COVID-19: How schools will reopen safely

For children, keeping schools closed in the face of the COVID-19 pandemic amounts to a cure that’s worse than the disease. Children are much less likely than adults to suffer any severe consequences of the virus, and they are at risk of suffering academically and emotionally if they miss more months of school.

That’s one reason it’s good news that K-12 schools in the United States are gearing up to reopen in the fall. “We know that in all kids, active engagement in learning is important for their development,” says Yale University infectious disease expert Albert Ko. There will be changes, however, that will make the school year far from normal.

As with everything else associated with this pandemic, safety measures will vary from place to place, as there’s not yet a scientifically agreed-upon standard for protecting students from SARS-CoV-2. Scientists are still trying to figure it out, and everyone is learning as they go along. Masks will undoubtedly be required for some students, though there’s still disagreement over whether they should be worn all the time by very young kids. The experts say they may end up touching their faces to fiddle with masks, thus increasing their odds of becoming infected.

Experts should gather lots of data to identify best practices among the hodgepodge of approaches, so that schools can find ways to stay open even if the pandemic worsens.

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If there’s any consensus, it’s that getting kids back into the classroom is worth the risks. “There’s accumulating evidence that even two months of schools closing in the spring did significant damage to the educational process in children,” says Colorado paediatrician Sean O’Leary, a spokesman for the American Academy of Paediatrics who has been helping put together a set of safety guidelines for restarting schools.

This is a big change from March, when scientists thought this disease might act like influenza pandemics, whose spread can be fuelled by school outbreaks, and which can be deadly to children.

With the flu, the youngest and oldest members of the population are the most adversely affected, says Vineet Menachery, an immunologist at University of Texas Medical Branch. Coronaviruses, including those causing the previous SARS and MERS epidemics, don’t seem to have the same pattern. Kids and teens are much less likely than adults to get severe cases or die.

Kids less likely to test positive for coronavirus

Still, a few children have been hospitalised with a severe inflammatory syndrome, which affects their blood vessels, skin and organs. “It’s driven by something the virus is doing that we don’t understand,” says Menachery. They still don’t have reliable statistics on the risk, he says, except that so far it appears to be rare. O’Leary, the Colorado paediatrician, says more kids die and are hospitalised for complications of flu and other respiratory infections, which aren’t deemed dangerous enough to close schools.

Another concern is that the virus will have a chance to spread in schools and spark outbreaks in communities. But the good news is that kids may be less likely to transmit the disease than adults. A study in Iceland that used a random sample of people revealed that children and teenagers were about half as likely to test positive for the virus as adults. By reading slight genetic differences from one virus to the next, they could track how the disease spread from person to person, and determined that within families, there were only two cases where kids gave the virus to an adult.

O’Leary says it’s also reassuring to see that while thousands of day care centres have been running for children of essential workers, only a couple of cases have been documented in the adults who work there. And another study from France showed schoolchildren were unlikely to spread the disease to parents, teachers or each other.

Some remote learning may be necessary

Many decisions are being left up to individual schools, says Sharon Nachman, Chief of Division of Paediatric Infectious Diseases at Stony Brook University, New York. Younger kids will be encouraged to wash their hands more often, hand sanitisers will be ubiquitous, and masks will be common. She says she it may be difficult to expect younger children to wear masks all day long. In some places it might be required, while others will focus on getting kids to mask up when they’re on the bus or walking through the hallways.

Different schools will also find ways to limit the number of children in a classroom — whether it’s having an early and late shift, or having half the kids attend every other week on Zoom, though remote learning will be complicated by parents’ return to work. One thing every school should do is make sure sick kids don’t come to class.

The new guidelines are flexible, says O’Leary, because measures such as spreading kids out in classrooms will be easier for some schools than others. And some remote learning may remain necessary in situations where a particular child’s health problems or those of a family member make classroom learning too dangerous. There’s also a risk that severe outbreaks force some schools to close again.

All these changes will have unintended consequences. Will students be able to hear masked teachers? Will staggered schedules cause sleep problems for the early shift or conflicts with parents’ works schedules? Will bus drivers be put at unacceptable risk?

We’ll soon find out. And as we do, experts should gather lots of data to identify best practices among the hodgepodge of approaches, so that schools can find ways to stay open even if the pandemic worsens. There’s a lot at stake.

— Bloomberg

Faye Flam is a Bloomberg Opinion columnist.