Many schools around the country have already made the decision for the students. At least 63 of the 101 largest school districts in the country decided to start the year with virtual learning. There are other school districts that have decided to go personal, though many with virtual options. My children’s own school left the choice to the individual families, and although it is difficult, I am grateful that we have options. Families across the country are struggling with access to childcare, technology and even food – all of which can make a physical return to school a necessity.
Knowing my family would have to make a decision about school, we started doing our homework a few weeks ago, looking at the data and existing criteria, to come up with the best science based choice for us.
For a start, I visited my children’s school and spent time with the principal of the school to understand the best precautions they put in place. They are very much in line with the recommendations of the US Centers for Disease Control and Prevention. There will be a mask mandate, many hand hygiene stations, physical distance plans, frequent disinfection of surfaces and even outdoor classes if possible. Students will have lunch in class, and there will be no mass meetings or gatherings. While physical distance is the most difficult challenge, the school has made creative use of space in libraries, gymnasiums and cafeterias to get the necessary square images to try this. It has been a herculean attempt in recent months, but of course none of this works if the students themselves are not eager to follow these practices on buses, in corridors and in classrooms.
Our school also took the extra step of testing all students and faculty and staff this past week, and the results were made available within 96 hours. My girls have all tested negative, and that gives us some confidence for those kids who choose to attend school, because those students who test positive will be asked to isolate at home. I fully realize that this kind of “assurance” testing is unfortunately not yet nearly available in this country, nor is it a perfect tool. Some tests were known to give a significant amount of false negatives, depending on the type of test you are taking and how early you are taking it. And although anyone can test negative today, there is no guarantee that they will not test positive for the virus tomorrow.
Much of the discussion about returning to school revolves around the risk to our children’s health. According to the CDC, the largest pediatric study from China found that 90% of children with Covid-19 developed mild to moderate symptoms, 4% were completely asymptomatic and 6% became severely or critically ill.
By the first week of August, 90 children in the U.S. had died of Covid-19, representing less than 1% of all deaths, according to an analysis by the American Academy of Pediatrics and the Children’s Hospital Association.
As of August 6, MIS-C, a multi-system inflammatory syndrome, was identified in at least 570 children nationwide, ranging in age from less than 1 to 20. About two-thirds of those children had no underlying conditions before joining. MIS-C has been diagnosed, as has Juliet Daly, a Louisiana 12-year-old who nearly died in April.
It is true that children are much less likely to get Covid-19, compared to adults, but they are by no means immune. They can become infected and they can spread it quickly. A widely cited study from South Korea showed that children 10 to 19 spread the virus just as much as adults. In fact, they had the highest rate of Covid-19 among household contacts. Interestingly, in that same study, children younger than 10 did not account for a significant amount of viral spread. This was surprising because a recent study published in JAMA Pediatrics concluded that younger children may carry higher amounts of the virus in their nose, compared to adults. And every parent will tell you how easily young children spread viruses in their own homes. (When our children were very young, one cold in one of them meant that the whole family would soon become infected.)
So, I decided to take a closer look at the South Korean study, and noticed one very important detail: It included less than 30 positive cases younger than 10 years old. Of the nearly 60,000 contacts found in that study, only 237 were from children under 10. The low prevalence rate among young children was perhaps not because they were less likely to transmit the virus, but because they were for the most part part have been home the last few months, and had a few contacts as a result.
As our children become more and more mobile, they will become part of a larger national experiment, and there is little doubt that infection rates will increase. In the past four weeks alone, the number of infected children in the United States has increased by 90% to more than 380,000 cases, according to the same analysis by AAP and CHA. While some of that increase may be due to increased testing, younger children are playing a role for the first time out of their homes. And for a large part of the country, schools are not even open yet.
It is also important to remember that a school community consists of more than just young students. According to one recent analysis, nearly a quarter of teachers working in the U.S. school system have a higher risk of serious Covid-19 disease, whether because of age or for existing conditions. I was particularly struck by the stories of worried teachers around the country who said they were writing their wills in anticipation of going back to school.
My family also took a closer look at the overall rate of viral spread in our own area. Within the Fulton County Schools system in which we live, the guidelines for schools to return to full, face-to-face instruction require the county governor’s percentage of new cases per 100,000 people to be less than 100 in the last 14 days. being. The current Fulton County rate? 316.2. Atlanta Public Schools have decided to go all-virtual for the first nine weeks. In addition, our province, which includes part of Atlanta, also does not meet the federal government’s criteria for returning to school. According to the gating criteria of the Coronavirus Task Force, we would have to go through two phases, each requiring a 14-day downward trajectory of documented cases and the ability to treat all patients without crisis care. We’re just not there yet.
Finally, the seven-day positivity rate in Georgia (ending August 10) is 11.3%, based on data from the Covid Tracking Project, which means we are not doing enough testing in our area yet. Recently, the Surgeon General said he would see positivity figures at less than 10% in communities before schools reconsider. We are close, but it is still worrying to place students back in an environment with so much shared viral spread. It is worth noting that when we started pulling children out of school around mid-March, there were less than 5,000 known cases that people were known to have infected in the United States and confirmed that dead were in the double digits. Now, school districts are considering reopening because more than 5 million people have been infected and more than 164,000 people have died in the U.S., according to Johns Hopkins University.
Just the last few weeks we have been getting various hints about what might happen if schools start up again. An overnight summer camp in northern Georgia had infected nearly 260 attendees, though the CDC noted that some Covid-19s could have contracted in some other way. A high school in Woodstock, Georgia, has been temporarily closed after at least 14 positive Covid-19 cases in its first week. Hundreds are in careers in the province. Another school in Dallas, Georgia, opened and closed its doors after six students and three faculty members became infected. Their plan is to reopen after disinfecting the school, though it’s not clear how much of a difference that will make, as there is no mask obligation – and a single snow or cough can contaminate a classroom again.
It’s a lot to consider, but in the minds of our family the evidence is clear. After considering all the objective criteria and assessing the situation in our own community, we made the decision to keep our girls out of school first. This was not an easy decision, but one that we believe will best respect science, reduce the risk of further proliferation and follow the criteria of the task force. As a compromise, we will allow our children to have a physically distant orientation meeting with their new teachers so that they can meet them in person before they start interacting with them on screen. And, after two weeks, we will re-evaluate. It will also be important for us to understand what the triggers will be in our school, in terms of newly diagnosed infections as well as illnesses, which need a return for virtual learning. Full and honest transparency of everyone will be more necessary than ever.
None of this is easy, and some families may come to a different conclusion after seeing the same data. At the age of Covid-19, it seems like we’re all forced to become amateur epidemiologists, while also being the best parents we can be.
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