A layer of smog is seen near Shanti Vana in New Delhi on November 25, 2024. | Photo Credit: The Hindu

Schooling in India in times of poor air quality

Considering scientific rationale and the benefits and risks, the functioning of schools needs to be delinked from Graded Response Action Plan measures

by · The Hindu

In a stark reminder of the COVID-19 pandemic period, schools in Delhi State, in mid-November 2024 — as a part of the Graded Response Action Plan (GRAP) to tackle air pollution, which is triggered when the Air Quality Index (AQI) is “poor” — had been asked to switch from physical to online mode. While other restrictions imposed as a part of GRAP might have an impact on air quality, the decision to switch schools to online mode needs to be examined for its scientific rationale, practicability, and benefits and risks.

Poor air quality in many north Indian States is harmful for any age group and not just children. The harmful health effects of poor air quality are on a continuum from the moment the AQI crosses normal range. Children (and everyone in any age group) should be protected from poor air quality the moment the AQI crosses 50, which is considered ‘good’ air quality by Indian norms. However, there are only a few days in a year when the AQI is within acceptable limits. In 2024, till now, there has not been even a single day with ‘good’ air quality in Delhi; there was just one such ‘good’ air quality day in 2023. Alongside, it is naive to believe that an AQI that is more than 400 (classified as ‘severe’ or ‘severe plus’) is harmful and anything below this is not. This arbitrary and high cut off does not help except inadvertently normalising the harmful health effects of air quality that is in the range of AQI 51 to 399.

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More importantly, most children in Delhi or other parts of the country are likely to have the same air quality inside their homes or in their schools. For some underprivileged children, air quality in the classroom might be better than at home as many schools have air purifiers. The idea of having online classes due to poor AQI puts all children at an additional disadvantage of learning loss and nutritional loss (as many children get mid-day meals in schools), while there is no respite from the health impact.

It is widely known that online classes are not a replacement for school-based learning and the only beneficiaries here are EdTech platforms and Apps. Then, the younger children are not supposed to have exposure to screen time. Therefore, when they are forced to attend online classes, they are being exposed to more harmful behaviour than receiving any possible or perceived benefit. In the three years of the COVID-19 pandemic, all of us have learnt that schools are not the places where children read only books; there is life learning. Therefore, the focus has to be on keeping schools functional and ensuring learning continuity. There was an article related to this, in this daily, by one of the writers: “The pathology of school closure in India”, February 16, 2022.

The oversold idea of face masks

Poor air quality nearly always brings up the issue of face masks. Even before GRAP stages III and IV recommended the suspension of physical classes, a few schools sent out advisories to parents that children should wear face masks in order to attend schools. Though it was argued that these advisories were to provide guidance, what was forgotten was that such advisories from schools became an ‘informal mandate’ for children and parents. Such a uniform advisory for all children to wear a face mask is not fully backed by science. As far as children are concerned, even during the COVID-19 pandemic, masks were not recommended for children who were younger than five years for various scientific reasons and utilising empirical data. For those between six to 11 years, masks were advised (and not mandated). There is no rationale for anyone to wear face masks if the set-up has air purifiers. In short, the face mask wearing guidance for children has to have a nuanced and personalised approach. Therefore, schools should refrain from issuing such advisories, which should come only after guidance from medical experts.

Adopt a science-based approach

First, schools should not be made to switch to online classes, no matter what the level of AQI is. The focus should be on keeping the school functional and ensuring learning continuity. This could be done with some mitigants such as completely halting all outdoor activities in schools when the AQI is poor. Everyone should take appropriate personal protective measures, such as the use of purifiers and face masks, taking into account recommendations by age, and pre-existing health issues. Those who have any pre-existing respiratory health issue are likely to benefit more from mask wearing, specifically in a polluted and open space.

Second, to attend school, there is no need for a uniform directive for mask wearing. Schools are not the source of pollution. Arguably, air quality in schools is similar to the homes of children. Therefore, it does not make any sense to do anything differently in school than what is done at home. So, if children and parents wear a face mask at home, they can wear it at school as well. Else, no additional mandatory mask wearing measure is needed. There is a need to remember that face masks can also have negative effects such as causing a skin allergy and other discomforts. So, one should keep in mind the benefits and the associated risks. Also, except for medical recommendations, children younger than 12 years should not be made to wear N95 masks. During periods of severe or above AQI, children who have pre-existing health issues or any other parents who wish to keep their children at home, should be given an ‘opt-out’ option from physical classes, and the rest of the children should have the opportunity for learning continuity.

Third, in schools or other settings which have functional air purifiers, mask wearing is not going to provide any additional advantage. For such settings, i.e., schools, ensuring that the classroom doors and windows are closed properly and switching on air purifiers at least an hour before children arrive would ensure ‘good’ quality air.

Fourth, ‘online schooling’ is an oxymoron — it is not school if teaching is online. The option of hybrid classes should not be interpreted conveniently by schools. Also, other than air quality, there are other reasons such as foggy or cold winter days, which many schools exercise as a reason for switching to online or hybrid classes. These 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 referred to as ‘offline’ or ‘online’, placing electronic devices at the centre of teaching and learning. We need to break this mode of thinking. Therefore, in future, if and when the government or any authority fails children by passing an order to switch to online classes, the management in every school needs to come up with innovative approaches to ensure that learning is not in front of a mobile or computer screen.

Fifth, poor air quality is a reminder that anyone who has pre-existing health or respiratory conditions should take better care of their health. This means having a routine checkup and a regular follow-up visit with health-care providers. Preventive interventions such as annual influenza vaccination or age-appropriate recommended vaccines like pneumococcal, measles, Haemophilus influenzae Type b (Hib) are administered to those who need it.

Policy must be people-centric

From a larger social angle, most of the actions recommended as a part of GRAP, adversely and disproportionately, impact the poor and the vulnerable in terms of wages (for the poor and the marginalised) as well as learning and nutrition (for children) losses. This is a reminder that whatever is done in the name of the policy should have a people-centric and pro-poor focus. Air quality and school functioning need a nuanced approach. India had one of the longest closures of schools during the COVID-19 period and we need to learn from those mistakes. There was another article on this, in this daily, by one of the writers: “Building back to avert a learning catastrophe”, April 28, 2022.

Schools are not the source of air pollution. Rather, there is far greater loss than benefit from school closure. While there are valid reasons for implementing other measures under GRAP to improve the AQI, closing schools for physical classes makes the least sense. It has happened for the last eight years, but now is the time that school functioning is delinked from GRAP measures. Nelson Mandela had said, “There can be no keener revelation of a society’s soul than the way in which it treats its children.” When it comes to handling air quality and the functioning of schools, Indian States and society seem to be failing in their responsibility and their duties.

Dr. Chandrakant Lahariya is a medical doctor who specialises 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 a former Director of the All India Institute of Medical Sciences (AIIMS), New Delhi and a specialist in respiratory medicine

Published - November 28, 2024 12:16 am IST