Joseph G. Allen is an assistant professor of exposure assessment science, director of the Healthy Buildings program at Harvard University’s T.H. Chan School of Public Health and co-author of “Healthy Buildings: How Indoor Spaces Drive Performance and Productivity.”
In all of these investigations, I was asked, “Is it safe to go back in the building?” If, after the appropriate controls were in place, my answer was “yes,” I always paused for one final gut-check question: Would my answer be any different if my family was involved?
When people ask me whether schools are safe during the coronavirus pandemic, I ask the same question: Would I let my kids go back to school in the fall? The answer is yes.
Let’s first acknowledge a hard truth: Widespread school closures come with devastating costs.
First, school closures are creating “virtual dropouts.” Twenty percent of Boston high school students didn’t log into class in May, and only half of the elementary school children in Philadelphia made daily contact. Even those with access to computers who do check in are not learning in the same way. This will increase our country’s education gap and exacerbate racial and social inequalities — with impacts that will persist for years.
Second, school closures impact kids’ health. Students who are out of school are more likely to be sedentary and experience weight gain. Many also lose access to hot meals; millions of children rely on federal programs for free or reduced-price meals.
Third, a disproportionate burden of working from home is falling on women. Many are now working two extra jobs: household manager and home-schooling supervisor. This widens another gap in our society, as working women risk either dropping out of the workplace or face career advancement challenges that many men, and those without children, won’t have.
Finally, lockdowns put children at greater risk of abuse, neglect, exploitation and violence. Full stop.
Now for the good news: Kids are at lower risk from complications of covid-19, and basic risk-reduction control measures are working.
On children, a study in Switzerland confirms what we have known for some time: School-age kids have extremely low infection fatality rates. Of the thousands of children found to have been infected, not a single one died.
On prevention, we are seeing that in many hospitals, the number of infections of front-line doctors and nurses has dropped way down. Why? Strict controls are in place focusing on just three things: mask-wearing, hand-washing and air-cleaning.
To get our kids back to school in the fall, we can start with similar strategies and then build in additional controls. My team at Harvard put together a report on risk-reduction strategies that can keep kids safe. A few important recommendations:
- Create a culture of health, safety and shared responsibility. No single control strategy alone is sufficient, and no single individual is solely responsible. Reopening schools safely will require changing culture to a “health-first” mind-set with everyone playing a role.
- Stay home if sick. Students with symptoms should be sent home immediately or quarantined in an open and well-ventilated space.
- Wear masks, with breaks built into the day. Students, teachers and administrators should wear masks to and from school, in common areas and in classrooms when physical distancing is not possible. Schools should create “mask-free” time to reduce fatigue.
- Wash hands frequently. Cleaning and disinfecting all surfaces all day long is impractical. The better approach is frequent hand-washing and the use of hand sanitizer.
- Clean the air indoors. Start working on air-cleaning now. Schools should find out how much fresh air they can bring into their building. Increase the ventilation rate if you have a mechanical system and open windows if you don’t. Supplement that with higher-level filters and consider getting portable air purifiers for your classrooms.
- Physically distance to protect individual health. Do your best to maintain six feet of separation in classrooms, but don’t keep kids out of the classroom just because there isn’t enough space (remember, hospitals don’t physically distance; they rely on other controls).
- Socially distance to slow transmission chains. Keep classes operating as subgroups and separate these groups as much as possible. This can help prevent mini-outbreaks from infecting the whole school.
Make no mistake, there will be outbreaks in some schools even with these measures. Whether we open schools will be determined by our risk tolerance as a society. What will we accept for schools? If the answer is “zero cases,” that will require us shutting schools for another year. The costs of that approach are too great, especially when there are proven risk-reduction strategies at hand.
Let’s also be clear that it did not have to be this way. Many countries around the world have shown that there is a way to control the number of cases. In the United States, we have so far failed to put necessary systems in place.
I wish it was different. We can continue to push for things to get better — and maybe our government will course-correct. Until then, we must forge a path forward with the reality we have, not the one we want.
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