Position Statement No. 2: On students returning to school in September 2020

No one knows what the COVID-19 pandemic in Poland will look like in a few months’ time. No one knows what the COVID-19 pandemic in Poland will look like in a few months’ time.

However, we need to posit forecasts based on experiences of other countries in order to prepare for possible scenarios depending on the rate of spread of the pandemc, known as the effective reproduction number R0.

1) Good, when R0 does not exceed 1.1;

2) Moderate, when R0 falls between 1.1 and 1.7;

3) Worst-case, when R0 exceeds 1.7.

In the worst-case scenario, even though we are currently accustomed to R0 remaining around 1.1, in a matter of weeks the value will start exceeding 1.7 and the pandemic will reach dramatic levels. It is possible that we are already seeing the first symptoms of this process, given that recent estimates show that R0 has increased to around 1.3.

Considerations which encourage us to take this scenario seriously are as follows:

1. The demands on the healthcare system show seasonal variation, and typically peak1. The demands on the healthcare system show seasonal variation, and typically peak in winter.

2. Given that adherence to sanitary precautions is likely to have relaxed over the summer months, we can expect a significant increase in COVID-19 cases with local and even regional hotspots.

3. The demand on medical professionals to focus on COVID-19 hampers their ability to care for patients with other health problems. This is likely to result in an increased number of cases of chronic or undiagnosed illnesses. Additionally, the difficulty indistinguishing between infection with SARS-CoV-2 and other viruses means that many people will be completely unable to access basic medical care. Research shows clearly that patients with comorbidities experience more severe symptoms of COVID-19,which leads to an increased number of patients requiring intensive care.

4. It is likely that seasonal influenza epidemics, typical in our region, and high rates of other viral and bacterial infections in autumn and winter (the co-infection effect),combined with other factors such as lowered immunity and increased air pollution,will make the course of the disease more severe in many patients.

This is why all three scenarios outlined above must be taken into consideration when planning social policies for the coming months.

When it comes to students returning to schools, it is important to recognize that the situation will not be the same as before the outbreak of the pandemic anywhere in the country,and that schools will not be able function the same way or with only minor adaptations. Weare fully aware that the disadvantages of children not returning to school are significant,not only in terms of the economy (parents unable to return to work to care for younger children),but also in terms of health (increased incidence of obesity, depression and anxiety)and children’s development. This is why are approaching the issue of children returning to school with great care. However, even in the most optimistic scenario (R0 remaining below1.1 in the coming months), which would mean the pandemic is maintained at a relatively low level, we recommend introducing mandatory mask-wearing for staff and at least older children in all schools.

In the event of the moderate scenario, we also recommend introducing increased distances between desks, creating bubbles of students who can be in contact with one another but not with those in other bubbles, delegating teachers to specific classes to prevent extensive transmission if the teacher becomes infected, limiting movement in common spaces (such as by introducing asynchronous breaks), airing all rooms during the day and disinfecting desks, door handles and any common items between all lessons.

Additionally, we recommend that the health situation in families of all students, teachers and other staff be closely monitored, and any confirmed COVID-19 infection in a given school should trigger carefully prepared sanitary procedures. Since testing all individuals may not be possible, we recommend using group and environmental testing methods which are currently under development by the PAS and associated researchers.

In the event of the worst-case scenario, schools in areas with relatively high pandemic levels which cannot maintain the strict sanitary regimes outlined above should return to remote teaching.

Education authorities should be working on recommendations for all schools in the event of all the scenarios outlined above, whereas schools, parents and students, sanitary institutions and local authorities need to make preparations for all cases. This will help head teachers make decisions based on clear guidelines, which should take the form of an algorithm for action in each given case to help maintain the highest possible functionality and ensure fast response times to local or regional events.

About the team

The Interdisciplinary COVID-19 Advisory Team to the President of the Polish Academy of Sciences was set up on 30 June 2020. The team is led by Prof. Jerzy Duszyński, President of PAS, with Prof. Krzysztof Pyrć (Jagiellonian University) acting as deputy. Dr. Aneta Afelt (University of Warsaw) is the secretary of the board. Other members are Prof. Radosław Owczuk (Medical University of Gdańsk), Dr. Anna Ochab-Marcinek (PAS Institute of Physical Chemistry), Dr. Magdalena Rosińska (National Institute of Public Health – National Institute of Hygiene), Prof. Andrzej Rychard (PAS Institute of Philosophy and Sociology) and Dr. Tomasz Smiatacz (Medical University of Gdańsk).