The campaign to vaccinate school-aged children is not slated to intensify until the third week of September, which means that its effects will make themselves felt near the end of November. In the absence of a vaccine approved for children under 12 years of age and the lack of compulsory vaccination for children over 12, only non-specific prophylactic measures can be applied in schools: room ventilation, masks, testing, social distancing, and disinfection.
As the new school year begins, the COVID-19 outbreak is once again gaining momentum. We are in the early stages of a fourth wave, and the vaccination rate among society is still too low to stop it. Questions remain: How high will this wave surge, and how many people will as a result face the delayed effects of an initially mild illness? How many will struggle with respiratory failure in hospital wards, or finally, how many lives will it take? Only urgent and decisive action taken right now can minimize the effects of the fourth wave. Every day of delay will translate into human tragedies.
In Poland, 50% of the population has already been vaccinated. Between the ages of 12 and 18, 24% of children have been vaccinated. Among their parents, relatively meager success has been achieved after months of campaigning to promote getting vaccinated. For example, the share of vaccinated individuals among those aged 25-49 stands at 30% in the Podkarpackie Province, 31% in the Lubelskie Province, 33% in the Świętokrzyskie Province, and 34% in the Warmińsko-Mazurskie Province. Thus, it can be assumed that the vaccination drive among school-aged children in these provinces will not yield results that might significantly lower the degree of pupils’ susceptibility to infection with DELTA SARS-CoV-2. The highest vaccination rates in the same age category can be found in the Mazowieckie Province (50%), followed by the Wielkopolska Province (46%) and the Dolnośląskie Province (45%). The level of vaccination rates is therefore very different in different regions of the country. We should sound the alarm especially in areas where the vaccination level is relatively low. There, the fourth wave, whose main infectious factor will be DELTA SARS-CoV-2, may have particularly dangerous consequences for the functioning of schools and of course also for the health of those in them.
Schools are particularly likely to see a surge in SARS-CoV-2 infections in the fall, as we already know that previous variants of the virus, which were less infectious than DELTA SARS-CoV-2, did affect children and adolescents. Serological testing methods have shown that more than 40% of children and adolescents had already experienced a SARS-CoV-2 infection before the summer vacation period began. So far, they only rarely presented COVID-19 symptoms, so it has mostly gone unnoticed. With DELTA SARS-CoV-2, this situation may be changing. Infection with this virus variant spreads particularly easily in confined spaces with large groups of people and is more likely to cause severe symptoms. With this variant, children may be more severely infected and more likely to develop cases of pediatric inflammatory multisystem syndrome (PIMS, MIS-C). Children may also transmit the infection to parents, siblings, grandparents, and friends. A similar source of infection may be school staff, especially those who are unvaccinated – which means about 20% of them. The effect of the end of the summer vacation period was also observed last year. Therefore, it is certain that the start of school classes for 4.5 million pupils will also bring a significant increase in the intensity of the epidemic this year.
DELTA is a variant of SARS-CoV-2 slightly different from earlier ones. It is spread more by the airborne route and less by the droplet route, so the priorities for individual prevention efforts should be somewhat different than before. First of all, intensive ventilation of school rooms, even at the cost of children and teachers having to function in warmer garments at school on particularly cold days. Ideally, the windows should be kept open or distinctly ajar during lessons. A constant influx of fresh air dilutes virus-contaminated air and means that infections do not occur so easily. The second thing we strongly recommend is the wearing of masks. However, it is important that masks should be worn correctly – with the mouth and nose covered. Moreover, masks should be replaced twice a day with new or clean ones, and used disposable masks should be disposed of at school after the ear-straps are properly cut. A third extremely important practice should be to ensure that even in the case of the mildest cold symptoms (fever, the appearance of a runny nose) the pupil will remain at home or be sent home. We also recommend that rapid, certified antigen tests be donated to schools. This will allow testing of students who have even minor symptoms or have had contact with people with the infection. Rapid tests could be used here. Perhaps group tests using saliva samples (e.g., Sonar Anti-CoronaVirus) could also be used in schools for testing. These are less disruptive and less expensive. Adherence to the above principles is what seems most important to us at this time.
In UK schools, among the relevant recommendations, ventilation has been given first priority, post-contact testing second, and masks third. In South Korea, strict rules of conduct are followed in schools: temperature checks at school entrances, rigorous ventilation of the premises, a rule of maintaining a distance of at least 1 m between persons. Masks are to be worn at all times while in school, except when eating a meal, which is to be done in silence. In France, on the other hand, the work of schools has been planned according to the following rules: masks are changed twice a day and provided by the school; hand hygiene is obligatory; sports and other activities requiring contact without a mask are cancelled; masks are obligatory on the way to and from school, on public transport and at bus stops. These are just three examples from among many. Everywhere, the functioning of schools in the traditional form is recognized as a priority value. We have already written about the costs of remote learning in our Position Statement #10: “Implications of the COVID-19 pandemic for the mental health and education of children and adolescents,” which we released on 25 January 2021. We stand by the conclusions of that position statement and make an even stronger appeal for applying the principles outlined above in schools: Ventilation, Masks, Testing (VMT). We should also not forget in schools to observe an appropriate distancing between people, to wash our hands as often as possible and to disinfect surfaces.
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 chaired by Prof. Jerzy Duszyński, President of the PAS, with Prof. Krzysztof Pyrć (Jagiellonian University) as deputy chair and Dr. Anna Plater-Zyberk (Polish Academy of Sciences) as its secretary. Other members of the team are:
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