THE BEHAVIORAL HEALTH CRISIS:

Understand how we got here — and how to move forward.

X

July 10, 2020

Will it be safe for children to go back to school this fall?

Daily Briefing

    President Trump and members of his administration are pushing for schools to reopen in the fall, but experts are divided: Some are concerned about the possibility of children carrying the new coronavirus and transmitting it to adults, while others have said the risks of keeping children at home outweigh the risks associated with the virus.

     
    Your top resources for Covid-19 response and resilience

    Trump pressures states to reopen schools

    In a roundtable discussion at the White House on Tuesday, Trump said his administration will "very much … put pressure on governors and everybody else to open the schools." Separately, Trump in a tweet posted Tuesday wrote that his administration "[m]ay cut off funding if [schools do] not open."

    Department of Education Secretary Betsy DeVos said cutting funding to schools that don't reopen in the fall is "definitely something to be looked at." She added that "it's not a question of if—it's just a question of how" schools will reopen.

    CDC Director Robert Redfield said the agency's reopening guidance for schools, which CDC last updated in May, should be seen as a recommendation for schools to reopen. "CDC encourages all schools … to do what they need to reopen," he said. "Nothing would cause me greater sadness than to see any school district or school use our guidance as a reason not to reopen."

    However, Trump in a separate tweet posted Tuesday wrote that he disagreed with CDC's guidance, calling it "very tough [and] expensive." Trump added that he would meet with CDC regarding the guidance.

    On Wednesday, Vice President Pence said CDC beginning next week will issue additional guidance to provide "more clarity" on reopening schools, and he encouraged local officials to make their own judgements on how to move forward.

    "We don't want the guidance from CDC to be a reason why schools don't open," Pence said. "I think that every American … knows that we can safely reopen our schools," and "[w]e want … to make sure that what we're doing doesn't stand in the way of doing that."

    Redfield on Thursday said CDC won't revise its current guidelines, but will "provide additional information to help schools be able to use the guidance that we put forth."

    "Our guidelines are our guidelines," Redfield said during an interview with ABC's "Good Morning America."

    A draft of CDC's forthcoming guidance, obtained by the Associated Press, states that the agency "cannot provide one-size-fits-all criteria for opening and closing schools or changing the way schools are run," though there are recommended steps schools can take to reopen safely. Ultimately, though, the draft guidance states that "[d]ecisions about how to open and run schools safely should be made based on local needs and conditions," the AP reports.

    Is reopening schools safe?

    Experts are divided on whether it's safe to reopen schools in the fall.

    Evidence suggests children may not be immune from experiencing complications related to the new coronavirus. Over the past few months, for example, doctors have reported a growing number of cases of a rare, life-threatening, multi-system inflammatory syndrome in children that has been linked to the virus, leaving scientists scrambling to identify and understand the condition.

    In addition, Dean Hart, an expert in microbiology and the transmission of viruses and diseases, said children could easily become "silent spreaders" of the new coronavirus, which would "almost certainly lead to more death of the older and vulnerable."

    "We are seeing spikes across the country that in certain areas would mean the reopening of schools would spread [the virus] at a faster pace due to shared classrooms, dormitories, desks, and surfaces," he said.

    Jeffrey Shaman, an epidemiologist at Columbia University, said he believes reopening schools is risky, and noted that some research has shown children could pass the new coronavirus on to their families. "I haven't seen enough evidence to convince me that children are less involved in the transmission of Covid-19," he said.

    Further, Benjamin Linas, an infectious disease doctor and epidemiologist, in Vox writes that teachers could be at risk of contracting the new coronavirus if they're required to return to schools—and not just while they're in the classroom. "[W]hile many of us immediately think of the risk to teachers from exposure in the classroom, we may not consider the additional risk that teachers face in break rooms and staff meetings," he writes. "Working in the hospital, I have personally seen that staff have a difficult time maintaining personal protection at all times. … The same will likely be true in schools." He added, "Staff risk in schools likely looks similar to the risk of any adult working in a crowded indoor environment during the pandemic."

    Anita Cicero, deputy director of the Johns Hopkins Center for Health Security, said while getting children back in school is important, "the idea of sending kids back to indoor public places with large numbers of [people] … when the [country's coronavirus epidemic] is raging at the level it was in April in New York and New Jersey—I feel like there is a disconnect there," particularly because the Trump administration doesn't appear to be aiding schools with reopening plans. The administration is "sort of asking schools to do the undoable—'just make it work, get all the kids back, and get them in five days a week, and keep their distance and do all the hygiene … but if you can't do it, that's not our fault, that's up to the locals,'" she said.

    Other experts have acknowledged the risks associated with reopening schools, but they said the risks of keeping children home too long are even greater.

    For instance, Barry Bloom, former dean of the Harvard T.H. Chan School of Public Health, said he thinks schools should reopen. "I believe that the process of socialization is really important, and that long-term deprivation of that is probably going to do more harm than the occasional child becoming infected," he said. "We also need to liberate parents and get them back to work, but as carefully as we can."

    Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, said, "The idea of keeping kids at home, and having parents work at home, for however long, until we get a vaccine, it seems to me that there are harms that kids are experiencing that we are not accounting for."

    In addition, experts have noted that some research has indicated children infected with the coronavirus may not be as contagious as adults, nor are they as affected by Covid-19, the disease caused by the virus, The Atlantic reports. One study published in Nature found that children and teenagers are around 50% as likely as adults to become infected with the virus, for example.

    Ashish Jha, director of the Harvard Global Health Institute, said, "The good news is we think kids transmit less. They are certainly less likely to get sick." However, he added, "If we see large outbreaks happening across communities, it's going to be very hard to keep schools open."

    Paul Volberding, a professor of medicine and emeritus professor of epidemiology and biostatistics at the University of California-San Francisco, said data he's seen suggests that "really young kids are not much of an infection reservoir, so I think it might be okay for preschool, day care, and elementary school [to reopen]." However, for older students, schools may have to make adjustments, like having morning and afternoon shifts and limited hours, Volberding said.

    In an opinion piece published by JAMA, Josh Sharfstein, vice dean of the Johns Hopkins Bloomberg School of Public Health, wrote that schools should reopen with modifications, keeping students six feet apart, staggering student drop offs, and requiring students to wear masks. He also suggested that, to promote physical distancing, "kids [should] be in school one day, out of school the next day; in school one week, out of school the next week."

    Ultimately, Linas writes, "Will someone in America contract Covid-19 from their sick child? Yes. Should I structure my life around such a rare occurrence? I do not think so." He adds, "A discussion of school closures that focuses only on Covid-19 and not at all on education is incomplete. There are real risks to keeping our children at home. In fact, the risks of staying home are in many ways clearer than the risks of returning to school" (Collins/Jackson, USA Today, 7/7; Sprunt, NPR, 7/7; Gaudiano, Politico, 7/7; Gaudiano/Perez, Politico, 7/4; Whittle/Thompson, Associated Press, 7/5; Khazan, The Atlantic, 6/25; Cimons, Washington Post, 7/3; Wagner, Washington Post, 7/8; Owens/Fernandez, Axios, 7/9; Amy/Feldman, Associated Press, 7/9; Reyes, USA Today, 7/9; Linas, Vox, 7/9).

    Have a Question?

    x

    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.