ANNALS OF IBADAN POSTGRADUATE MEDICINE
The Annals of Ibadan Postgraduate Medicine (Journal of the Association of Resident Doctors, U.C.H. Chapter) is published bi-annually.
O.S. Ilesanmi1,2 and A.A. Afolabi1
The global spread of the novel Coronavirus disease (COVID-19) has necessitated the implementation of non-pharmaceutical public health measures globally, including school closure. After five months of school closures, the Nigerian government is planning towards the suspension of school lockdown. However, in a bid to ensure that schoolchildren are academically equipped, and measures such as adequate ventilation, handwashing, social distancing, and increased infrastructure need to be implemented to ensure that school reopening does not result to a spike in COVID-19 cases and fatalities in Nigeria.
Keywords: Coronavirus, COVID-19, School closure, School reopening, Infection prevention and control, Nigeria.
Dr. O.S. Ilesanmi
Department of Community Medicine,
College of Medicine,
University of Ibadan,
The global spread of the novel Coronavirus disease (COVID-19) has necessitated the implementation of non-pharmaceutical public health measures globally, including school closures (SC).1 The reduced ability to adhere to infection prevention and control (IPC) measures further necessitated the implementation of SC in the COVID-19 era. Nigeria reported her index case of COVID-19 on February 27, 2020, and implemented SC barely three weeks after this period.2 SC has affected nearly 1.6 billion students globally, but has helped to maintain minimal levels of COVID-19 infection.3 The declaration of resumption of schools in September, 2020 by the Nigerian government emanated from a desire to reduce learning loss, reduce inequality, and enhance the realization of the Sustainable Development Goal 4: Inclusive and Quality Education.4,5 This study therefore aimed to assess the provisions of the Nigerian government regarding school reopening and the level of preparedness of educational institutions amid the COVID-19 pandemic.
Infection Prevention and Control System
The need for strong IPC system has been essential in the guidelines for the reopening of schools during the COVID-19 outbreak in Nigeria. IPC system have been described as vital to preventing spikes of infections in health facilities and educational institutions. Most Nigerian schools however have inexistent or weak IPC system. Most government and private-owned schools lack school clinics or dispensaries, while these facilities are not being used in others.6,7 Due to these reasons, ailing schoolchildren recurrently remain exposed to healthy children. In addition, most Nigerian schools lack IPC committees. How then can schoolchildren be compelled to abide by IPC measures which have been recommended for their safety? The pitiable state of IPC systems in most schools thus calls for the active involvement of stakeholders especially government personnel to make regular checks to schools and ensure the existence of IPC focal persons. School-based COVID-19 referral system and a statement of procedures for ailing schoolchildren would be required to assure of a horizontal system in the COVID-19 response.8
Water, Sanitation, and Hygiene Protocols Portable water supply is either lacking or inaccessible in many Nigerian schools.7 Also, the lack of standard toilet facilities in most schools have compelled “jungle” defecation in bush around or close to the school premise”.7 These circumstances do not encourage social distancing as schoolchildren visit such areas in groups of threes or more. Fumigation exercise has been done in many schools and face masks are being used in many schools. However, it should be known that fumigation is not a one-off event which kills SARSCov-2.9 Total compliance to the use of face masks is a necessity among defaulters of the use of face masks. In addition, compulsive handwashing has been disregarded following the partial reopening of schools. Handwashing practices have been discouraged as a result of the unavailability of water supply and the insufficient provision of soaps or alcohol-based hand sanitizers.2,6 If these basic necessities which are required to maintain the safety of the few ones in exit classes is lacking, how possible would scaling up of such provision be done for the entire schoolchildren?
Social Distancing in Classrooms
A minimum distance of 2m has been specified between learners in educational institutions in halls, dining areas, and classrooms during the COVID-19 outbreak.4 Exceptions were however for primary school children among whom social distancing may seem impossible. In this regard, the organization of learners into small groups to be overseen by teachers has been recommended.4 The adoption of small group learning in the reduction of COVID-19 associated risks seems unlikely due to the lack of sufficient human resources. In addition, the unavailability of basic learning equipment such as single chairs and desks to serve each child does not support social distancing practices when schools get reopened.2,6
Instances of the use of public transport system for conveying chairs and desks from home could exacerbate the risk of community-wide transmission of COVID-19 among schoolchildren.10 Furthermore, many Nigerian schools are overcrowded and lack adequate ventilation systems. It is therefore required that all schools get equipped with single chairs, desks, and improved ventilation systems to calm the fears on many minds regarding the reopening of Nigerian schools during the COVID-19 outbreak. In other circumstances, recruitment of more teachers, and the adoption of outdoor learning, platooning of learners into morning and afternoon shifts, or alternate attendance may be worth considering.