Recent research suggests we CAN open schools safely, but we need to refocus our priorities.
School administrators, public health officials and parents have struggled to answer the question of how—or whether—to send kids and teachers back to school this fall, with COVID-19 cases on the rise in the majority of states and local transmission rates remaining high in many areas.
The biggest voices have picked up their megaphones to amplify the debate, with the American Academy of Pediatrics and the Centers for Disease Control coming out in support of reopening schools with specific protections in place. Other organizations, such as the National Federation of Teachers, urged a gradual, cautious approach.
But recent data seems to point toward good news: Preschools and elementary schools are not superspreaders of the virus, according to researchers. The major outbreaks that some educators and parents feared might result from schools re-opening for in-person instruction do not seem to be coming to pass.
Shockingly (and sadly) there is currently no coordinated, federal effort to track COVID cases in schools. So all of the information that we have is coming from uneven reporting from school districts and from independent researchers, such as the National Covid-19 School Dashboard project, led by parent and researcher Emily Oster of Brown University.
And admittedly, it's still early days yet—cold and flu season has scarcely begun, and the New York City public school system, for example (the nation's largest, with over 1 million students) has only been open for hybrid instruction for six weeks. But in many states, schools have been open since late July or early August, and in numerous other countries schools have reopened, to various degrees, without a corresponding surge in coronavirus infections.
A recent report on school reopening research from the United States and internationally put it clearly: "Widespread transmission can occur among school-age children, but that there is very little evidence, at least in the context of relatively low community transmission, that schools have been a driver of transmission."
That sentence bears re-reading, though, because it puts the good news about schools reopening into an important context: where there is relatively low community transmission, schools can reopen safely without fears of creating a major outbreak.
In almost every conversation about reopening schools, the focus has been on what schools need to do to lower the risk of viral transmission: Temperature screens, frequent testing, student cohorts, in-school health clinics, planning for outbreaks, spacing out desks, serving lunch in classrooms, staggering arrivals, alternating schedules, requiring masks, washing hands.
But according to health experts, reopening schools safely isn't about what schools need to be doing. It's about what our country needs to be doing. And we're not doing it.
The sad truth is, when coronavirus transmission is unchecked in the community that a school serves, no amount of hand-washing or social distancing will prevent the risk of infection from traveling to the school community too.
This summer, the New England Journal of Medicine published its own paper on reopening schools, voicing its support for reopening elementary schools but shifting the focus away from a laundry list of to-dos and must-haves for beleaguered school administrators, underfunded school districts and overtaxed teachers.
Instead, the health and education experts who wrote the opinion focused on what should be painfully obvious to all of us by now: We need to close nonessential indoor services, such as restaurants, bars, gyms, theaters and bowling alleys, in order to lower local virus transmission rates so that kids can go to school safely.
As the NEJM article explains, "It would be best—and evidence from many countries demonstrates that it's possible—to lower community transmission rates by means of stringent control measures...so that schools can reopen this fall with an acceptable level of safety." Epidemiologists have been urging for months that communities work to get their transmission ratio down to 10 (or fewer) new daily cases per 100,000 people in order to safely reopen schools—although with the virus out of control in many states, some infectious disease experts have suggested that the case ratio could be as high as 25 in 100,000 before shut-down measures need to be put into place.
Under conditions of controlled community spread, however, more schools could reopen with more confidence, as long as they were also supported and funded appropriately. "We believe that primary schools should be recognized as essential services—and school personnel as essential workers—and that school reopening plans should be developed and financed accordingly," the NEJM article notes.
Controlling community spread of the virus is an achievable goal, as has been observed in other countries where schools have managed to reopen without seeing an accompanying spike in transmission—bu that requires both national leadership and responsible local prioritization. "This should be a national priority," Anita Cicero, deputy director of the Johns Hopkins Center for Health Security, told Pro Publica. "It's measurably more important than reopening bars and restaurants."
And therein, apparently, lies the real problem. We have chosen, as a country, to prioritize non-essential services and activities like bowling alleys and restaurants over schools.
The authors of the NEJM paper, Dr. Meira Levinson of the Harvard School of Education and epidemiology experts Dr. Müge Çevik and Dr. Marc Lipsitch, addressed the risks and benefits of children and teachers returning to schools, emphasizing the many reasons why in-person school is such a high priority—for our economy, for social equality and children's well-being and development.
"The fundamental argument that children, families, educators, and society deserve to have safe and reliable primary schools should not be controversial," the authors write. "If we all agree on that principle, then it is inexcusable to open nonessential services for adults...if it forces students to remain at home even part-time this fall."
So how do we make schools safe to reopen? We choose to, by making decisions that prioritize controlling the spread of the virus.
We choose to open schools for kids by choosing to wear masks.
We choose to open schools for kids by choosing not to open non-essential services for adults.
We choose to open schools for kids by choosing to fund schools so that they can afford the services, tools and staff they desperately need in order to follow public health recommendations.
We choose to open schools for kids by making responsible decisions—the kinds of "adult" decisions our kids are relying on all of us to make.
"Our sense of responsibility toward children—at the very least, to protect them from the vicissitudes of life, including the poor decision making of adults who allow deadly infections to spiral out of control—is core to our humanity," the authors write. We can be the grownups our kids need us to be.
Close the bars. Close the bowling alleys. Close the gyms, the indoor restaurants, the indoor movie theaters.That way, we can really show that we prioritized reopening schools.
This post has been updated.
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