As the debate on reopening schools continues at the local, state, and national levels, infectious disease and engineering experts are trying to keep up with the ever-evolving situation with the coronavirus pandemic so that they can advise administrators to consider and reconsider if and when Facilities open for the year.
On Friday, the Denver Public Schools canceled their plan to host in-person classes five days a week this fall, opting to start the year online on August 24, a week later than originally planned. The decision was made after consulting with local public health experts, superintendent Susana Cordova said. The district will consider gradually reopening schools and welcoming students after Labor Day.
Colorado is experiencing an upward trend in COVID cases with more than 2,900 new cases reported the second week of July, the highest increase the state has seen since May. Still, the circumstances are not as alarming as many other places in the United States.
So far, most districts plan to welcome students for full-time in-person instruction this fall while implementing safety protocols such as mask requirements, student cohort, and modified schedules to mitigate the risk of a possible outbreak. But school and public health leaders warn that plans could change, again.
In May, districts came up with the idea of a hybrid approach that would have kids in school to receive part-time in-person instruction and supplement them with online work remotely. That remains a contingency plan for many if the circumstances around COVID-19 escalate.
“What happens in schools will be a reflection of the community at large, no matter how good a job we do to implement mitigation measures,” said Dr. Sean O’Leary, a professor and pediatric infectious disease specialist at the College of University of Colorado Medicine. Medicine in Aurora. “If we see that in mid-August we are seeing disease levels similar to what we are seeing in Texas and Arizona, I do not know if it is safe to open schools at that time because there is a lot of virus circulating.”
Much of the guidance on reopening suggests that the benefits of sending children back to school outweigh the risks, as children appear to be less susceptible to the virus. We speak to pediatric physicians, as well as public health and engineering experts, to discuss what is known, and what is unknown, about children and their risks associated with COVID.
What we know
Dr. Glen Mays, professor and chair of the Department of Health Systems, Management, and Policies at the University of Colorado School of Public Health, says medical experts have been looking at observational data from reported cases nationally and internationally to deduce how it affects the new coronavirus. children. Mays called the data “imperfect,” but said it is useful for identifying patterns and trends among sectors of the population.
For example, children appear to have a lower risk of contracting COVID-19 and those who do have a substantially lower risk of developing health complications, he said. Fewer children have been hospitalized with the disease and fewer deaths have been reported compared to adults, said Dr. Sam Domínguez, an infectious disease specialist at Children’s Hospital Colorado.
“In general, children are much better off with this virus,” he said.
The data also suggests that the transmission rate among children is lower, which means they don’t transmit the disease to each other as easily as adults do, the doctors said. But if they catch it, the symptoms of COVID-19 are typically different for young people.
Domínguez said children can experience a runny nose and cough similar to a mild cold, as well as vomiting and diarrhea. While about 80% of infected adults have a fever, Domínguez said, only about 50% of children do. And the evidence shows that many children who get COVID-19 are asymptomatic, possibly between 30% and 40% of them, O’Leary estimated.
To further complicate matters, the symptoms and severity of COVID can also vary among teens and younger children.
“As we get closer to fall and winter, we assume that influenza will return, SARS-V will return. We will have those regular seasons, but it will be in the context of this virus that also circulates, “said Domínguez. “It will be a great challenge to differentiate this virus from other viruses or other causes of respiratory and gastrointestinal symptoms.”
Another important fact to consider when talking about reopens, doctors said, is that children suffer academically, emotionally, and often physically when they are not in school. A recent survey of US school social workers conducted by researchers at the University of California, Los Angeles, Loyola University in Chicago, Cal State Fullerton, and the Hebrew University found that many students and families are struggling to meet their needs. basic during the pandemic.
Of the 1,275 social workers who responded, approximately 62% said their students had food-related needs, about 62% cited individualized tutoring needs, and more than 75% said their students needed access to health services. mental, all services typically provided by schools.
“It increases obesity, it increases mental health problems, anxiety, depression, suicidal tendencies,” said O’Leary. “Many, many things have already come to light in the short time that the children were away.”
What we don’t know
For all the indicators experts have on children and the new coronavirus, there are so many questions. The biggest?
“I think the big research question is, why is that the case?” Domínguez said. “We really don’t fully understand why children are better off than adults and perhaps why they don’t spread it as efficiently.”
There are theories, of course. Doctors suspect that biological differences may play a role. For example, children have fewer receptors than the coronavirus uses to enter cells, O’Leary said.
Children also have different responses of the immune system to the disease, Domínguez said. Some have developed a multi-system inflammatory syndrome, known as MIS-C, after becoming infected. Doctors don’t fully understand what causes it or how common it is, he said, but it is believed to be a rare condition.
The factors driving youth trends could also be circumstantial, the doctors said. Perhaps because the nation closed schools in March, children had fewer opportunities to be exposed to the virus, Domínguez said. It’s also worth considering how children in different age groups interact with each other and how that could cause variations in transmission rates between teens and young children, she added.
Despite having no answers to those questions, Domínguez, O’Leary and Mays were in favor of reopening the schools. That doesn’t mean they don’t have worries.
“Even if we take children out of the equation, there are still a large number of adults in an indoor environment over a long period of time. That is a higher risk activity, ”said Mays.
“The overall risk to children, at least as of today, appears to be similar to other respiratory viruses that we regularly accept,” O’Leary said, adding that he and his wife caught COVID-19 earlier this year while their children, 16 and 12 years old, no.
“It is much more serious in adults and people with chronic medical conditions than the flu,” he said. “But for children, the risk of COVID-19 seems to be in line with the flu, roughly. That’s how I’ve been thinking about it as a parent. “
What the experts say we should do about it
Shelly Miller, a professor of mechanical engineering at the University of Colorado Boulder, was one of more than 200 scientists who implored the World Health Organization to consider COVID-19 as an airborne disease. That distinction is important, he said, because it informs what precautions schools must take to create a safe environment.
Engineers have been rapidly studying how COVID-19 spreads based on factors such as ventilation, how many sick people are in a room, how long they are in a space, and different measures of social distancing. Miller has conducted studies on how singing and playing wind instruments could spread the virus, as well as the rate of transmission in a nursing home where a 30-room ward was converted to negative pressure ventilation.
She believes the three most effective ways to mitigate the spread of the virus in schools are to require masks, to circulate outside air inside school buildings, and to minimize the time students and faculty spend indoors.
“Outside air is needed in the space to dilute the virus concentration,” said Miller. “If you can’t reduce the virus concentration by adding air, you can filter it with an air purifier.”
Even if many children do not show fever, it is important that schools continue to conduct health screenings as a measure to find possible cases, the doctors said. Also, O’Leary said, there has never been a more important time to make sure children are up to date on their vaccinations.
“The last thing we can manage is an outbreak of vaccine-preventable disease at our school in addition to COVID-19,” he said.
