Resuming in-person classes: Pediatricians weigh in

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MANILA, Philippines — In-person classes in low-risk areas for COVID-19 infections are possible because children are unlikely to be a major source of transmission, according to a pediatric infectious disease specialist.

“However, there are many things to think about” before schools reopen, said Dr. Maria Liza Antoinette Gonzales, associate dean of faculty and students at the University of the Philippines (UP) College of Medicine.

“Although we do know that children get mild disease or are not as susceptible to [COVID-19 infection]However, they can still get the infection, Gonzales said in her presentation at a UP-hosted webinar on Friday titled “COVID-19 in Children.”

“Before we reopen [schools], we must consider: is there an ongoing community transfer? Are the teachers vaccinated? Is the infrastructure of the schools prepared, with sufficient ventilation and sufficient space to ensure that children have sufficient physical space?” said Gonzales.

‘Domination of infection’

According to Gonzales, children generally get a mild form of COVID-19 and account for only 1 to 10 percent of coronavirus cases worldwide.

But she also cited a study published April 21 in the British medical journal Archives of Disease in Childhood, which examined pediatric COVID-19 cases involving 9,335 children.

Gonzales said, “the findings were consistent with previous reviews that identified the prevalence of infection in school-aged children with mild male predominance. [but] low hospital admissions and death rates.”

“Comorbidities were reported in approximately 30 percent of immunosuppressed cases[,] and [with] lung disease as [among] the most common reported comorbidities,” she added.

Thus, children may still be at risk for more serious outcomes due to underlying comorbidities related to severe or critical illness, Gonzales said.

In the Philippines, an online registry of epidemiological data in children – posted on the website of the Pediatric Infectious Disease Society of the Philippines – recorded only 972 pediatric COVID-19 cases from July 3, 2020 to May 31, 2021, or a period of nearly 11 months.

Of these cases, 25.4 percent were 1 to 5 years old; 18.9 percent were 11 to 15; 16.3 percent were 6 to 10; 15.8 percent were 1 to 11 months old; 12.9 percent were 16 to 18 years old; and 10.7 percent were less than 30 days old.

‘Disruptions’

dr. Jocelyn Eusebio, president of the Philippine Pediatric Society, agreed with Gonzales that “[W]e should always start with pilots [in-person classes] initially in certain low-risk areas and to ensure that schools have the facilities for all safety measures to be followed.”

She noted that “about two days ago, the Ministry of Health convened child health experts with educators and some other stakeholders and we discussed reopening classes.”

Despite the risks of giving face-to-face classes, Gonzales said there are many benefits to resuming them, as Filipino children were already suffering mentally from a prolonged period of distance learning.

She emphasized the urgency to address issues that could negatively impact children’s health and well-being as they remain homebound during the pandemic.

“Disruptions in children’s normal routines are likely to affect their health whether or not they are infected with COVID-19,” Gonzales said.

“Now is the time to maintain a trusting relationship and open communication with children, even as it becomes the government’s duty to provide security to those families in need of economic and social support,” Gonzales said.

President Duterte has repeatedly rejected proposals to resume in-person classes, citing the need for the general population to achieve herd immunity to COVID-19 first.

Undersecretary of Education Diosdado San Antonio said the Department of Education respected the president’s decision “by putting the health and safety of children and Filipinos first.”

“We are respectful and we agree that the health and safety of children and our fellow teachers is more important than making [in-person] classes, even if they are done on a limited scale,” he said.

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