated with COVID-19 and very few of these infections are likely to lead to complications.  
• Further increase in the infections among children can be restricted by ramping up immunisation, by continuing non-pharmaceutical interventions, including requiring face masks, improving ventilation, shifting more activities to outdoor venues, and increasing the number of students attending school slowly over a period of several weeks until we achieve an overall seroprevalence of 75%-80%, adding numbers from recent infections and from vaccinations.
• Model also found that opening schools was not likely to contribute to an increase in cases among older individuals. 

INTERPRETING MODELS

• Keeping children at home during Covid has not served the purpose as Seropositivity levels in children are comparable to those in adults. If children are as likely to pick up an infection from the community while staying at home, there is little reason to keep them out of school.
• Report also emphasises that there is a need for prioritising the vaccination of family members, especially elderly ones, of school-going children as well as of teachers and other school staff. 

WAY FORWARD

• It is true that models are imperfect guides to the future, especially because they must make assumptions about human and virus behaviour, they provide useful tuition.
• With COVID-19 and schools, the trade-off is between the long-term consequences of disruptions in learning and socialisation in children and the short-term possibility of their contracting an infection.
• Finding the right balance between these two factors is crucial. Given the state of the Indian epidemic as well as the likely possibility that COVID-19 will transition into endemicity, there seems to be little reason to continue to have schools closed. This should be true especially in States and communities where seropositivity is in excess of 80%.
• Also there is a need for a state specific approach for states like Kerala and Maharashtra.  where there are low seropositivity rates.  
• There should also continue study about the spread of COVID-19 over the next six months to understand how quickly immunity due to prior infection wanes over time.
• Comparisons to other countries are not particularly helpful. The decision to open school should be by local authority and should be  guided by the principle that if the positivity rates exceed a preset bound. 
• There is also a need to sustain the current uptick in vaccination which will be helpful in ensuring that children return to school. 

Reference:

1. https://www.thehindu.com/opinion/lead/the-prognosis-for-school-reopenings/article36236989.ece