Pakistan, like many other countries around the world, is experiencing its second wave of Covid-19 infections. The number of new cases recorded on November 24, 2020 was 3009 as compared to August 31, 2020 when the number of new reported cases was 313. With these statistics, it is incumbent upon public health experts to provide clear evidence-based guidance to communities on measures that can be taken to limit the spread of infections, and to relieve the pressure on our health services.
It is noteworthy that Pakistan has fared relatively well in terms of its recovery rate, which is currently 87%, and a low mortality rate of 2%. This does not mean that the situation in Pakistan is not urgent, rather that with the right combination of interventions we may be able to flatten the curve, limit the onset of new infections and mitigate the risks to the resulting social, educational and economic hardships that are a consequence of the pandemic.
Throughout the country, stringent measures of smart lockdowns have been enforced recently. The government has been monitoring the situation closely and one of the measures was to announce the closure of schools, colleges, and universities across the country. This is the second time that educational institutes across Pakistan are shutting down. The first closure happened in March 2020 and lasted until September 2020.
The first school closure gave us valuable insights on how disruption of education during the pandemic can result in loss of learning and reduce safety nets for many children. This time round, we have more information about the risks that children face with respect to health and learning as well as experience, both national and global, on how to minimise these risks and allow schools to remain open safely.
Firstly, based on the limited data that we have available, children infected by Covid-19 form a limited 2% of the total number of cases. The perception that child-to-child transmission can occur in schools even when standard operating procedures are being properly observed is not substantiated; additionally, transmission is also dependent on the viral load.
The susceptibility of being infectious seems to be lower in younger primary school aged children. Evidence is also lacking when it comes to the idea that schools may be “hot-spots” when it comes to spread of infection in premises where SOPs are being adequately observed. Studies suggest that children less than 10 years of age are less susceptible and less infectious than older kids.
We also saw that as schools were being prepared to close down across Pakistan for a second time, public gatherings in the form of political rallies and recreational get togethers were still taking place in the country. These may perhaps explain the rise in cases that we now observe.
With this information at our disposal, it is important that we resist the easy urge of going with blanket school closures without looking at alternative strategies. If not handled responsibly, our children may end up paying a high price when it comes to their education and future prospects.
Pre-Covid, we had an estimated 22.8 million children aged 5-16 years out of school — the world’s second highest number — with girls, children from poorer households and those in rural communities at greater risk of not being able to attend school. Additionally, lack of access to high quality education further impacts future economic opportunities for individuals and our human capital development as a country. At a time like this, school closures will only serve to exacerbate educational inequalities in our society, particularly when many of the resources required for home learning are not uniformly accessible to families across the country. For example, according to the Inclusive Internet Index 2020, access to the internet is only available to 78 million users. It is also noteworthy that 65% of the population in Pakistan lives in rural areas which lack the infrastructure to benefit from digital education. Without greater investments to ensure access to digital services, is home learning a viable option for all children?
Alternatively, we can learn key lessons from the re-opening of schools in September in Pakistan and elsewhere to consider how to keep children in schools safely. Following strict preventive measures in school settings has proven to be an effective tool. Studies from countries which went ahead with re-opening schools without following safety guidelines reported significant increases in infection cases. In contrast, countries such as England, which initiated enhanced surveillance, reported fewer number of cases in children and contact-tracing linked to staff members.
The way ahead for Pakistan to secure the educational future for all children is to give increased attention towards implementing evidence-based safety protocols in schools. Based on current evidence, it may be feasible to keep primary schools open with protocols such as wearing masks, regular handwashing, enforcing social distancing and ensuring appropriate ventilation in classrooms.
For children older than 10 years, when susceptibility to Covid-19 infection begins to increase, hybrid models such as staggered returns and phased classes in addition to compliance to wearing masks and other safety measures may be viable.
For adolescents and young adults, given the higher risk of infections, closures of colleges and universities for the time being as we battle against increasing infection rates in communities is necessary. However, efforts to improve equitable access to remote and digital learning for all need to be made.
Dealing with Covid-19 has given us valuable lessons for every sector. Our greatest lesson as human beings has been to adapt to the changing circumstances and to protect one another. Our current systems of health have been forced to improve and innovate at speed. Educational systems worldwide, with very little time, have made significant leaps to benefit the next generation. It is now time to collaborate and coordinate health and education efforts to ensure that both the lives and the future of our children are not jeopardised.