How to reopen schools after the Covid-19 emergency?

The experience of the Covid-19 pandemic has been dramatic and especially the youngest children have suffered isolation the most due to lockdown measures: now it is necessary to understand how to get back to class safely. UniboMagazine talked about it with the pediatrician Marcello Lanari, director of Emergency Pediatrics Unit and A&E of the Sant’Orsola University Hospital, and with Maria Pia Fantini, director of the School of Specialization in Hygiene and preventive medicine.

The closure of schools was one of the first measures implemented on a large scale to contain the spread of the contagion from Covid-19 in Italy, with the didactic activities continuing at a distance during the lockdown. In view of the next school year, attention is now focused on how to organize the return to class and what measures to implement to avoid a recovery of the infections.
A group of researchers from the University of Bologna has collected some useful data on the topic, offering a series of suggestions in an publication by the Italian Journal of Pediatrics, official body of the Italian Society of Pediatrics: indications for outlining a reopening strategy that will put at the center the social,
educational and psychological value of attending the school community, while ensuring the safety of children and their families, as well as of the staff who work there.

UniboMagazine talked about it with the two professors leading the research group: Marcello Lanari, Professor of General and Specialist Pediatrics of the Department of Medical and Surgical Sciences, and Professor Maria Pia Fantini, Director of the School of Specialization in Hygiene and Preventive Medicine of
the Department of Biomedical and Neuromotor Sciences
. Together with them, the students of UNIBO Chiara Reno and Giovanni Battista Biserni, and Elena Savoia from the Harvard T.H. Chan School of Public Health, signed the intervention.

Professor Lanari, starting from the health topic, what do we know about the spread of coronavirus among the younger population?
While taking into account the many uncertainties that still exist on the topic, the data we have available on cases of Covid-19 in the pediatric age show a high percentage of asymptomatic patients or with mild or moderate symptoms. In general, in these cases, healing occurs without any particular complications within a week or two and hospitalization is generally not necessary.

Numbers that are confirmed even if the gaze is focused on the Italian context?
Yes, the incidence of Covid-19 cases among children up to 9 years old both in Lombardy, Emilia-Romagna, and in Veneto is lower than in the rest of the population. Significant is the case of Vo ‘, in Veneto, one of the first outbreaks identified in our country, where the entire population was subjected to swabs twice and none of the 234 testes children between 0 and 10 years was positive. Our own experience has confirmed the presence of a few dozen infected minors and among them a very limited number of cases that required hospitalization.

Like everyone, even children, however, had to deal with the restrictive measures put in place to stop the pread of the infection, starting from the closure of schools: with what consequences?
For children, in particular the ones aged between 2 and 14, school is a very important part of their social life: it allows them to develop their sense of identity, belonging to a community and their personality. For this reason, the lack of interaction with their peers can lead to negative consequences such as anxiety, sleep-wake rhythm disturbances, depression, post-traumatic stress disorder: in addition, distance teaching, from this point of view and probably also from a training point of view, is not a sufficient alternative.
Without taking into account that large sections of the pediatric population have not been able to take advantage of it for various reasons, including the lack of technological means or internet connection, or the parental impossibility in supporting offspring. And last but not least, the not insignificant share of children with specific learning disabilities or disabilities who were unable to take advantage of support teachers.

Professor Fantini, now the priority is the return to class in September. What are the solutions to be adopted for a safe return?
A first measure could be the reorganization of classes in small groups of children in order to favour physical distancing. This solution implies also a rethinking of school spaces, starting from the common areas, and
possibly the introduction of differentiated shifts to ensure the presence of everyone in safety. Finally, of course, frequent sanitation of the school premises.

What can the role of teachers be in this new phase, also to guarantee the safety of children?
It would be important to train teachers by providing them with the necessary skills to identify and deal with possible signs of difficulties arising from the period of quarantine and isolation to which the children were subjected. In addition, teachers and parents must receive all the information necessary to identify and report quickly suspected cases of infection.

Can the experience of other countries that have chosen to reopen schools in recent months provide useful information also for the Italian context?
The case of Denmark, with small classes and physical distancing, is a good example, but also that of Japan, which has left autonomy to local authorities on the reopening based on the cases of Covid-19 recorded in the different areas of the country, can provide useful indications. In general, it is necessary to adopt a flexible approach, which can guarantee the necessary safety conditions, adapting from time to time to the individual local contexts and to the available resources.

This article is available in Italian: