Webinar: Challenges in the institutions of education during COVID-19 pandemic Forum organized by Hospital Sungai Buloh and Institute for Clinical Research, Ministry of Health, Malaysia Speaker: Dr See Kwee Ching, Consultant Neonatalogist and Head of Pediatrics Department, Hospital Sungai Buloh, MOH Malaysia. More info, please go to: https://clinupcovid.mailerpage.com/resources/v3h7k9-cabaran-institusi-pendidikan-di-e

1. PREVENTION OF COVID-19
OUTBREAKS IN SCHOOL
Presenter:
DR SEE KWEE CHING
CONSULTANT NEONATOLOGIST
& HEAD OF DEPARTMENT OF
PAEDIATRICS HOSPITAL SUNGAI BULOH

2. ACKNOWLEDGEMENTS
Dr Hieu Yu Jin, Paediatrician
Dr Yasmin, Paediatrician
Dr Tan Li Peng, Medical Officer
Paediatrics Team Hospital Sungai Buloh
National Early Childhood Intervention Council, 2020 SOP: Post- Lockdown COVID –
19 Safety Guidance for Early Childhood Centres, Malaysia Version 1, 10th April
2020

3. COVID-19 TRANSMISSION
Droplets of virus-laden mucus are
the MAIN mode of transmission.
Virus detected: FAECES – no reported transmission
Can transmit through :
- contact ( direct or indirect )
- droplets spray in short range transmission
~ 6 feet / 1.8m
- aerosol in long range transmission ( airborne transmission )
~ 13 feet / 4m

4. SIGNS AND SYMPTOMS
COMMON
-Fever
-Dry cough
-Tiredness
LESS COMMON
-Aches and pains
-Sore throat
-Diarrhoea
-Loss of smell ( anosmia) and/ or taste
-Conjunctivitis
-Headache
-Rashes and skin manifestations
SERIOUS
-Shortness of breath
-Chest pain

5. SPECIAL CONSIDERATIONS
CHILDREN WITH UNDERLYING MEDICAL CONDITIONS
• Genetic disease e.g. Down Syndrome
• Neurologic disease
• Metabolic disease
• Chronic lung disease e.g. Asthma
• Congenital heart disease
• Obesity
• Diabetes
• Immunosuppressed e.g. Cancer patients
• Etc.
(Adapted from CDC “Information for Paediatric Healthcare Providers” on 18 Mar 2021)

6. INCUBATION PERIOD
The incubation period is the time between exposure to the virus
(becoming infected) and till when the symptoms appear/ onset
COVID
-19
PRE-SYMPTOMATIC /
INCUBATION PERIOD
CAN BE INFECTIOUS
Average 2-4 days
(up to 14 days)
SYMPTOMATIC /
DISEASE ONSET
INFECTIOUS
(up to 10 days)
NOT
INFECTIOUS

7. P.O.S. OUTLINE
PREVENTION OF OUTBREAKS IN SCHOOL
INDIVIDUAL
MEASURES
INSTITUTIONAL
MEASURES

8. INDIVIDUAL MEASURES
– STUDENTS & TEACHERS

9. UNIVERSAL PRECAUTIONARY
MEASURES
1.General Personal Hygiene
2.Clean Environment
3.Physical Distancing
4.Health screening

10. A. GENERAL PERSONAL HYGIENE
HANDWASHING COUGH ETTIQUITTE PERSONAL PROTECTIVE
EQUIPMENT

11. HANDWASHING
SOAP & WATER IS ENOUGH!

12. B. MAINTAIN CLEAN ENVIRONMENT
Frequent touch surfaces will be need to be
cleaned - railings, door knobs, table tops,
counters, dining area
Learning aids – laboratory equipment,
keyboards clean after each student use
How often – Frequency will be dependant,
take into account change of students using

13. C. MAINTAIN PHYSICAL DISTANCING
No handshake No hugging

14. D. HEALTH SCREENING
COMPLY to daily health
screening
WARN if having symptoms
DO NOT ATTEND SCHOOL if
symptomatic OR under
quarantine by PKD

15. INSTITUTIONAL MEASURES

16. EDUCATE &
INFORM
Regular online meetings for
teachers
Training sessions
Posters
Communicate with PTA
EDUCATION
FACILITIES
PROTOCOLS

17. CLASSROOM &
STAFF ROOMS
WELL-VENTILATED
AVOID AIR-
CONDITIONING
Exam-style seating
Personal belongings by own
table
No mixing between classes
Disinfect tables
Picture of a classroom in Denmark post lockdown
EDUCATION
FACILITIES
PROTOCOLS

19. PLAY AREAS
Cordon off
EDUCATION
FACILITIES
PROTOCOLS

20. CAFETERIA
Packed meals / Food from
home
OWN utensils
Staggered meal times
Clean & disinfect after each
session
EDUCATION
FACILITIES
PROTOCOLS

21. LIBRARY
“Rest” between each check-
out
No-sharing policy
EDUCATION
FACILITIES
PROTOCOLS

22. PRAYER ROOMS
Limit number of users
Take turns
EDUCATION
FACILITIES
PROTOCOLS

23. RESTROOMS
Limit number of users
Frequent cleaning
Ensure proper handwashing
after use
EDUCATION
FACILITIES
PROTOCOLS

24. EDUCATION
FACILITIES
PROTOCOLS
ENTRY & EXIT
Carpooling with fixed
group
Staggered arrival &
release times
Reduce interaction when
queuing
Designated pick-up/drop-
off areas

25. EDUCATION
FACILITIES
PROTOCOLS
HEALTH
SCREENING
Daily temperature &
symptom check
Keep log book for student /
staff / visitors
Health declaration by
visitors

26. EDUCATION
FACILITIES
PROTOCOLS
STAFF &
STUDENT
MOVEMENT
Map out pathways
Discourage loitering in
corridors

27. EDUCATION
FACILITIES
PROTOCOLS
TEACHING
STRATEGIES
Reduce indoor time
Reduce physical grouping
activities
No sharing of books
1-to-1 assistance
Be creative with online
learning

28. EDUCATION
FACILITIES
PROTOCOLS
SICK DAY
PROTOCOL
Identify sick bay
Staff to wear PPE
Emergency contact with
PKD / CACs
Follow-up on after return to
school

29. EDUCATION
FACILITIES
PROTOCOLS
CHILDREN WITH
UNDERLYING
ILLNESS
Emergency contact
Standby medication e.g.
MDI for children with
asthma

30. EDUCATION
FACILITIES
PROTOCOLS
OTHERS
Written SOP
LIMIT non-essential
personnel on compound
Repairs during out-of-office
hours
INFECTION CONTROL UNIT
Work with PIBG / PTA to
facilitate communication

31. COVID-19 VACCINATION
1.Not yet allowed in under-18
2.Insufficient evidence for now
– studies ongoing
3.Aim to achieve herd
immunity for this group

32. Take Home Message
1. COVID 19 Infection in Children and Adolescents are mainly mild
2. Intra School Transmission is rare
3. COVID 19 Vaccines not licensed for use in children at the moment
4. Elderly People with co morbids are more at risk
5. Need to achieve herd immunity for children
6.Prevention of Outbreaks in School (POS) needs government-public
cooperation to ensure our children gets the best education possible during this
pandemic

33. THANK YOU
A child in a lockdown
Is like a bird in a cage
Unable to fly away and
Spread its wings
Let them go to school
And fly again

34. REFERENCES
1. National Early Childhood Intervention Council, 2020 SOP: Post- Lockdown COVID
– 19 Safety Guidance for Early Childhood Centres, Malaysia Version 1, 10th April
2020
2. COVID -19, Health prevention and control in non healthcare settings, EDITORIAL,
Occupational Medicine 2020
3. Water, Sanitation, Hygiene and Waste management for the COVID – 19, Interim
Guidance, WHO, 23rd April 2020
4. COVID -19, Cleaning and Disinfection of Hospital Surfaces and Equipment, ANMF
Evidence Brief, 7th April 2020