Schools need to reopen in the fall. Schools cannot reopen in the fall.
As both a parent and a science and health journalist, I feel torn between these twin truths. And it’s clear I’m not the only one.
Earlier this month, the American Academy of Pediatrics urged officials to aim for students to be “physically present” in schools this fall. The virus’s potential effects on child health, they said, did not outweigh the many benefits of going to school—not just to learn but also to eat meals, to interact with peers and educators, to stay in a safe place, to receive therapy and health care and other essential services. Before the pandemic, for instance, schools fed 35 million children, providing two-thirds of their nutritional needs. Research suggests that kids already fell behind on their education this spring, and the school closures widened racial and economic gaps. Like many adults, kids have also experienced mental and behavioral health issues during the lockdown, and rates of domestic violence and physical abuse are on the rise. With careful precautions, some child health experts said, reopening schools could be more beneficial than harmful to kids.
Political leaders including President Trump and Vice President Pence quickly seized this message, touting the importance of full in-person reopening of schools. Betsy DeVos, the U.S. Secretary of Education, threatened to cut funding from school districts that don’t fully reopen.
But only a few days later, the pediatricians clarified their position: School reopening should be based on the best available health information, backed by science. “Public health agencies must make recommendations based on evidence, not politics,” the AAP said in a joint statement with education associations.
So, what is the science?
Here’s the part that has led some people to suggest reopening schools is worth the risk: In the United States, less than 2 percent of recorded Covid-19 cases have been confirmed among children. Researchers in China found that susceptibility to the virus seemed to increase with age, meaning kids may be less likely to get it even when they come into contact with the virus. And they’re more likely to have mild or even no symptoms when they do have it. (That also might affect the number of confirmed cases: If kids don’t seem sick, they might not be tested.) The younger the kids, the better they seem to fare against the virus. Researchers believe the infection rate among younger children is lower because they have fewer ACE2 receptors, which they gain with age; the virus uses these receptors like doorknobs to enter the body.
But research on Covid-19 is evolving. And the latest research, in particular, is far less optimistic. Last week, a study conducted in South Korea and published online by the U.S. Centers for Disease Control and Prevention found that symptomatic kids between the ages of 10 and 19 are just as likely to spread Covid-19 as adults. Younger kids are about half as likely to spread the virus—but that’s not nothing. It’s also important to note that this study took place during school closures, when kids are less likely to interact with others than adults who work at essential jobs, for instance. The study also didn’t look at how much asymptomatic children can spread the virus. That could mean that even this study underestimates kids’ ability to transmit the illness: Researchers studying Covid-19 in general, so far, have found that “silent transmission” from those who haven’t yet developed symptoms, or never do, seems to contribute to a “majority” of cases. There’s evidence that even young children can spread the virus. Cases at daycare centers are rising—including one in-home center where at least 16 children and adults were sickened while a parent and baby waited for days on test results that eventually came back positive.
So while healthy children are at lower risk for the virus, they’re not no-risk. Long-term health issues, including neurological complications, are poorly understood—especially in children. And even healthy children present a risk to others: to their peers, teachers, bus drivers, other school staff, and family members back home.
What parents and administrators alike want to know is whether there’s anything individual schools can do to mitigate that risk. There is, researchers say—but it’s complicated, it’s not cheap, and in some areas, it’s impossible.
“Whenever we’re talking about school reopening, we talk about it as kind of a monolith,” Sara Johnson, an associate professor of pediatrics at the Johns Hopkins University School of Medicine and co-director of the Hopkins Consortium for School-Based Health Solutions, told me. But “each school reopening is a totally different set of considerations, and even within districts, there’s a huge amount of variability.”
Megan Collins, co-director of the Hopkins consortium, agreed. “There’s no one-size-fits-all solution here. There has to be the flexibility to adapt according to what different communities need.”
Johnson and Collins said they’d ask two main questions when it comes to reopening: What do transmission rates look like in a given school’s community, and what resources does the school have?
If a community has the virus under control—cases are steadily falling, hospitals have enough capacity, testing and contact tracing are robust—then they can begin preparing for in-person classes. That preparation requires resources: implementing strong testing and tracing strategies; providing personal protective equipment for everyone; ensuring physical distancing is possible; improving ventilation and air circulation; giving sick leave to school staff and parents who may be sick; and offering additional health, safety, and cleaning measures. Teachers and families also need support for housing and income so they can safely distance and quarantine as needed. “All of those things take money in order to make them work,” Johnson said.
Widespread availability of rapid, frequent testing is a “critical” part of keeping schools—and communities—safe, Collins added. “It really is one of the linchpins of being able to reopen in-person school safely.” Effective contact tracing is another important element. But neither of these methods are working well in the U.S. now: Results sometimes take days to come back, making effective contact tracing difficult.
If the virus isn’t under control in a community, schools need the resources to conduct virtual classes. That means everything from giving each student a laptop to making sure all homes in the country have access to high-speed internet. About one in seven children do not have internet access at home, and those with cell phones often have limited data plans. Some students have taken to sitting in parking lots to complete their Zoom lessons. Schools will also need funding to retool many of the other forms of support they usually offer, which have been located within schools simply because it’s the simplest method of delivery. That includes meals, health services, and therapy.
Either way, Johnson said, “we need to do school differently this year.”
A huge part of the difficulty with school reopenings has to do with developing research on Covid-19 transmission, which increasingly suggests schools are a potential breeding ground for this virus. The World Health Organization recently reversed its earlier position, conceding that the coronavirus may spread through airborne transmission in certain circumstances. Schools check all of the boxes for those conditions: crowds of people indoors, often with poor ventilation, for long periods of time. Even if students and educators manage to stay three to six feet apart all day long, the distance between them won’t protect them fully if the air they’re all breathing in and out is not filtered quickly and effectively.
Some building ventilation systems can be retrofitted with filters, Joseph Allen, an assistant professor of exposure assessment science at the Harvard T.H. Chan School of Public Health, told me recently when we discussed his airborne transmission research. But many schools—particularly those that were already under-resourced—are dealing with aging infrastructure that makes retrofitting expensive or impossible. In those cases, Allen suggested portable air purifiers with HEPA filters, which capture nearly all airborne particles.
Another solution might be throwing open the windows—provided the windows can open, and have sturdy screens on them, and the weather allows. Some schools are also considering holding classes outside in a tent or field—again, climate permitting. “One hundred percent outdoor air would be best,” Allen said, in addition to other precautions like plenty of distance, masks, and frequent hand-washing. But even playing together outside has its risks: Several summer camps shut down following outbreaks, despite taking abundant precautions.
At summer camps and in the South Korea study, teens have been at higher risk than younger kids, prompting some experts to recommend opening only elementary schools, not middle or high schools. That’s what some countries have done, with many precautions in place. On July 15, a panel of experts from the National Academies of Science, Engineering and Medicine recommended that schools open, where possible, for younger kids and those with special needs. Shayla R. Griffin, a researcher and educator based in Detroit, who works on issues of equity and inclusion, similarly suggested in a recent blog post that schools open only for those who need in-person classes the most—including younger students who struggle with online learning and those with special needs. These in-person classes could use empty middle and high school classrooms for greater distancing, with traditional district lines blurring based on need. While it is difficult to replace in-person instruction for any student, it is nearly impossible to replace in-person occupational therapy, social adaptive skills, and other interventions for children who need them.
“Many of the kids who are going to be unable to participate in in-person school, or who may have the most challenges in engaging in this hybrid model, are likely to be the same kids who are already potentially facing the biggest challenges in schools to begin with,” Johnson said. “The pandemic has really amplified, or has the potential to amplify, some of those disparities.” So while parents everywhere are eager for schools to reopen, shoring up resources for the children who are at the greatest risk for being disproportionately affected by this pandemic is an important part of the response, she said.
School districts still hoping to find a way around this problem by simultaneously preparing for all-online, all-in-person, and hybrid models are probably doing both teachers and students a disservice. “We have a month to do it. Don’t distract teachers by asking them to come up with three versions of plans when two of them are unlikely to be safe to implement,” Griffin wrote in her blog post. In any case, she argued, with teachers focused on keeping classrooms clean and getting students to wear masks and maintain a distance, it’s not clear students would actually learn more in-person than online.
Johnson and Collins also pointed to the potential risks to teachers. Earlier this month, three teachers conducting virtual summer school together in Arizona caught the virus; one teacher, Kimberly Chavez Lopez Byrd, died. All of the teachers wore masks, sanitized their hands and equipment, and kept a physical distance.
“This is not something that should be happening to teachers; we should be talking specifically with them around strategies to keep everyone safe,” Johnson said. If teachers don’t feel safe or are focused on mitigating the spread of the virus within the classroom, she said, “then they’re not going to be able to be present in the classroom, doing the work that every parent who has tried to teach their children over the last four months recognizes is incredibly difficult and important.”
That’s the heart of the issue when it comes to reopening schools: Children need and deserve a good education, social interaction with their peers, a safe place to spend their days, reliable meals, and therapy and health services. And parents need childcare.
But children and parents also need to stay alive. And they need their families, teachers, and friends to stay alive, too.
Temporary policy measures could help reduce the strain. Griffin, who recommended having most students learn from home, said that families should receive a guaranteed basic income during the pandemic, since parents and caregivers will be functioning as “co-teachers” and can’t count on having childcare while they work. Paying parents for the work they do to support their children’s education would not only help stabilize families’ income, which means they would still be able to put food on the table and keep a roof over their heads; it would also help children learn better, with in-person assistance from their caregivers.
Every realistic measure proposed to resume education, whether in-person or at home, is expensive. Anything cheap or simple is probably ignoring one of two realities: first, that schools are hugely important to the students and parents they serve and to the U.S. economy; and second, that this virus is deadly—and still here. If the goal is to be able to return to normal life or some semblance of it, where kids can learn and play and grow, parents can get some work done, and teachers can teach, then we have to focus on controlling a pandemic that, in this country at least, still hasn’t reached its height.