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| Focus on Opening Schools, Not Bars | |
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| The way states lifted social distancing restrictions imposed to fight the coronavirus sadly demonstrates our priorities. Officials let bars, restaurants and gyms open, despite warnings from public health experts that these environments pose the greatest risk for spreading the disease. | The way states lifted social distancing restrictions imposed to fight the coronavirus sadly demonstrates our priorities. Officials let bars, restaurants and gyms open, despite warnings from public health experts that these environments pose the greatest risk for spreading the disease. |
| Yet political leaders seem to have paid scant attention to safely reopening schools. | Yet political leaders seem to have paid scant attention to safely reopening schools. |
| The consequences of those backward priorities — Covid-19 rampaging through states that reopened quickly — makes it even more vital that we extensively prepare to reopen classrooms as safely as possible this fall. | The consequences of those backward priorities — Covid-19 rampaging through states that reopened quickly — makes it even more vital that we extensively prepare to reopen classrooms as safely as possible this fall. |
| Research suggests that the sudden switch to online instruction has cost some students a full year of academic progress. These harms disproportionately affect children in homes without computers and stable internet connections, deepening educational inequality and widening racial and economic divides. The disruption of learning can have lifetime effects on students’ income and health. | Research suggests that the sudden switch to online instruction has cost some students a full year of academic progress. These harms disproportionately affect children in homes without computers and stable internet connections, deepening educational inequality and widening racial and economic divides. The disruption of learning can have lifetime effects on students’ income and health. |
| The school shutdowns left millions of children without access to meal programs and school-based health services. Reports of child abuse slowed since school employees couldn’t identify and notify the authorities about children they thought were being harmed. And the need for parents to supervise their children on school days or arrange child care has disrupted the economy and made it even harder for many families to get by. | The school shutdowns left millions of children without access to meal programs and school-based health services. Reports of child abuse slowed since school employees couldn’t identify and notify the authorities about children they thought were being harmed. And the need for parents to supervise their children on school days or arrange child care has disrupted the economy and made it even harder for many families to get by. |
| Would returning children to school be dangerous for them? The American Academy of Pediatrics has concluded that the harm to children from not having in-person education outweighs the risk. Children are 24 percent of the American population but account for only 2 percent of Covid-19 cases. In the United States, school-age children have been hospitalized at a rate of 0.1 per 100,000, compared with 7.4 per 100,000 for those ages 50 to 64. Very few deaths among children have been reported. | Would returning children to school be dangerous for them? The American Academy of Pediatrics has concluded that the harm to children from not having in-person education outweighs the risk. Children are 24 percent of the American population but account for only 2 percent of Covid-19 cases. In the United States, school-age children have been hospitalized at a rate of 0.1 per 100,000, compared with 7.4 per 100,000 for those ages 50 to 64. Very few deaths among children have been reported. |
| Children play less of a role in the spread of Covid-19 than in the spread of influenza. Early in the Covid-19 epidemic, Australia identified 18 infected youth in 15 schools; health officials traced 863 contacts of the students, only two of whom were found to have been infected. The Pasteur Institute in France found just three probable cases of Covid-19 in school-age children among 510 students in a town that experienced a major outbreak; the children did not pass the infection to other teachers or students. | Children play less of a role in the spread of Covid-19 than in the spread of influenza. Early in the Covid-19 epidemic, Australia identified 18 infected youth in 15 schools; health officials traced 863 contacts of the students, only two of whom were found to have been infected. The Pasteur Institute in France found just three probable cases of Covid-19 in school-age children among 510 students in a town that experienced a major outbreak; the children did not pass the infection to other teachers or students. |
| However, less risk does not mean no risk. The true infection rate may not be well captured by studies conducted to date. | However, less risk does not mean no risk. The true infection rate may not be well captured by studies conducted to date. |
| And in rare cases, Covid-19 has been linked to serious illness in children, either directly as a consequence of the virus or through a post-inflammatory syndrome related to the immune system. The syndrome remains rare, but still a concern. | And in rare cases, Covid-19 has been linked to serious illness in children, either directly as a consequence of the virus or through a post-inflammatory syndrome related to the immune system. The syndrome remains rare, but still a concern. |
| Schools need to take the risk of spread seriously, for children and staff, even as they resume classroom instruction. | Schools need to take the risk of spread seriously, for children and staff, even as they resume classroom instruction. |
| Austria, Denmark, Germany and Norway have reopened schools without major outbreaks. These nations and others have taken a variety of measures to be safe, including opening slowly, limiting class size, and adopting aggressive infection-control practices. Israel experienced outbreaks in schools, but only after loosening limitations on class sizes. | Austria, Denmark, Germany and Norway have reopened schools without major outbreaks. These nations and others have taken a variety of measures to be safe, including opening slowly, limiting class size, and adopting aggressive infection-control practices. Israel experienced outbreaks in schools, but only after loosening limitations on class sizes. |
| A responsible strategy for reopening school starts with controlling the community spread of Covid-19 through distancing and use of face masks, as well as robust tracing, isolation and quarantining, as all countries that have opened schools without spikes in cases did before resuming instruction. | A responsible strategy for reopening school starts with controlling the community spread of Covid-19 through distancing and use of face masks, as well as robust tracing, isolation and quarantining, as all countries that have opened schools without spikes in cases did before resuming instruction. |
| Reopening businesses that pose a major risk of community spread should be a lower priority than reopening schools, for which continued closure carries far greater harm. Reopening schools supports the economy, so businesses should do their part in reducing community transmission by allowing employees to work from home and following strict in-person social distancing. | Reopening businesses that pose a major risk of community spread should be a lower priority than reopening schools, for which continued closure carries far greater harm. Reopening schools supports the economy, so businesses should do their part in reducing community transmission by allowing employees to work from home and following strict in-person social distancing. |
| Meanwhile, all school districts should receive the financial support needed to accomplish several critical goals: | Meanwhile, all school districts should receive the financial support needed to accomplish several critical goals: |
| First take care of those who would benefit the most. Young children, in particular, may require in-person instruction and socialization. Special- needs students need services provided by schools in person. | First take care of those who would benefit the most. Young children, in particular, may require in-person instruction and socialization. Special- needs students need services provided by schools in person. |
| Increase distance and focus on hygiene. For crowded schools, this could require finding other buildings and space where they could expand. | Increase distance and focus on hygiene. For crowded schools, this could require finding other buildings and space where they could expand. |
| Some countries in Europe are creating outdoor classrooms to allow for distancing and to take advantage of the reduced risk of transmission in the open air. Tents and other covered structures could be used to create outdoor classrooms in some areas. | Some countries in Europe are creating outdoor classrooms to allow for distancing and to take advantage of the reduced risk of transmission in the open air. Tents and other covered structures could be used to create outdoor classrooms in some areas. |
| Urban school districts may need to lease space. Students and staff members should be checked for symptoms daily and required to wash hands or use hand sanitizer frequently. Masks should be required for all who can wear them, and schools will need extra masks on hand for students and staff members who do not bring their own. | Urban school districts may need to lease space. Students and staff members should be checked for symptoms daily and required to wash hands or use hand sanitizer frequently. Masks should be required for all who can wear them, and schools will need extra masks on hand for students and staff members who do not bring their own. |
| Create in-school “bubbles.” Elementary and middle schools should establish small groups of students who will learn, eat lunch and have recess together. Students and teachers in these groups will interact only with one another. Bubbles many not be feasible in high schools, where students typically move from room to room, so there should be strict requirements for masks, class size reduction and distances between desks. | Create in-school “bubbles.” Elementary and middle schools should establish small groups of students who will learn, eat lunch and have recess together. Students and teachers in these groups will interact only with one another. Bubbles many not be feasible in high schools, where students typically move from room to room, so there should be strict requirements for masks, class size reduction and distances between desks. |
| Plan for an outbreak. If a coronavirus infection is found, schools should follow Centers for Disease Control and Prevention guidance, which encourages schools to coordinate with local health authorities and to plan to dismiss students and staff members for two to five days. | Plan for an outbreak. If a coronavirus infection is found, schools should follow Centers for Disease Control and Prevention guidance, which encourages schools to coordinate with local health authorities and to plan to dismiss students and staff members for two to five days. |
| Refine online instruction. If cases are rising significantly in the area, schools may have to close until that outbreak is under control. They should be prepared by using curriculums that can be rapidly adapted for online instruction. | Refine online instruction. If cases are rising significantly in the area, schools may have to close until that outbreak is under control. They should be prepared by using curriculums that can be rapidly adapted for online instruction. |
| Allow families and staff members to opt out. Families in households with much older relatives or people with health problems may fear sending their children to school, out of heightened concern that they may bring the virus home. For students in these circumstances, continued remote education should be made available. | Allow families and staff members to opt out. Families in households with much older relatives or people with health problems may fear sending their children to school, out of heightened concern that they may bring the virus home. For students in these circumstances, continued remote education should be made available. |
| Older staff members or those with chronic medical conditions who want to be kept out of physical contact with students could teach online classes for those students who remain at home. | Older staff members or those with chronic medical conditions who want to be kept out of physical contact with students could teach online classes for those students who remain at home. |
| Get creative with transportation. It doesn’t make sense to practice distancing in school and then crowd students together for a long bus ride home. School districts should consider car pools and van rides for children in their bubbles. Schools can also increase the number of buses in service and employ staggered start times to transport fewer children at once. | Get creative with transportation. It doesn’t make sense to practice distancing in school and then crowd students together for a long bus ride home. School districts should consider car pools and van rides for children in their bubbles. Schools can also increase the number of buses in service and employ staggered start times to transport fewer children at once. |
| Each of these steps requires resources now. Congress has provided hundreds of billions of dollars of relief for small businesses, but early funding for schools has largely been spent on meals and laptops for remote learning. States should provide funding to school districts in advance of pending legislation in Congress that would provide $915 billion to state and local budgets. | Each of these steps requires resources now. Congress has provided hundreds of billions of dollars of relief for small businesses, but early funding for schools has largely been spent on meals and laptops for remote learning. States should provide funding to school districts in advance of pending legislation in Congress that would provide $915 billion to state and local budgets. |
| Congress should also support research into viral transmission in children to establish best practices for schools and guide real-time changes that make teachers and students even safer. | Congress should also support research into viral transmission in children to establish best practices for schools and guide real-time changes that make teachers and students even safer. |
| Deciding whether to reopen schools is not only a question of benefits versus risks, but also a matter of priorities. Covid-19 is harming a generation of children. Whether we can fight back effectively is up to us. | Deciding whether to reopen schools is not only a question of benefits versus risks, but also a matter of priorities. Covid-19 is harming a generation of children. Whether we can fight back effectively is up to us. |
| Jennifer B. Nuzzo (@JenniferNuzzo), is an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security. Joshua M. Sharfstein (@drJoshS), is a pediatrician and a professor at the Bloomberg School of Public Health at Johns Hopkins. | Jennifer B. Nuzzo (@JenniferNuzzo), is an epidemiologist and senior scholar at the Johns Hopkins Center for Health Security. Joshua M. Sharfstein (@drJoshS), is a pediatrician and a professor at the Bloomberg School of Public Health at Johns Hopkins. |
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