Getting Back to School in The Age of COVID-19

This information refers only to K-12 education. 

The best place for children to get their education and further their development is in a structured environment in school. They can still be safe if the correct procedures are in place and monitored regularly.  Nothing is a 100% guarantee, but lots of information exists suggesting that children can attend school if the right environment is in place.

So let’s try to cut the politics and make sense of data that are available. 

I will tell right up front there are no standard metrics for making a yes/no decision on whether or not schools should be opened. 

I attended an online American Public Health Association seminar on 8/12/2020 entitled “Covid-19 Conversations – Returning to K-12”.  

Important data were presented which put the young child’s handling and transmission of SARS-CoV-2 in perspective.   Dr. Wendy Armstrong, Emory University indicated that as of 8/9 9.1% of the Covid-19 cases have been in children yet they represent 22% of the population.  Further, only 3% were hospitalized and 1% died. I’m not minimizing this; any number is too many. I wanted to show the data suggesting that the disease is less severe and less common in children. 

There are differences in virus transmission based on age, looking at children <10 and those 10-19 years of age.  Younger children do better and also do not transmit the virus to adults as efficiently as older children.   This has been shown in several studies and does not seem to be related to the amount of virus the young children grow (their viral load), J Ped. July 30, 2020). 

Denmark reported reopening K-5 grades on April 15th after virus peaked on the 1st.  This was on a background of a lockdown and it was a success. Children were kept 2 meter apart and hand washing was done often. 

An interesting anecdote (not discussed at this meeting) is a 9 year old French boy with Covid-19 who unknowingly exposed 80 of his schoolmates.  None of them developed disease. 

Now to the Metrics. How can we open schools if there are no metrics?   Dr. Caitlin Rivers from Johns Hopkins School of Public Health suggested no more than a 5% positive virus rate in the community.  Greater than 10% would suggest school closing, and virtual schooling.  Dr. Anthony Fauci now has been advocating these numbers as well. 

What is a community?  This will have to be defined locally.  Is it the county?  School? District?

Here are other some other issues to consider:  A teacher might be commuting from a high to a low viral area.  Protocols have to be established for all such employees. 

Temperature measurements:  do you use resources measuring temperatures?  Virus can be present for days before a fever.  And someone may never get a fever. 

Safety:

-podding or cohorting:  consider developing subgroups of children such that interactions with large groups will be limited. 

-masks must be a requirement.

-social distancing.

-constant reminders to children not to touch each other or their faces. 

-hand washing when coming into school and leaving restrooms. 

-sanitizing procedures.

The CDC has provided several sets of guidance   I have attached them below for your convenience. 

CDC guidance for complete details 

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/prepare-safe-return.html


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