In the reminder of the period of the pandemic of COVID-19, schools in the State of Delhi, in mid-November 2024 – as part of the Leveled Response Action Plan (GRAP) to deal with air pollution, which is triggered when the Air Quality Index (AQI). ) is “poor” – has been asked to switch from physical to online mode. While other restrictions imposed as part of GRAP may have an impact on air quality, the decision to switch schools to online mode should be examined for scientific reasons, practicality, and benefits and risks.
Poor air quality in many northern Indian states is dangerous for all age groups and not just children. The harmful health effects of poor air quality are on a continuum since the AQI crosses the normal range. Children (and everyone in any age group) should be protected from poor air quality when the AQI crosses 50, which is considered ‘good’ air quality according to Indian norms. However, there are only a few days in a year when the AQI is within acceptable limits. In 2024, so far, there has not been a single day with ‘good’ air quality in Delhi; there will only be one ‘good’ air quality day in 2023. Also, don’t believe that an AQI over 400 (classified as ‘severe’ or ‘worsening’) is dangerous and anything below that is not. This arbitrary and high cut does not help unless it inadvertently normalizes the harmful health effects of air quality in the 51 to 399 AQI range.
More importantly, most children in Delhi or other parts of the country have the same air quality at home or at school. For some disadvantaged children, the air quality in the classroom may be better than at home because many schools have air purifiers. The idea of ​​having online classes because the poor AQI makes all children have additional losses due to loss of learning and loss of nutrition (because many children eat lunch at school), while there is no break from the health impact.
It is common knowledge that online classes are not a substitute for school based learning and the only thing that benefits here are EdTech platforms and Apps. Then, younger children should not be exposed to screen time. Therefore, when forced to attend an online class, they will engage in more harmful behavior than any benefit they may or may not feel. In the three years of the COVID-19 pandemic, we have all learned that school is not a place where children only read books; there is life learning. Therefore, the focus should be on maintaining the function of the school and ensuring the continuity of learning. There is an article related to this, in this daily, by one of the writers: “The pathology of school closures in India”, February 16, 2022.
The oversold idea of ​​a face mask
Poor air quality almost always causes face mask problems. Even before GRAP stages III and IV recommended the suspension of physical classes, some schools sent advice to parents that children must wear face masks in order to enter school. Although there is a claim that the admonition is to give guidance, but what is forgotten is that the admonition from the school is an ‘informal mandate’ for children and parents. Such uniform advice for all children to wear face masks is not supported by science. As for children, even in the COVID-19 pandemic, masks are not recommended for children younger than five years old for various scientific reasons and using empirical data. For those six to 11 years old, masks are recommended (and not required). There is no reason for anyone to wear a face mask if the set-up has an air purifier. In short, face masks that use guidance for children must have a different and special approach. Therefore, schools should refrain from publishing such advisory, which should come only after guidance from medical experts.
Use a science-based approach
First, schools should not switch to online classes, regardless of AQI level. The focus should be on maintaining the functioning of the school and ensuring the continuity of learning. This can be done with some mitigations such as stopping all outdoor activities in schools when the AQI is low. Everyone should take appropriate personal protective measures, such as using cleansers and face masks, taking recommendations based on age, and existing health problems. People with pre-existing respiratory health problems may benefit more from wearing a mask, especially in polluted and open areas.
Second, to enter school, there is no need for uniform instructions to wear a mask. Schools are not sources of pollution. Arguably, the air quality in schools is the same as in children’s homes. Therefore, it makes no sense to do anything different at school than you do at home. So, if children and parents wear face masks at home, they can also wear masks at school. Otherwise, there is no need to wear an additional mandatory mask. You should remember that face masks can also have negative effects such as causing skin allergies and other discomforts. So, one should keep in mind the benefits and risks involved. In addition, except for medical recommendations, children younger than 12 years old should not wear N95 masks. During a severe or higher AQI, children with existing health problems or other parents who wish to keep their children at home, should be given the option to ‘opt out’ of physical education classes, and other children should have the opportunity for continuous learning.
Third, in schools or other settings with functional air purifiers, wearing a mask will provide no additional benefit. For these settings, for example, schools, ensuring that classroom doors and windows are properly closed and turning on air purifiers at least one hour before children arrive will ensure ‘good’ air quality.
Fourth, ‘online school’ is an oxymoron – it’s not a school if it teaches online. The choice of a hybrid classroom should not be interpreted lightly by schools. In addition, in addition to air quality, there are other reasons such as fog or winter days, for which many sports schools are the reason to switch to online or hybrid classes. This should be actively discouraged and teaching should be in physical mode for all parents, who are willing. In fact, it is problematic that school classes are often called ‘offline’ or ‘online’, making electronic devices the center of teaching and learning. We need to break this way of thinking. Therefore, in the future, if and when the government or any authority fails children by ordering them to switch to online classes, the management in each school must create an innovative approach to ensure that learning is not in front of mobile phones or computers. screen.
Fifth, poor air quality is a reminder that anyone with pre-existing health or respiratory problems should take care of their health. This means regular checkups and regular visits with your health care provider. Preventive interventions such as annual influenza vaccination or age-advised vaccines such as pneumococcal, measles, Haemophilus influenzae Type b (Hib) are given to those who need them.
Policy should be people-centric
From a larger societal perspective, most of the actions recommended as part of GRAP, adversely and disproportionately, impact the poor and vulnerable in terms of wages (for the poor and minors) as well as learning and nutrition disadvantages (for children ). . This is a reminder that anything done in the name of policy must have a people focus and be pro-poor. Air quality and school functioning require a different approach. India has had one of the longest school closures during the COVID-19 period and we need to learn from that mistake. There is another article about this, in this daily, by one of the writers: “Rebuilding to prevent learning disasters”, April 28, 2022.
Schools are not a source of air pollution. However, there are greater losses than benefits from school closures. While there are legitimate reasons to implement other measures in GRAP to improve AQI, closing schools for physical classes does not make sense. This has been the case for the past eight years, but now is the time for school functions to be unrelated to GRAP measures. Nelson Mandela said, “There is no clearer revelation of the soul of a society than the way it treats its children.” When it comes to air quality and school functioning, Indian States and society seem to be failing in their responsibilities and duties.
Dr. Chandrakant Lahariya is a medical doctor specializing in early childhood development, lifestyle diseases and preventive medicine. He has over 16 years of work experience with the World Health Organization and UNICEF. Dr. Randeep Guleria is the former Director of All India Institute of Medical Sciences (AIIMS), New Delhi and a specialist in respiratory medicine.
Published – 28 November 2024 12:16 IST
