INTRODUCTION

As of September 21, 2020, Spain was the ninth country in the world with the most cases of COVID-19 ¹, with a total of 671,468 infected persons and 30,663 deaths ². The first measure taken by most countries to curb the pandemic was the suspension of face-to-face activities ³. In Spain, more than 840,000 teachers have had to use information and communication technologies (ICT) in an improvised and hurried manner to avoid slowing down the educational process ⁴.

The World Health Organization (WHO) establishes recommendations for the reopening of educational centers, including hand hygiene, cleaning and ventilation of classrooms, and the use of masks. As well as the evaluation and management of students, teachers, other school personnel, tele-training facilities, etc. ⁵

Planning for reopening should begin as soon as possible, establishing mechanisms to guarantee the continuity of learning in a safe manner, both for staff and students ⁶. However, the possibility of contagion among students and teachers during the reopening process, and the consequent closure of the educational center, cannot be ignored ⁷. Therefore, the establishment of socio-health protocols, contingency educational plans and a digitalization plan in the center are some of the proposals that could minimize the impact of COVID-19 in the educational environment ⁷.

Because of what was previously mentioned, and due to the limited number of studies carried out on teaching personnel, we set ourselves the objective of describing the attitudes and knowledge about the COVID-19 pandemic among teaching personnel in the Canary Islands.

THE STUDY

We conducted a cross-sectional study in the Autonomous Community of the Canary Islands in Spain, between May 14 and 18, 2020. The target population was teachers from any public or private educational institution, that is, from primary school teachers to university professors. Teachers who signed the informed consent form and answered all the questions in the questionnaire were included.

The recollection instrument is based on a study published by the research team in 2019 to learn about the attitudes and beliefs of healthcare personnel during a hypothetical influenza pandemic ⁸. Because it is an ad hoc questionnaire, we made an adaptation for the educational sector; the research team reviewed that the questions were not ambiguous or difficult to understand, and that they correlated to the objective of the study.

To validate the instrument, we used the Delphi technique with 19 experts from different levels of the educational sector, guaranteeing at least two participants for each level (nursery school, kindergarten, primary school, secondary school, special education center, vocational training center, university, others). These experts assessed the suitability of each of the items by means of a Likert scale score of 1 to 7 points, where 1 represented disagreement and 7 represented agreement. The consensus of the experts was reached when the score for each item reached a mean greater than 5 and a standard deviation less than 2; thus, three questions were excluded from the initial questionnaire. Subsequently, to assess the level of reliability, Cronbach’s alpha was calculated using the experts’ scores, which resulted in a value of 0.943.

The questionnaire had 16 questions, divided into 4 sections: attitudes (3), knowledge (6), sociodemographic information (5) and employment information (2). The virtual questionnaire was created in a Google form and disseminated through social networks. Informed consent was requested from each participant, which guaranteed their anonymity at all times.

Statistical analysis was performed with R Core Team 2020 version 4.0.0. The descriptive analysis of the data was presented with frequencies and percentages. From a population of approximately 25,000 teachers, a sample size of 587 was calculated for the data to be significant at 95%, with a sampling error of 4%. Finally, 1,509 surveys were obtained, which allowed us to perform a statistical analysis with a sampling error of less than 2%, for a confidence level of 99%.

This study has been approved by the Ethics Committee for Research with Drugs of the University Hospital of Gran Canaria Dr. Negrín (CEI/CEIm HUGCDN).

FINDINGS

DISCUSSION

In general, the teaching staff do not believe that they have the protection and hygiene measures in place in their workplaces and are not willing to work if there is a risk of infection. However, they state that they would be willing to work if they were provided with the appropriate hygiene and safety measures. Regarding knowledge, we observed that they are aware of the measures to protect themselves from infection, however, they need training in hygiene and infection prevention.

Regarding attitudes, we observed a general belief of lack of protection, since most of them expressed that they do not have protection and hygiene measures in their workplaces. This impression is not unique to this guild; similar results were described in a national survey on the working conditions of nurses in Spain, during the COVID-19 health crisis ⁹.

Currently, children represent a low proportion of all reported cases, as they remain mostly asymptomatic or develop mild disease ¹⁰. Teachers’ concern about COVID-19 transmission could lead to absenteeism under certain circumstances described in the items explored; similar findings have been described in a similar study ⁸.

Teachers should use hygienic masks that comply with the specific quality standards UNE 0064 and 0065 ¹¹. However, the WHO states that inadequate use of the masks, far from reducing the risk of contagion, could even increase it ¹². In addition, all measures should be applied to prevent the spread of the pandemic ¹³. According to Law 31/1995 on Occupational Risk Prevention, the Spanish public administration must guarantee workers effective protection in terms of occupational health and safety, in addition to training them in the correct use of protective equipment ¹⁴.

Teachers would probably not go to their place of work if they were at a higher risk of becoming infected and, therefore, of infecting their family members. This risk has been demonstrated in a study carried out by the University of Granada, where a group of students composed of 20 children would have contact with more than 800 people after only two days ¹⁵.

Some gaps in knowledge among teachers have been described, so it will be necessary to implement training measures. We emphasize that they were aware of the basic hygiene and protection measures to be applied in the centers to prevent infection and spread of the coronavirus ¹³. In addition, more than half of them consider the use of gloves as an effective protective measure against COVID-19. Therefore, it would be necessary to insist on infection prevention measures, such as proper hand hygiene, and to standardize this practice throughout the educational community ¹⁶.

The teaching staff is key to promoting health promotion measures, so it is recommended to include health professionals in the educational environment to provide teachers with training in prevention, thus collaborating in the adequacy of hygiene and protection measures in the centers, in addition to helping to manage possible contagions ¹⁷.

The major limitation of this study is that the sample covers different types of educational population, from kindergarten teachers to university teachers, in spite of which, our general conclusions encourage further research on the different characteristics of each of the different educational levels. Furthermore, all the respondents belong to an autonomous community, which prevents the extrapolation of the data to other regions with different characteristics outside the Spanish educational sphere. On the other hand, since this is an anonymous and electronic questionnaire, it is assumed that some of the interviewees do not belong to the teaching profession.

In conclusion, teachers in the Canary Islands are willing to work in the classroom as long as there are guaranteed hygiene and safety measures in their workplace; however, they do not believe they have them at the moment. In terms of knowledge, there are certain educational gaps, which could be filled with adequate training in infection prevention.