A new paper out Friday is the latest by experts arguing that grade schools in the U.S. could be reopened safely in the fall — given evidence that kids are unlikely to spread the coronavirus easily and provided that certain precautions are in place (a big if). There are many questions about whether the U.S. can meet these thresholds for safety in time, especially in the hardest-hit areas of the country. Unfortunately, much of the research surrounding covid-19 and schools has also focused on the risks to children, not the teachers and other adult employees who are more at risk of serious illness.
The paper, published in the journal Pediatrics, summarises much of the existing research on the risks of covid-19 among children, both in how it affects them and how likely they are to spread it to others.
The good news there is that children do seem to have a much easier time dealing with the virus once they catch it than adults, with most having mild or no symptoms. They also don’t appear to spread it very easily to other children or adults. One new study referenced by the paper looked at families living in the Swiss city of Geneva where at least one family member had contracted the virus. Children did get covid-19 occasionally, but more than 90% of the time, the first known case came from an adult in the family.
While the Geneva study and others are not conclusive proof that children can’t spread the virus to others, it’s more evidence that such transmission is relatively rare, according to William Raszka Jr, a pediatric researcher at the University of Vermont and one of the authors of the Pediatrics paper.
“The major focus of our editorial is to say that children, particularly younger children, seem to be less likely to transmit the disease,” Raszka told Gizmodo by phone. Because of this lowered risk, he adds, it should be possible to open schools safely, at least under the right circumstances.
Raszka’s opinion is echoed by other pediatric experts, including those at the American Academy of Pediatrics (AAP), which runs the journal Pediatrics. In late June, the organisation issued guidelines that emphasised the need to have kids “physically present in school” as much as possible this fall. In addition to the lowered risk of spread, the AAP cited the added risks of having children stay at home, including increased rates of domestic abuse, poorer academic performance, and a widening disparity between households that can afford reliable internet or other virtual tools and those that can’t.
Raskza also notes that countries elsewhere have reopened schools, while Sweden has kept them open the whole time. Unfortunately, data on how these schools have fared and whether they’ve contributed to transmission in the community is still limited. But there’s some early encouraging evidence. One preliminary study of an elementary school in France, for instance, found no evidence of “onwards transmission from children in the school setting.”
In these schools, there have been a variety of strategies used to lower the risk of covid-19 spreading that US schools could adopt. These have included mask usage, reduced days of physical schooling, keeping certain employee positions remote, and keeping classes from mixing together in group activities like gym. The AAP has recommended that kids are kept 0.91 m away from one another, if the standard 1.83 m rule is too cumbersome to implement. And still other experts have advocated the use of pooled testing, a relatively inexpensive way of testing large groups at once, as a screening tool in schools.
As reasonable as the evidence for schools reopening might be to some, the harsh reality is that the U.S. as a whole has failed to contain the pandemic. And many of the industries whose workers are most vulnerable to the virus have continuously flouted public health recommendations at every turn. States where the worst hotspots of illness are right now have outright ignored the advice of public health experts. The cynicism that many people have about schools being able to open safely is one that’s been fostered by the months of ineptitude they’ve seen from the country’s leaders.
So while it seems theoretically possible to have schools open and relatively safe, it’s another question entirely as to whether many schools in the U.S. can do so. In most countries where schools have opened, the rate of active covid-19 cases has been much lower than it currently is in the U.S., particularly in states like Texas and Arizona. While some pockets of the country have avoided major spikes in new cases, 33 states have seen a rise in reported cases over the last week, according to data analysed by Reuters. By some estimates, we’re now seeing the same number of total cases every day that we were in March and April, during the initial peak of the epidemic.
Joshua Sharfstein, a physician and public health expert at Johns Hopkins, is supportive of schools reopening in general. But he thinks it would be nearly impossible to do so safely in states like Texas and Arizona.
“I don’t know how you could open schools in that situation, because it’s just not practical — too many people will be getting sick, just because of the community spread. And I think it’s gonna be very hard,” he told Gizmodo by phone.
In a more ideal situation, there would be pressure and adequate resources to ensure that schools can meet the guidelines established by the AAP or the Centres for Disease Control and Prevention before opening their doors, including low transmission rates in the surrounding community. But nothing about the country’s response to covid-19 has been close to ideal. President Trump this week criticised the CDC guidelines for school reopenings as too restrictive and threatened to cut funding from schools that didn’t open. Soon after, there was speculation that CDC would pull back its guidelines at the behest of Trump. On Thursday, CDC director Robert Redfield said that wasn’t the case but that the agency would issue “additional reference documents” next week.
“The public health community is saying, look, you can put these ingredients together in a certain way and you bake at a certain temperature and you can get a cake. You know, you could actually have something that makes sense. But it seems like the administration is saying, ‘Forget the ingredients, don’t worry about the oven, and it’s still a cake,’” Sharfstein said of the recent CDC back-and-forth.
There’s also the consideration of age. Elementary school children seem the least at risk, but the risk likely climbs for high schoolers. And it’s a whole different story for college students, who often live in their own residential areas and seem just as likely to catch and spread covid-19 as any other adults, though their overall risk for serious illness remains low.
In Vermont, which has consistently reported low case rates of covid-19, Raskza doesn’t anticipate many hurdles from having schools open. But in covid-19 hotspots, he said, it might be wise to have a staggered approach, such as having physical classes for the youngest children first and seeing how it goes from there.
Ultimately, it may be the case that the risk of children spreading covid-19 to others is low enough that even a bungled plan for schools nationwide will keep outbreaks to a minimum. But schools aren’t just made up of kids, and we may be setting up yet another opportunity for the virus to spread widely among the many underpaid teachers and workers who keep schools running.
Many schools and teachers are already running on fumes financially, and it’s unclear where the funding for many of the added safety measures experts are advocating for will come from if not the federal government. One estimate by the American Federation of Teachers, one of the largest teachers’ unions in the country, found that $US116 ($167) billion would be needed to help public schools open safely.
While the coronavirus has proven a formidable threat worldwide, many countries have beaten it back with some success. But not the U.S. When I asked Sharfstein what he thought would happen once schools began to open this fall, he cited a quote from Albert Camus’ The Plague: “What’s natural is the microbe. All the rest — health, integrity, purity (if you like) — is a product of the human will, of a vigilance that must never falter.”
In other words, what happens next, not just with our schools but the pandemic in general, is up to whether we’re capable of pulling ourselves together.