世界衛生組織歐洲區域技術諮詢小組：新冠肺炎疫情下學校教育之建議

世界衛生組織歐洲區域技術諮詢小組：新冠肺炎疫情下學校教育之建議

Schooling during COVID-19. Recommendations from the WHO European Region Technical Advisory Group

國立臺灣師範大學研究生 劉彥妤

議題一、維持學校開放是關鍵目標

• 學校應該是在疫情防制下最晚關閉的場所之一，因為關閉學校已被證明不利於兒童的健康和福祉以及教育成果。
• 如果爆發大規模疫情或社區內的傳播，無法透過任何其他措施進行控制，關閉學校可能被視為最後的手段。
• 控制學校SARS-CoV-2傳播的措施應不同年齡層的需求。

Key issue 1.Keeping schools open is a key objective

• Schools should be among the last places to be closed, as school closures have been shown to be detrimental to child health and well-being and educational outcomes.
• If large outbreaks occur or transmission in the community cannot be controlled by any other measures, reactive school closures may be considered as a last resort.
• Measures to control transmission of SARS-CoV-2 in school settings should be specific to the needs of different age groups.
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議題二、校園中的篩檢策略

• 需確定學校廣泛使用快速篩檢抗原測試在開放學校和控制傳播的效果。
• 患有任何嚴重程度的急性呼吸道感染有症狀的兒童，屬於易感染族群、高風險群體、處於高風險傳播的特殊情況，應優先進行篩檢。另外無症狀的高危險暴露（密切）接觸者，也應該考慮對其進行篩檢。
• 在學校環境中對兒童進行的群體檢查應該以能夠不中斷學習的方式有組織的進行。
• 避免在學校進行常規體溫或症狀檢查，因為尚未有實證支持。
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Key issue 2. Testing strategy in the school setting

• The value of widespread rapid diagnostic antigen tests in school settings in terms of opening schools and controlling transmission needs to be determined.
• Testing should be prioritized for symptomatic children with acute respiratory infection of any severity if they belong to a vulnerable group, risk group or are in a special situation with a high risk of further spread, but asymptomatic high-risk exposure (close) contacts of cases should also be considered for testing.
• Cluster investigation in children in school settings should be organized in a way that enables continuity of learning.
• Routine temperature or symptom checking in schools should be avoided, as no evidence is available to support their use.
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議題三、採取有效控制措施與風險緩解措施

• 學校應制定風險緩解策略，各國應確保這些感染預防策略實施和，謹慎衡量對不同年齡層兒童可能帶來的益處和傷害。
• 戴口罩、勤洗手、範圍消毒等所有措施都需要與較不佳的選擇如關閉學校互相進行平衡比較。
• 學校採取的任何措施都應遵循標準實施流程。
• 各國應定期審查一系列措施並根據新出現的實證進行更新，應停止被視為無效或有害的措施，所有措施均應平等處理。
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Key issue 3.Effectiveness of applied risk-mitigation measures on infection control

• Schools should have a risk-mitigation strategy in place; countries should ensure these strategies carefully balance the likely benefits for, and harms to, younger and older age groups of children when making decisions about implementing infection prevention and control measures.
• All the above needs to be balanced with the even worse alternative of schools being closed.
• Any measure introduced by schools should follow standard protocols for implementation.
• Countries should review the package of measures regularly and update according to emerging evidence; measures deemed to have no effect or to be harmful should be discontinued, and all measures should be equity-proofed.
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議題四、教育效果、心理和社會健康福祉

• 在關閉學校時，各國需要保證，盡可能為在校需接受服務的學生提供替代方案，例如健康服務和學校營養午餐。
• 各國應保證提供線上學習所需的設備和設施，包括為學童和教師提供有效的網路通訊平台，無論學校是關閉還是開放的。
• 各國應設立專線，提供給需要尋求心理支持的兒童和青少年。
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Key issue 4. Educational outcomes, mental and social well-being

• When closing schools, countries need to guarantee substitute services for those normally delivered in the school setting, such as health services and school meals, where possible.
• Countries should guarantee access to devices and facilities required for online learning, including functioning Internet connections for schoolchildren and teachers, regardless of whether schools are closed or open.
• Countries should establish hotlines for children and adolescents seeking psychological support.
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議題五、弱勢族群之孩童

• 各國應為貧困地區的學校和生活在弱勢環境中的兒童提供額外支持。
• 學校應採取額外措施，進一步保護處於社會弱勢地位的兒童，包括訪視有輟學風險的兒童。
• 處於弱勢學生（並且在家中無法使用電腦和網路者），應讓一些學生可以留在學校，接受線上教育或完全線上學習。
• 學校現場教育應包括教育，而不僅僅是監督。
• 已有健康狀況的兒童不應被排除在學校的學習，應評估他們的風險與需要。
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Key issue 5. Children in vulnerable situations

• Countries should provide additional support to schools in deprived areas and for children living in vulnerable situations.
• Schools should implement additional measures to further protect children in socially vulnerable situations, including direct outreach to those at risk of dropping out of school.
• Living in a vulnerable situation (and lack of access to computers and the Internet at home) should be among the criteria for allowing some children to continue to be physically present in schools when it is necessary to switch to hybrid schooling or full online learning.
• On-site schooling should include education and not consist solely of supervision.
• Children with pre-existing health conditions should not routinely be excluded from on- site schooling, but rather be assessed individually for their specific risk.
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議題六、推動感染控制和兒童健康有益之學校環境調整

• 各國應利用其健康促進學校網絡來確保在疫情期間持續改善學校環境，並制定因應未來突然爆發疫情的策略。
• 學生、家長、教師和其他學校工作人員應積極參與討論學校可採行哪些可行的風險緩解措施。
• 各國應確保聘用足夠數量的教師以減少班級規模，這將有助於改善感染控制以及兒童健康和教育成果。
• 各國應確保學校教學人員與健康及社工人員間的最佳合作。
• 學校應改善其設施和相關設備，包括確保洗手設施有自來水和肥皂供應，足夠的廁所設施和空氣通風設備等。
• 學校應確保學生、家長、教師和其他學校工作人員有能力實施這些防制措施，以執行其核心職責。
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Key issue 6. Changes in the school environment that are likely to be of overall benefit to infection control AND child health

• Countries should use their health promoting school networks to ensure sustained improvement in the school environment throughout the pandemic, and develop a strategy for preparedness for future outbreaks.
• Students, parents, teachers and other school staff should be involved actively in deciding at school level what risk-mitigation measures are feasible in their daily context.
• Countries should ensure that a sufficient number of teachers are hired to reduce class sizes, which will serve to improve infection control as well as child health and educational outcomes.
• Countries should ensure optimal collaboration between teaching staff and health and social workers.
• Schools should improve their infrastructure and associated maintenance, including ensuring handwashing facilities with running water and reliable supplies of, for instance, soap, sufficient and adequate toilet facilities and fresh-air ventilation.
• Schools should ensure that students, parents, teachers and other school staff are empowered to implement the measures while being able to deliver their core functions.
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議題七、兒童和青少年參與決策決定

• 各國在疫情期間邀請兒童和青少年共同討論，並重視他們對學校教育和介入方面的觀點及意見。
• 應邀請不同年齡層和不同背景的兒童和青少年，提出他們對防制措施及是否會影響或幫助他們的看法。
• 兒童和青少年應積極參與學校的決策過程。
• 青少年組織應參與這些過程。
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Key issue 7. Children’s and adolescents’ involvement in decision-making

• Countries are urged to recognize children’s and adolescents’ perspectives and give weight to their voices in relation to schooling and interventions during the pandemic.
• Children and adolescents from different age groups and all backgrounds should be asked to provide their perspectives on the measures affecting them and whether they are helping them.
• Children and adolescents should be involved actively in the decision-making process at school.
• Youth organizations should be involved in these processes.
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議題八、維持推動教育社會健康福祉之疫苗接種策略

• 迫切需要針對所有年齡層的兒童進行疫苗試驗，以便完善疫苗接種策略。
• 研究應發展兒童和青少年的疫苗接種計劃，以對健康、社會和教育的全方位結果有正面的影響。
• 國家疫苗接種策略應確保在學校工作的教師和其他專業人員優先接種新冠肺炎疫苗。
• 疫苗接種策略應考慮如何讓學校能有更長開放時間，以維持正向的教育成果，同時減少和預防負面的心理和社會影響。
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Key issue 8. Vaccination strategies with the purpose of maintaining education as a societal good

• Vaccine trials are needed urgently with respect to children of all ages so that vaccination strategies can be refined.
• Research should seek to determine the positive impact that vaccination pro- grammes for children and young people can have on a full range of health, social and educational outcomes.
• National vaccination strategies should ensure teachers and other professionals working in schools are considered when prioritizing access to COVID-19 vaccinations.
• Vaccination strategies should consider how they can support schools to be open longer, maintaining positive education outcomes while minimizing and preventing negative mental and social outcomes.