Commit to opening in-person school (and let everything else follow)

Really been meaning to write a post on opening up schools, but have not because there’s just so much I want to say.  But, now that I’ve seen the idea I’ve been advocating is also what Emily Oster is saying, well, damnit, time to write.  

We’re never going (safely) get kids back in regular, in-person, school, unless we actually commit to this as our #1 national priority.  So, we need to commit to that, because it is so damn important to the kids and the overall functioning of society (working parents and all), that we need to say we are going to make it happen to force ourselves to find ways to make it happen.  Otherwise, it’s just too easy to go with half-assed plans (like my school system’s current 1 week on; 2 weeks off plan that seems largely logistically nightmarish) that offer something but are insufficiently innovative and, perhaps, insufficiently risk tolerant. 

But, let’s start with schools as the priority.  And a huge thing we need to do is get the virus under better control in most states.  Like, you know why we need to keep you out of bars, gyms, and restaurants now?  So your kids can go to school safely.  You know why you need to wear a mask every damn time you are indoors around non-family members?  So your kids can go to school safely.  You know why it sucks that your high-schooler is home, but your elementary kid is in the building?  So your kids can go to school safely.  (Lots of research and experience with other nations suggests that we start with elementary school kids) You know why we are doing this weird thing with “pods” in the school and pooled testing and whatever else?  So your kids can go to school safely.  

Why are we spending more money on a bunch of stuff?  So your kids can go to school safely.

I think ventilation may actually be the most important on this list.  I don’t think there’s been actual studies, but from what I’ve read, let’s open some windows!  And where there’s not enough windows, jury-rig some solutions.  

Okay, so some good stuff I read.  Let’s start with Oster.  So much good stuff:

A successful approach will meet two main goals: First, it will protect the safety of kids and staff (teachers, sure, but also cafeteria workers, janitorial staff, coaches, and everyone else) as well as the broader public. Second, it will, if at all possible, have kids in classrooms, in some form, full time.

The question, then, is: What’s it going to take to do that?

In the big picture, there are four crucial elements: commitment, flexibility, realism, and a focus on staff.

This will never happen if policymakers do not commit to doing it now. Rhode Island Gov. Gina Raimondo has come under a lot of criticism for saying schools will open Aug. 31 without providing a lot of details about how that will happen. I see the critics’ perspective, but the fact is that if you start by saying, “Let’s explore the possibilities,” it will not happen. The logistics of opening schools are daunting to the point of breaking even the best of us. If it feels like there is a choice, it will be too easy to decide not to.

When someone comes out and says, “We are opening,” it puts on the pressure to find a way. It encourages people to think about creative solutions and push past the problems. The only way this is even a passing hope is if we commit to making it so. emphases mine]

We will need to be flexible. We may find that, come August, the pandemic situation is such that it is unsafe to open despite having done our best to be as safe as possible. The same way that we are backtracking on indoor dining, we may need to backtrack on schools. I really, really hope not. But we must be ready to do so.

We also need to be realistic. When we reopen schools, some people at schools—kids, staff—will get COVID-19. Some of these infections would happen anyway, outside of school. Many of them will not be driven by school contacts. But there will be in some in-school transmission, no matter how careful we are. This is the unfortunate reality. Some of these people may get very sick. If we are not willing to accept this, we cannot open schools. We also, in that case, should not open anything else.

[It’s on Slate, it’s free, read all of it]

Juliette Kayem in the Atlantic:

If American society is going to take one major risk in the name of reopening, ideally it should be to send children back to school…

Reopening indoor bars—closed spaces where wearing masks and maintaining social distancing are difficult—was clearly a mistake. Yet approximately zero public officials believe that letting adults drink is more important than educating kids, and any implication that reopening bars and reopening schools are roughly equivalent tasks badly understates the enormous barriers to the latter. From the government’s perspective, the only thing bars need is permission to reopen. Once they get it, owners and employees can go back to work, and the money starts flowing.

Schools do not have a simple on-off switch. To reopen schools will not just take a lot of money. Classroom layouts, buildings, policies, schedules, extracurricular activities, teacher and staff assignments, and even curricula must all be altered to minimize the risk of coronavirus transmission. Stakeholders—including teachers’ unions, scared parents, and the colleges and universities that will someday enroll a portion of the 50 million students in the nation’s public K–12 schools—all have interests, some not easily avoided or ignored by a governor. Assigning a young, healthy high-school math teacher to substitute for a second-grade reading teacher with chronic health conditions—or inviting idle recent college graduates to sign on as teaching assistants—might sound easy on paper; in reality, the regulations meant to ensure that adults in classrooms are appropriately trained and vetted to work with children are also impediments to making rapid personnel moves in a crisis. Without clear direction and substantial financial support from the state or federal agencies, the easiest course for school administrators is to say nothing. According to a survey in mid-June, 94 percent of K–12 superintendents weren’t ready to announce when or how their schools would reopen.

Two things need to happen before students can go back to school: First, Americans and their elected representatives must consciously decide that children’s needs are worth accepting some additional risk. Second, states and communities must commit the money and effort necessary to reinvent education under radically changed circumstances. Even in states where case counts have plunged, doing what’s right for children will require a massive civic mobilization.

We need this commitment!  Not Trump’s tweets.  The American public needs to demand this commitment from our “leaders.”  Not that I’m optimistic (my mantra whenever I’m feeling hopeless and frustrated– monoclonal antibodies are coming).  

We also need to learn from other nations (there’s a lot to learn).  And, accept that there is some risk (hard when school systems will close over even the threat of a dusting of snow).  But, there really is less risk of kids spreading Covid.  Great article in Science summarizing what we’ve learned from schools in other countries under Covid:

Do schools spread the virus to the wider community?

Because children so rarely develop severe symptoms, experts have cautioned that open schools might pose a much greater risk to teachers, family members, and the wider community than to students themselves. Many teachers and other school staff are understandably nervous about returning to the classroom. In surveys of U.S. school districts, as many as one-third of staff say they prefer to stay away. Science could find few reports of deaths or serious illnesses from COVID-19 among school staff, but information is sparse. Several teachers have died of COVID-19 complications in Sweden, where schools did not modify class sizes or make other substantive adjustments.

Early data from European countries suggest the risk to the wider community is small. At least when local infection rates are low, opening schools with some precautions does not seem to cause a significant jump in infections elsewhere…

In a broader study of COVID-19 clusters worldwide, epidemiologist Gwen Knight at the London School of Hygiene & Tropical Medicine and her colleagues collected data before most school closings took effect. If schools were a major driver of viral spread, she says, “We would have expected to find more clusters linked to schools. That’s not what we found.” Still, she adds, without widespread testing of young people, who often don’t have symptoms, it’s hard to know for sure what role schools might play.

Also, kids should wear masks!  Enough with the, “ooohhh, there’s just no way a kid can wear a mask all day.”  Are Korean and Chinese kids really so different?  They do it:

Should kids wear masks?

Masks likely blunt spread at school, but children—even more than adults—find them uncomfortable to wear for hours and may lack the self-discipline to wear them without touching their faces or freeing their noses. Does discomfort override a potential public health benefit?

“For me, masks are part of the equation” for slowing the spread of COVID-19 in schools, especially when distancing is difficult, says Susan Coffin, an infectious disease physician at the Children’s Hospital of Philadelphia. “Respiratory droplets are a major mode of [virus] transmission,” she says, and wearing a mask places an obstacle in those droplets’ path.

In China, South Korea, Japan, and Vietnam—where masks are already widely accepted and worn by many during flu season—schools require them for almost all students and their teachers. China allows students to remove masks only for lunch, when children are separated by glass or plastic partitions. Israel requires masks for children older than age 7 outside the classroom, and for children in fourth grade and above all day—and they comply, says Aflalo, who has 8- and 11-year-old boys. On the bus ride to school, “all the kids are sitting with masks on,” she says. “They don’t take them off. They listen to the orders.”

I also find it compelling that Linsey Marr– the go-to virologist on aerosols– wants her kids back in school in masks.

And, while we’re at it, and I love the science of this stuff, here’s the details on why younger kids spread less Covid:

  • Asymptomatic non-coughing people release less virus-loaded aerosols.
  • Children have less alveoli and terminal bronchioles where breath droplets are formed.
  • Children have a lower respiratory minute volume and tend to have lower viral load.
  • All this combined can explain why children are poor COVID-19 virus spreaders.

Okay, that was a lot!  But at least now I’ve done it.  

 

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