Jul 23, 2020
Is School Safe?
By Dr. Claire Neely
As we move toward resuming activities during the time of COVID-19, naturally the question arises as to whether or not our children should be back in school this fall. Schools and COVID-19 pose a challenge. In a nutshell we need to determine – is school safe?
It’s not a question that has a definitive answer. Like so many topics surrounding the pandemic, we need to consider many different factors and perhaps rephrase the question in several different ways. Is it safe for your child to return to school given your family situation and dynamics? Is it safe for your child to return to school given the level of infection in your immediate community? Are the developmental risks greater than the rate of infection for your child? And of course, are we equipped to keep our teachers and school staff safe from infection?
Most of the conversation around reopening schools has naturally focused around the risk of infection. As I talk to my fellow pediatricians and other colleagues in the healthcare community, it’s become clear that we need to identify several conditions to help us answer the question of re-opening schools not universally, but at a community, family and individual level.
This list is certainly not inclusive, but should provide some idea of the challenge we’re faced with in making a good decision for our children and our families right now.
- The infection rate within the community needs to be low and testing needs to be readily available. If a community infection rate is pushing 15-20%, it’s probably not a good plan to send our kids back to school. On the other hand, if the infection rate in the community is somewhere between 5-7%, and good testing and screening practices are in place in that community, the risk is much lower. If – along with these low community risk factors – the schools are also able to provide good mitigation strategies (as described in this link from the MN Department of Education), we can probably operate fairly safely.
- Schools need to be configurable for infection prevention. Some schools may not have enough room to design social distancing within classrooms, for example. Others may have classes of such size that cohorts of ten or smaller are not possible, given staffing levels. Lockers are not likely to be a good idea at this time, so there may need to be a design for storing books and other items that may be too much to carry all day long. And of course, transportation needs to be considered, as buses may be the only way children can get to school.
- Students adherence to safety practices depends on age. While there are a variety of environmental controls can work for middle school and high school students and they are more likely to adhere to wearing face-coverings and social distancing, it is different in younger kids. Expecting a kindergardener to wear his mask or stay 6 feet away from her friends is not realistic. While young children appear to be less likely to develop serious illness from COVID and may not spread it to others as easily, we need to remember that we are still learning about this illness.
- We should consider the developmental impacts on young children. Thinking about the decision to open schools requires considerations in addition to the ones around COVID infection and spread. We know that psychological pathways are being formed in young children (3-6 years) and that being in school has an important, lifelong, positive impact. Interactions with other children – and other adults – are important to their development. Some children are in homes where abuse or neglect occurs. Teachers are one of the main identifiers of when a child is in an unsafe situation, which is a very real protective factor for children. Schools also provide an important function in providing healthy food – for many children, their best meal(s) of the day come from school. School provides more than formal education for our kids and we must consider that as well.
- Families need an “out.” As schools resume in-person, it will be important to have guidelines that address family situations where attendance in school could result in higher risk for families. This might be in the case of an expectant mom, or a family trying to become pregnant. Immuno-suppressed people or others with high-risk, chronic conditions should be considered if they’re in the immediate household with a child. (These are factors that affect teachers and school staff, too.)
These are just a few of the areas that need to be considered when asking questions about schools re-opening. In late June, the American Academy of Pediatricians released their COVID-19 Planning Considerations: Guidance for School Re-entry. The AAP highly recommends a collaborative approach to this question, and one that provides a high degree of flexibility not only for static circumstances, but also to address conditions that are constantly changing as situation evolves.
The decision about opening schools is not one to be based only on numbers. Parents need to think across the spectrum of factors to determine whether or not a return to school is beneficial for their child. School administrators and school boards need to do the same. They also need to consider the safety and wellbeing of their teachers and staff and how to provide options for individual needs.
And we all need to remain flexible. As community conditions change and as we learn more about this virus, today’s decision may need to change tomorrow.
Claire Neely, MD, FAAP is the CEO and President of ICSI and a Minnesota healthcare leader for more than 30 years. Dr. Neely has been a Fellow of the American Academy of Pediatrics since 1995 and a board-certified Pediatrician since 1985.