Guidelines for Return to Presential Classes: Consensus Proposal in Accordance with the National and International Health Regulatory Agencies ()
1. Introduction
The coronavirus disease pandemic (COVID-19) caused an unprecedented crisis in the area of education, causing the massive closure of classroom activities by educational institutions in more than 190 countries, to prevent the spread of the virus and mitigate its impact. According to data from the United Nations Educational, Scientific and Cultural Organization (UNESCO), by mid-May 2020, more than 1.2 billion students at all levels of education worldwide have stopped taking face-to-face classes. Of these, more than 160 million were students in Latin America and the Caribbean (UNESCO, 2020).
When entering the recovery phase of COVID-19, it will be essential to reflect on the role of educational systems and, particularly vocational education, in promoting resilient societies (WHO & UNICEF, 2020). The global health crisis and the ensuing blockade brought an unprecedented challenge to the professions, renewing awareness of its value to society. It also helped to restore a sense of esteem for those workers who struggled tirelessly during this time to maintain savings (WHO, 2020).
In this scenario, the pandemic exposed global vulnerability to crises and revealed how precarious and interdependent economies can be. It also resulted in natural diseases, political, economic and environmental disorder. Our ability to respond effectively and efficiently in the future will depend on government forecasting, readiness and preparedness (WHO, 2020).
Through their role in developing the competencies and skills needed for tomorrow’s society, education systems will need to be at the center of this planning (ANVISA, 2020). This includes rethinking how the economy should evolve to protect itself against adversity, and defining the skills, education and training needed. This also means working closely with other sectors of the government and the private sector to increase the attractiveness and prospects of the labor market for certain professions, including those considered essential for the common good (ANVISA, 2020).
The real change usually occurs in deep crises, and at this moment it keeps the possibility of not going back to the status quo when things are back to “normal”. Although this crisis has profoundly disruptive implications, including for education, it has no predetermined results. It will be the nature of the collective and systemic responses to these disruptions that will determine how we are affected by them (Brasil (SAPS), 2020).
In this sense, the pandemic is also a call to renew the commitment to sustainable development goals, ensuring that all young people have the opportunity to succeed in school and develop their knowledge, skills, attitudes and values. The current crisis has tested man’s ability to deal with large-scale disruptions. As a corollary, it is imperative to build a more resilient society (Brasil, 2020).
Therefore, the reopening of schools, colleges and universities during the COVID-19 pandemic represents a special challenge worldwide to ensure the safety of students and staff. The guidelines need to outline the creation of a task force at each university, risk screening based on the school, travel history, occupation, contacts and groups. Also, health self-management and quarantine measures, general hygiene measures (including the use of masks in indoor environments), principles of ventilation and sanitation, regulations on school assemblies, notification of suspicious cases and policies on closing schools and school classes replacement. Also, a class should be suspended if 1 student or employee tests positive and the school should be closed for 14 days if it has 2 or more confirmed cases (Cheng, Wang, Shen, & Chang, 2020).
In this way, the present work had as objective to propose a guideline of return to the face-to-face classes based on the main regulatory criteria of government agencies in Brazil and the world.
2. Methods
2.1. Study Design
The present study followed a review model of the main national and international public health legislation. After literary search criteria using the MeSH Terms that were cited in the item below on “Search strategies”, a total of 35 official documents from Brazi (ANVISA), WHO (World Health Organization) and scientific articles were submitted to the eligibility analysis and, after that, 16 documents were selected.
2.2. Search Strategy and Information Sources
The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, ScienceDirect Journals, Scopus, UNESCO, WHO and ANVISA website. MeSH Terms: Education. Face to face classes. Legislation. Monitoring. COVID -19, and use of “and” Booleans between MeSH terms and “or” among historical findings.
3. Development and Strategies
3.1. Guidelines for Gradual Return to Activities
• Controlled transmission of the virus.
• National health system with the capacity to detect, test, isolate, treat, and monitor the contagion network.
• Risk of outbreak minimized.
• Preventive measures are implemented in workplaces, schools, and places where the movement of people is essential.
• Risk of “importing” the virus under control.
• Society fully educated, engaged, and empowered to join new norms of social interaction.
• The decision of the appropriate time to reopen, in each location, is up to public authorities.
3.2. How to Return?
Figure 1 represents the main strategies according to the regulatory bodies in Brazil and the world, establishing several axes of decision making that are regulated by the Public Health Emergency Operations Center Network (EOC-NET) (WHO & UNICEF, 2020; WHO, 2020; ANVISA, 2020).
According to the process of economic reopening in Brazil and the world, the return to educational activities begins with the effective need to develop an action plan inherent to this resumption, gradually and safely, without prejudice to preventive and preventive measures. combating the COVID-19 pandemic. The resumption requires several strategic measures adopted by the executive powers of all spheres of power (federal, state and municipal), allowing at that moment the safe, but gradual, resumption of economic activity, reducing the harmful and collateral effects in terms of social inequality (Johns Hopkins University, 2020).
Also, the compatibility of these measures with the guidelines of the World Health Organization (WHO), the Ministry of Health (Brazil), and the regional and local health authorities about the response plan to COVID-19 and the biosafety guidelines and rules to be imposed for the gradual resumption of economic and educational activities (WHO, 2020; Brasil, 2010).
Besides, because Brazilian private institutions serve around 15 million students, being structured and built with investments from families, regulated and evaluated by governmental structures, it is essential to partner families not only in the formal education of their children, but as a structure of support so that fathers and mothers can develop their professional activities, promote their livelihood, especially when the more than 9 million students served in basic education are highlighted, with 2.5 million in early childhood education (Brasil, 2020).
In this scenario, it is essential to balance the variables involved, including seeking to ensure the safety of children in the school environment, following health and care protocols to avoid contagion with other children and adults. Thus, based on several government and private plans to resume face-to-face activities of schools and universities in Brazil and the world, a strategic plan for gradual and safe resumption is proposed. As an antecedent phase, it is necessary to follow the rules presented in Table 1 (WHO & UNICEF, 2020; WHO, 2020; Brasil, 2020).
4. Proposal for a General Protocol
Table 2 presents the proposals for a general protocol WHO & UNICEF, 2020; WHO, 2020; Brasil, 2020; Brasil (n˚ 5), 2020).
Figure 2 schematically represents the local monitoring action plan, as a possible model.
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Figure 1. Main strategies for returning to face-to-face classes. *Public Health Emergency Operations Centre Network (EOC-NET).
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Figure 2. Local monitoring action plan. Template for each educational institution. Source: Own authorship.
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Table 1. Norms of the previous phase.
5. Specific Protocols
HEALTH
Table 3 gathers the main protective measures for resuming safe, face-to-face classes about health (WHO & UNICEF, 2020; ANVISA, 2020; Brasil, 2020).
PEDAGOGICAL
Table 4 shows the main protective measures for resuming face-to-face classes in relation to the pedagogical proposal (WHO & UNICEF, 2020; WHO, 2020; Brasil, 2020).
LEGAL
Table 5 shows the main protective measures for resuming face-to-face classes about the legal proposal (WHO & UNICEF, 2020; Brasil (n˚ 1565), 2020; Brasil, 1988).
COMMUNICATION
Table 6 shows the main protective measures for resuming face-to-face classes about the communication proposal (Brasil, 1990).
MONITORING
Table 7 shows the main protective measures for resuming face-to-face classes about the monitoring proposal (Van Lancker & Parolin, 2020; Mangiarotti, Peyre, Zhang, Huc, Roger, & Kerr, 2020).
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Table 3. Protective measures for health.
Results of international studies that support the guidelines of the present study
Large-scale school closures have been implemented worldwide to stem the spread of COVID-19. However, the impact of the closing and reopening of schools on the dynamics of the epidemic remains with great challenges. Therefore, as scientific support, a study simulated the transmission dynamics of COVID-19 using a stochastic model based on individuals, incorporating social contact data of school-age children. Thus, assuming that children < 10 were half more susceptible to infection than older children and adults, it was estimated that closing schools prevented a similar number of infections (13,842 cases; 95% CI: 6290, 23,040) as closures workplaces (15,813; 95% CI: 9963, 22,617) and social distance measures (7030; 95% CI: 3118, 11,676). Under assumptions of moderate transmission in the community, it was estimated that the reopening of schools would increase symptomatic disease among high school teachers (an additional 40.7% should have an asymptomatic infection, 95% CI: 1.9, 61.1), high school teachers (37.2%, 95% CI: 4.6, 58.1) and elementary school teachers (4.1%, 95% CI: −1.7, 12.0). A hybrid learning approach with classes reduced to half 10 students may be required in high schools, while maintaining small groups of 20 students may be required for elementary schools (Head, Andrejko, Cheng, Collender, Phillips, Boser, Heaney, Hoover, Wu, Northrup, Click, Harrison, Lewnard, & Remais, 2020).
Another study analyzed the evidence that constitutes well-established scientific data and that can guide intervention policies and practices in the post-pandemic context. The outlets considered more obvious for the post-pandemic period, such as remote education, the use of technologies, and the increase in the workload, although they are being incorporated into the school’s daily routine with greater intensity, hardly contain the elements to help in the recovery most affected students. Thus, the most solidly based outlets in the literature include a diagnosis of students as a basis for the resumption of teaching programs. And, after that, robust and promising interventions must be carried out that include structured teaching, the use of appropriate literacy methods, the strategic use of homework, and reading programs. The best use of time is to reduce absences and intensive tutoring programs in small groups (Oliveira, Gomes, Matheus, Barcellos, & Thais, 2020).
Also, investments in Education must be increased, according to UNESCO, the natural drop-in learning may last for more than a decade if public policies are not created that invest in improvements in infrastructure, technologies, training, methodologies, and salaries, in addition to the reinforcement of school lunches, better use of time, tutoring outside the usual class hours and additional material (UNESCO, 2020). There is a need for an appropriate articulation between distance and face-to-face teaching, given that many in Brazil do not have access to quality computers, cell phones, or the Internet, and a considerable number of teachers needed the training to use digital platforms, insert online activities, evaluating students at a distance and producing and inserting material on the platforms that help the student to understand the contents (Dias & Pinto, 2020).
Besides, in the psychological field, it is notorious to encourage solidarity, resilience and the continuity of social relations between educators and students in this period is fundamental, as it helps to lessen the negative psychological impact of the pandemic on students. Now, it is important to prevent and reduce the high levels of anxiety, depression, and stress that confinement causes in quarantined students (Dias & Pinto, 2020).
6. Conclusion
Therefore, multiple intervention strategies at the school and reductions in transmission in the community, in addition to the extent achieved so far, will be necessary to avoid the excessive undue risk associated with the reopening of the school.
Funding
The work was supported by Faceres-Medical School, São José do Rio Preto, SP, Brazil.