The Center for Disease Control released two pieces of updated guidance on return to school during a pandemic. One is useful with guidance, checklists and key considerations. The other looks like an overdue draft that was written by an underperforming and over-caffeninated student on why schools are important. I want to pull out a key paragraph with my emphasis added:
Scientific studies suggest that COVID-19 transmission among children in schools may be low. International studies that have assessed how readily COVID-19 spreads in schools also reveal low rates of transmission when community transmission is low. Based on current data, the rate of infection among younger school children, and from students to teachers, has been low, especially if proper precautions are followed.
The key phrase is “COMMUNITY TRANSMISSION IS LOW.” Lots of things are possible when community transmission is low and proper precautions are available and followed.
Canada as a country had slightly more than 11 new cases per million residents yesterday. Parts of the United States have been fairly successful at suppressing broad, uncontrolled community spread. Per CovidExitStrategy.org, Vermont has 12 new cases per million residents. Maine has 14 new cases per million residents. These states can and are deploying the traditional public health playbook of prompt, wide spread testing, tracing the contacts of an infected individual and isolating both the infected individual and at least first degree close contacts so future spread is minimized. On the other hand, Florida is averaging 493 new cases per million and Louisiana reported 468 new cases per million residents. The median state, Delaware, has 119 new cases per million residents.
My friend and Margolis colleague, Dr. Charlene Wong writes about school re-openings today:
Where we set priorities, we invest our dollars. If we were to put the needs of children first, what would that look like? We would provide robust and generous financial support to teachers and schools. We would shut down other aspects of society, as much as we could bear, to drive down cases to allow more schools to reopen.
We would not be partying on the beaches. Disney World would not mind re-closing if that meant protecting children’s wellbeing. We would not be wasting breath debating how bars can operate if we can’t answer how schools can safely open. And for sure, we would not complain about wearing masks, if that small sacrifice was what it took for children to be taught, fed, and cared for. Kids would come first.
If we want to re-open schools (and I think we all do as our socio-economic structure is predicated on school age kids being in school while their grown-ups work for most of the year and we know that in-person instruction is usually far better than distance learning instruction and I expect I will be as bad a third grade teacher as I was a second grade teacher), we have to figure out ways to minimize community spread. It is that simple. Precautions and risk mitigation can work when community spread is low and quickly contained.
Re-opening schools is a good thing if that can be done safely. Any school that does in-person instruction will look different than it looked last February. Precautions will alter social interactions and expectations. Precautions will alter physical spaces. Precautions will alter the flow of the day. But in a context of low spread, those precautions have a reasonable chance of working. But the key question is not if we are to re-open schools, but on what conditions and how? The most important condition is suppressing community spread. From there, we can get to a new normal-ish at a reasonable level of specific and community level risk that we can mitigate and minimize with community wide efforts.
So the effort to re-open schools for in-person instruction really should start with efforts to minimize community spread. That means we need to value math class more than bars. It means we need to value reading instruction more than adult gym classes. It means we need to value 6th grade orchestra more than listening to the newest indy band at a hot, packed club. It means we need to prioritize what we value and make explicit trade-offs.