China should avoid any stop-start reopening of schools and colleges and be vigilant as the coronavirus situation eases, leading epidemiologist Zhong Nanshan told education officials.
Speaking during an online panel discussion, Zhong and other top communicable disease experts said it should be safe for students to go back to the classroom as there was a significantly lower risk of local transmission in China, though there was still a risk as it continued to spread rapidly elsewhere.
The discussion, organised by the Ministry of Education, took place on Monday but official media reported the details on Wednesday.
"China has already tamed the effective reproduction number [of the virus] to 0.2 or 0.3 - that's very low and unlikely to cause a massive outbreak," Zhong said. "But it's impossible to expect that China will have no infections, and I staunchly support [the idea] that we should move on."
Epidemiologists usually consider a reproduction number below 1 as an indicator that an outbreak could fade out. Some experts put the number in China at a range between 2.2 and 5.7 when the first cases were reported in Wuhan, Hubei province, in December.
"We should be vigilant about protecting [students] and this is a very difficult step to take in reopening schools. But education officials should not rush to shut down a school when there are isolated cases [after reopening]," Zhong said.
"We don't want to fall into the same situation as Singapore: They relaxed their disease control and prevention too much and too quickly - that can easily lead to a resurgence," he said. "Now it has reintroduced tough measures after reporting more new cases. We can't afford this back and forth."
Singapore said on Tuesday that it would bring forward its June school holidays to May 5, after the government extended its Covid-19 "circuit breaker" measures to June 1.
The Education Ministry made the decision to suspend schools for a month in early April amid a new wave of infections, which have now passed 10,000, with 11 deaths.
Zhong said the differences in countries' policy priorities - especially whether to put health ahead of the economy - in part explained why the global pandemic had continued its upward trend.
In addition, he said a lack of testing capacity in developing countries like India and some African nations had compromised their assessments of how fast the virus was spreading.
"Europe may slowly come down from their plateaus in the coming days, but the US looks likely to continue going up at least for another week or even longer - and there are countries with many unknowns," he said. "The global fatality rate has reached 6.9 per cent and that is relatively high."
Epidemiologist Li Lanjuan, who led a medical team in Wuhan until late March and was also on the discussion panel, said the risk of imported cases warranted a continuation of "ruthless" quarantines and health checks for all travellers arriving in China.
The Education Ministry discussion came as many schools across the country have gradually reopened over the past two weeks.
Li advised all schools to carry out extensive health checks on staff and students when they reopened to ensure a clean start.
Zhang Wenhong, head of the infectious diseases department at Fudan-Huashan Hospital, said school management should focus on preventing secondary infections and getting back to normal learning and social activities for students.
"Having a [case] on campus is not something that schools can prevent - the infection could happen outside [the school] and it's unavoidable," he said. "But if there are clusters of second- and third-generation infections on campus, then the school will have failed in its duties."
He said school authorities should keep in close contact with local hospitals and fever clinics, have contingency plans in place for when an infection occurs, consider outdoor social activities for students and reinforce messages like the importance of personal hygiene in preventing the spread of the virus.
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This article was first published in South China Morning Post.