Epidemiologist: Schools can open safely, and here’s how
Schools need to open for the good of kids, parents and the economy, and we can do it safely by focusing on protecting teachers. This is not only an educational issue, it's also a social justice issue.
As an infectious disease epidemiologist and economist, my specific skill set is really useful about once every 100 years. I had the privilege to serve as a pandemic responder at the Federal Emergency Management Agency and the White House in March and April. I’m also a single parent of two daughters who attend public elementary school in New York City. I have many reasons to care about the safe reopening of schools.
It is a great relief that kids have been relatively safe in this pandemic. Kids are less susceptible to the virus, don’t often feel sick if infected and are not big spreaders. Children are likely dead ends for this coronavirus.
Pressure to keep school buildings closed has been based on fear instead of data from consistent testing. While closing bars and restaurants clearly slowed the pandemic growth rate, school closures in the United States hardly made a difference. The Centers for Disease Control and Prevention never suggested closing them all in the first place. And now the American Academy of Pediatrics says the value of reopening schools far outweighs safety concerns of the virus.
It is a great relief that kids have been relatively safe in this pandemic.
Adult interactions are driving this pandemic. Transmission patterns in the Netherlands and clusters of cases in Japan showed no spreading of virus attributed to people younger than 18. Shocking results from Seattle found only 1% COVID-19 prevalence among sick kids during the epidemic peak — challenging the assumption that kids are infected at the same rate as grown-ups.
Exceptions, like a school outbreak explained by a superspreader teacher or signals of a syndrome among recovered children, are rare.
Remote K-8 learning further exacerbates the inequitable distribution of COVID-19 burden on Black lives, in terms of health and economic impact. We didn’t need the elegant equations of a National Bureau of Economic Research white paper to understand that poorer people in New York City had to keep using the subway to go to work (essential for society or their livelihood) while wealthier ZIP code residents worked from home or fled the city.
These disparities in exposure drove some of the racial disparities in health outcomes we observed. If schools remain remote, economic disparities will increase for people of color and low-incomes families.
Action is needed now to open classroom doors this fall. And testing is the key.
The focus should be on protecting teachers. It begins with a robust testing program, so they feel safe in the classroom. We know that uncertainty about one’s health and the health of others makes it difficult to feel confident enough to return to work.
Cost-effective, routine COVID-19 testing and on-site specimen collection for real-time evaluation could confirm that preventative measures are working. Other efforts could further reduce the risk of grown-ups infecting other grown-ups.
Require masks in school hallways and other spaces that classrooms share. Open windows and doors, weather permitting, to circulate more clean air. Keep parents outside the building at drop-off and pick-up. We also need to implement flexible administrative policies to allow the most vulnerable teachers and staff to stay home.
If we don’t open schools fully, it comes at a developmental and economic cost. Remote learning disproportionately cripples lower-income families trying to survive and about 20 million unemployed trying to find jobs.
Reduced work productivity, lost income, increased child care costs (if you can afford the luxury), and greater challenge for under- and unemployed to find jobs hinder our trajectory toward a robust economic recovery.
Benefits don't outweigh cost
From my perspective, there is insufficient justification for continued remote learning in the fall — the expected public health benefit does not outweigh the massive cost.
It’s time for the grown-ups to use evidence, administrative policies, available testing and engineering to protect our teachers. Learning in the classroom is a treasure to our society and essential for a productive workforce. It’s time to reopen school.
Blythe Adamson is an affiliate professor in the Comparative Health Outcomes, Policy and Economics (CHOICE) Institute at the University of Washington, a principal scientist at Flatiron Health in New York, and is on the advisory council of Testing for America.