To date, all countries that have reopened schools without further outbreaks did not open until after they had achieved near zero case incidence and low community transmission rates. They also have maintained focus on infection control and ongoing testing, tracing and supported isolation programs for disease control after opening. Combined, these tools represent the best (and least expensive) policy to support school reopening. Many of us have learned that lesson, but our window of opportunity for achieving that across the whole country before the start of the new school year has closed. We now must take a different path.
This is how it could work: States that are at near zero case incidence are at what the Harvard Global Health Institute, based on common metrics agreed upon by a broad network of public health organizations, calls a “green risk level.” States that are almost completely at near zero case incidence — including Maine, Montana, Alaska and Hawaii — should reopen.
States that are seeing more than 25 new daily cases per 100,000 people on a seven-day rolling average, putting them at a “red risk level” — including Arizona, Texas and Florida — should be reverting to stay-at-home orders and remote learning.
More difficult decisions will be faced by states between those parameters, at yellow and orange risk levels. States that reopen schools at these levels of covid-19 community spread will be attempting something not yet achieved anywhere in the world.
Can it be done safely? The very different risk levels facing young students, older students and adults in the school must be taken into account. Certainly both the transmission rate of covid-19 and its impacts are much lower for those younger than 10, as the National Academy of Medicine has pointed out. They may also be lower for those under 15, a point that researchers are seeking to clarify in the coming weeks. Older students, though, should be thought of as adults for purposes of planning the pandemic response. At higher levels of community spread, they too should avoid mass gatherings such as classrooms, crowded hallways and cafeterias. As for teachers and support staff, their ages and underlying conditions vary widely and need to be taken into account.
Learning spaces would need to be pandemic-resilient. They would need ventilation adequate for infection control, spatial reorganization to reduce density, and resources for sanitation and hygiene, to name just some elements. (For a full picture, see “Schools for Health,” a report from Harvard’s Chan School of Public Health). This would require significant public investment.
Also, teachers and other staff obliged to work in congregate settings situated in contexts of community spread at this level should be deemed essential workers and receive equivalent protections, including hazard pay and reassignment to remote work for high-risk individuals and/or access to disability benefits. This will require significant public investment.
We might succeed in reopening schools with reasonable safety if we focus on elementary and middle schools first, even using high school buildings for added space to open lower schools with sufficiently low levels of density. Denmark has proceeded this way.
With grades pre-K through 8 spread out through all available pandemic resilient learning spaces in a district, high school students would need effective remote learning. This too will require significant public investment.
Even with schools in jurisdictions at “red” risk levels operating remotely, achieving pandemic resilience for the rest of our schools will be expensive. It will be far more expensive than investing appropriately in the infrastructure of covid-19 suppression last April would have been. Pathei mathos.
Yet our students should not have to learn in conditions of suffering; our educators should not have to teach in conditions of suffering. We owe it to our children to get them back to school safely. We need a surge for education, just as we surged for health care. We redesigned hospital spaces and learned how to protect patients and essential workers. We invested in this. We’ve even done it for restaurants.
So far, our priorities have mainly taught my kids that this is the lesson: “Schools aren’t essential, Mom!”
How painful it is to hear that.
Our schools are essential. We should treat them as such. The pace of our reopening should track the pace of our investment in our school spaces and school personnel. We should send our kids back when we can do so in ways that are safe both for them and for the essential workers educating them. I think we’re all agreed that the sooner this is possible, the better.