Many common prerequisites for opening schools – vaccines for teachers or students, and low rates of infection in the community – are not necessary to teach children safely, a new survey concurs with pediatric infectious disease experts .
Instead, 175 experts – mostly pediatricians focused on public health – largely agreed that it was safe for schools to be open to full-time and individual instruction for elementary students. This is true even in communities where the Kovid-19 transition is widespread, unless basic security measures are put in place. Most important, he said, were universal masking, physical disturbances, adequate ventilation and shielding from large group activities.
The survey was conducted by The New York Times last week by experts. Most believe that the amount of virus spread in a community is not an important indicator of whether schools should be open, although many districts still rely on that metric. Schools should be closed only when there are Kovid-19 cases in the school itself, most said.
Assistant Professor of Pediatric Infectious Diseases at Washington University in St. Louis, Drs. David Rosen said, “There is no situation in which schools cannot open unless they have proof of school-transmission.”
Experts said the risk of dropping out of school was far greater. Dr. Head of Division of Pediatric Infectious Diseases at RWJBarnabas Health in New Jersey. Uzma Hassan said, “The mental health crisis resulting from school closures will be an epidemic worse than Kovid.”
For the most part, these responses coincide Current federal guidance, Which does not refer to vaccines, and reflects Important scientific evidence They are schools Is not a major source of spread For children or adults. The Centers for Disease Control and Prevention is expected to issue new recommendations on Friday on how schools can operate safely, and the Biden administration has prioritized primary schools.
But the expert consensus in the survey rests with the position of some policymakers, school administrators, parent groups and teachers’ unions. Some of these groups have indicated that they do not want to return to school buildings even next fall, when it is likely that teachers will be able to vaccinate, although most students do not. Some districts have faced fierce resistance to reopening, particularly in larger cities, where teachers have threatened to strike if they are called back to school buildings.
And some experts concluded that open schools pose a risk, especially to adults working there, adding that many parts of the country have not yet adequately controlled the virus to open it safely.
“If we wanted to reopen schools safely, we should work harder as a society to keep transmission rates down and invest resources in schools,” Dr. Lena Wayne, an emergency physician and a visiting professor of health policy at George Washington said university.
About half of the nation’s students are still learning from home, and most districts are offering at least some in-person learning and are trying to reopen this spring, with many students a few hours a day Or providing some day. one week.
The mismatch between experts ‘preferred policies and the rules governing the opening of schools in many districts reflects political views and union demands, but scientists’ understanding of the virus also changes. Several school policies were developed months ago, before mounting evidence that Kovid-19 does not spread easily to schools adopting basic safety precautions. Guidance may change again, he warned: Almost all expressed some concern that new coronavirus viruses could disrupt schools’ plans to open or fall this spring.
More than two-thirds of the respondents stated that they had school-age children, and half had children in school for at least some time. Despite all this, they were more likely to not support their own schools being open. Of the communities in which schools were open full-time, about 85 percent said their district made the right call, while one-third of the schools in those locations were still closed, which were the right choice.
“Closing school in spring 2020 was the right decision: We did not know much about Kovid at the time and did not know what role children might play in transmission,” said Dr., director of pediatric physical therapy at the University of California. Mitul Kapadia said. , San Francisco. “We know now, and know that schools can open safely. Fear is also deciding against guidance and recommendations from the medical and public health community. “
Most agreement points required masks for all. All respondents stated that this was important, and many said that it was a simple solution that made the need for other requirements less open.
“Masks in health care, will work in schools,” Dr. Said Danielle Zerr, a professor and division head of pediatric infectious diseases at the University of Washington. “Kids are good at wearing masks!”
Half the panel called for a full return to school without any precautions – no masks, whole classrooms and all activities were restored – requiring that all adults and children in the community have access to vaccination. (Vaccines have not yet been tested in children and will be unlikely until 2022.)
But not everyone agreed that young children needed vaccinations to return to pre-epidemic school life. One-fifth stated that full reopening without precautions would allow adults and high school students in the community to be vaccinated once, and 12 percent said that it could happen to all adults in the community once vaccinated Be available.
Experts also questioned another strategy used by many districts that plan or plan to open this spring: opening part time to smaller and fixed cohorts of students, which reduces class sizes and helps people Participate in the optional program to determine the maximum distance between. Only one-third said it is very important for schools to do so, although three-quarters said that students should be six feet from each other. Three-quarters said that schools should avoid congestion, such as in hallways or cafeterias.
With universal masking, “school transmission will remain close to zero and cohorts are unnecessary,” Dr. Jane Ann Noble, an emergency medicine physician and director of Kovid Response at the University of California, San Francisco.
Limiting time to school increased other risks, some said, such as disrupting children’s social development, disrupting family routines, and increasing children’s chances of exposure to older people outside school.
Experts expressed deep concern about other risks, including depression, hunger, anxiety, isolation and loss of learning to students living in the home.
“Children’s learning and emotional and, in some cases, physical health are severely affected by being out of school,” University of Colorado Pediatric Emergency Physician Dr. Lisa Abugi expressed her personal views. “I spend part of my clinical time in the ER, and the mental distress we are seeing in children related to schools is off the charts.”
Survey respondents came from membership lists of three groups: the Pediatric Infectious Diseases Society, the Academy of Decision Sciences and Epidemiology, Public Health and the American Pediatrics Sub-Group on Evidence for Child Health Cooperation. Some individual scientists also responded. Nearly all were physicians, and more than a quarter of them also had degrees in epidemiology or public health. Most worked in academia and about a quarter in clinical settings, and most stated that their daily work was closely related to the epidemic.
The survey asked experts about various strategies that schools are using to keep students and staff safe. Experts said that many such measures would have some merit, but two were considered the most important: wearing and removing masks.
Other widely adopted measures – such as repeated disinfection of buildings and surfaces, temperature checks or the use of plexiglass dividers – were seen as no less important. One-quarter stated that regular monitoring testing of students and staff was very important for opening schools.
“Masks Are Important,” Dr. Noble said. “Other interventions create a false sense of assurance.”
Many states tied the opening to community measures spread across school counties, such as test positivity rates, new infection rates, or hospitalization rates. But 80 percent of experts said school districts should not re-decide on data on transition to the county at large; They should focus on virus cases inside the school.
Many districts have considered opening or opening for younger students before older ones. Research has found that infection and prevalence for children around adolescence are higher than for adults. The Biden administration has shaped its reopening plan around students in kindergarten through eighth grade.
Just over half of pediatric infectious experts said that the fifth grade should be cutoff if schools are partially opened. Only 17 percent said there should be eighth grade. But despite the high exposure of high school students, many reiterated the one-year long-term effects of excessive isolation on adolescents.
While these experts specialized in children’s physical health, many concluded that the risks of mental health, social skills, and education reduced the risks of the virus. Future opportunities for students, said Dr. Pediatric Infectious Diseases Head at Sinai Hospital in Baltimore, Drs. Susan Lipton, “The best academics are without torpedoes, interacting with inspiring teachers, who are patrons, clubs, sports and other ways to shine.”
“It’s devastating to a generation,” she said.