Post Publication Independent Review of

"Mitigate the effects of home confinement on children during the COVID-19 outbreak"

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Post Publication Independent Review of "Mitigate the effects of home confinement on children during the COVID-19 outbreak"

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Post Publication Independent Review of

Mitigate the effects of home confinement on children during the COVID-19 outbreak

Guanghai Wang, Yunting Zhang, Jin Zhao, Jun Zhang, Fan Jiang

Published: March 04, 2020 DOI:

Review Comments:

1. Quote "In response to the coronavirus disease 2019 (COVID-19) outbreak, the Chinese Government has ordered a nationwide school closure as an emergency measure to prevent spreading of the infection" End of Quote

Quote "the emergency home schooling plan has been rigorously implemented.2" End of Quote

Reference 2 indicates content at link (which might require Google Translate to view in English)

A brief look at the notification indicates a well structured suggestion for online education when schools are shut down due to COVID-19.

If any suggestion is found good, the same can be used to improve the current online education systems in Nations wherever schools are shut down due to COVID-19.

2. Quote "Massive efforts are being made by schools and teachers at all levels to create online courses and deliver them through TV broadcasts and the internet in record time. The new virtual semester has just started in many parts of the country, and various courses are offered online in a well organised manner. These actions are helping to alleviate many parents' concerns about their children's educational attainment by ensuring that school learning is largely undisrupted." End of Quote.

Though laptops or personal computers may be accessible by Children at home, internet bandwidth congestion is a factor that needs attention. However, most homes have Cable Television and schooling programs can be beamed through dedicated Cable Television Channels at both National & State Levels depending on the schooling pattern. Assignments may be given to ensure that the children actively participate in educational programs. Due to lockdown, the whole family may be at home. Consequently, educational broadcast may be planned in such a way that the children participate in the programs at prescheduled time and the others in the family can watch television at a later time. Assignments may be planned so that the children are busy with the assignments when others in the family watch Television. To balance viewership, high TRP ratings content on all channels may be shifted to different time slots so that the educational transmission will have a separate unique transmission window.

3. Quote "Although these measures and efforts are highly commendable and necessary, there are reasons to be concerned because prolonged school closure and home confinement during a disease outbreak might have negative effects on children's physical and mental health.3, 4" End of Quote.

This observation by the authors need to be given attention.

4. Quote "Evidence suggests that when children are out of school (eg, weekends and summer holidays), they are physically less active, have much longer screen time, irregular sleep patterns, and less favourable diets, resulting in weight gain and a loss of cardiorespiratory fitness.3, 5 Such negative effects on health are likely to be much worse when children are confined to their homes without outdoor activities and interaction with same aged friends during the outbreak." End of Quote.

Perhaps, some of the educational transmission may need to have live participation by the children, with some physical activity (for example floor exercises or limited exercise).

5. Quote "Perhaps a more important but easily neglected issue is the psychological impact on children and adolescents. Stressors such as prolonged duration, fears of infection, frustration and boredom, inadequate information, lack of in-person contact with classmates, friends, and teachers, lack of personal space at home, and family financial loss can have even more problematic and enduring effects on children and adolescents.4" End of Quote.

Apart from short term effects, the observation by the authors seem to indicate long term effects too.

6. Quote "the interaction between lifestyle changes and psychosocial stress caused by home confinement could further aggravate the detrimental effects on child physical and mental health, which could cause a vicious circle. To mitigate the consequences of home confinement, the government, non-governmental organisations (NGOs), the community, school, and parents need to be aware of the downside of the situation and do more to effectively address these issues immediately." End of Quote.

A multipronged approach by multiple stakeholders may be the need of the hour.

7. Quote "The government should also provide guidelines and principles in effective online learning and ensure that the contents of the courses meet the educational requirements. Yet it is also important not to overburden the students. " End of Quote.

8. Quote "The government might mobilise existing resources, perhaps involving NGOs, and create a platform for gathering the best online education courses about healthy lifestyle and psychosocial support programmes available for schools to choose from. For example, in addition to innovative courses for a better learning experience, promotional videos can be useful to motivate children to have a healthy lifestyle at home by increasing physical activities, having a balanced diet, regular sleep pattern, and good personal hygiene.8 To make these educational materials truly effective, they must be age-appropriate and attractive. They require professional expertise and real resources to create." End of Quote.

Attempting to state in a simple sentence, the lockdown and subsequent time may be very appropriate to help motivate the students and prepare them to be better citizens of the future.

9. Quote "Communities can serve as valuable resources in managing difficulties of family matters. For instance, parents' committees can work together to bridge the needs of students with school requirements and to advocate for children's rights to a healthy lifestyle. Psychologists can provide online services to cope with mental health issues caused by domestic conflicts, tension with parents, and anxiety from becoming infected.7 Social workers can play an active role in helping parents cope with family issues arising from the situation, when needed. Such a social safety net could be particularly useful for disadvantaged or single-parent families,9 but action is needed to make it accessible to them." End of Quote.

All Stakeholders need to work together cohesively.

10. Quote "Schools have a critical role, not only in delivering educational materials to children, but in offering an opportunity for students to interact with teachers and obtain psychological counselling. Schools can actively promote a health-conscious schedule, good personal hygiene, encourage physical activities, appropriate diet, and good sleep habits, and integrate such health promotion materials into the school curriculum.3" End of Quote.

In short, the lockdown period due to COVID-19, is indeed a bessing in disguise, to take a break from regular schooling system and motivate the children to evolve into better citizens of the future.

11. Quote "In the event of home confinement, parents are often the closest and best resource for children to seek help from. Close and open communication with children is the key to identifying any physical and psychological issues and to comforting children in prolonged isolation.10, 11 Parents are often important role models in healthy behaviour for children. Good parenting skills become particularly crucial when children are confined at home. Besides monitoring child performance and behaviour, parents also need to respect their identity and needs, and they need to help children develop self-discipline skills. Children are constantly exposed to epidemic-related news, so having direct conversations with children about these issues could alleviate their anxiety and avoid panic.10, 11 Home confinement could offer a good opportunity to enhance the interaction between parents and children, involve children in family activities, and improve their self-sufficiency skills. With the right parenting approaches, family bonds can be strengthened, and child psychological needs met.12" End of Quote.

Not all parents may be aware of the concerns raised by the authors. Hence, the parents also need to be taught/schooled during the lockdown period.

12. Quote "Since the COVID-19 epidemic is no longer confined to China,13 school closure and home confinement-related issues also become relevant in other affected countries. As children are vulnerable to environmental risks and their physical health, mental health, and productivity in adult life is deeply rooted in early years,14 close attention and great efforts are required to address these emergency issues effectively and avoid any long-term consequences in children. Any sustainable programme must involve local professionals to culturally adapt the interventions to the administrative system and to the regional and community environment, and it must develop contextually relevant material for children and adolescents.7 Finally, children have little voices to advocate for their needs. The latest Commission14 on the future of the world's children urges a holistic strategy in preparing for the uncertainty that all children are facing. It is the responsibility and keen interests of all stakeholders, from governments to parents, to ensure that the physical and mental impacts of the COVID-19 epidemic on children and adolescents are kept minimal. Immediate actions are warranted." End of Quote.

The authors are making significant observations here. These concerns may be suitably incorporated into existing systems so that the next generation of adults (currently children) may be provided a chance to evolve into better principled and ethical law abiding citizens of the future.

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