School districts are in a challenging situation as they try to plan for the 2020-2021 school year during an unprecedented pandemic. Since social distancing is one of the most effective ways to limit the spread of coronavirus, it seems promoting “health and safety” would require limiting kids’ time in school. However, allowing kids only partial access to education, as many districts across the country are currently proposing, does not support children’s health and safety.

To the contrary, by failing to return children to school, we may actually be putting them at risk of other complications, many of them dire and long lasting. In a recent guidance document that reflects these concerns, the American Academy of Pediatrics “strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.” In other words, it is time to get kids back into the classroom. Even as we proceed cautiously, we cannot reasonably ask children who are at the lowest risk of infection to sacrifice the most to protect the rest of us.

The novel coronavirus that caused the pandemic will undoubtedly be with us in the fall. It’s understandable if some worry that children returning to school at full capacity will lead to increases in infection, though there are disagreements about to what degree kids present risk of spread. Some estimates suggest the effects of children in school are minimal compared to other social distancing efforts, with closures preventing as little as 2-4 percent of deaths. There are also indications children are half as likely to become infected as adults and are much less likely to spread the coronavirus than adults.

Children who do become infected are at very low risk of significant morbidity and mortality from infection. As of June 24, 28 children aged 14 years and younger have died with presumed or confirmed covid-19 diagnoses (whether or not covid-19 was the cause of death). In that same period, 9,622 children age 14 and under have died of all causes. Accidents, suicides, assaults and homicides remain the most common sources of preventable death for young people.

Meanwhile, keeping kids out of school puts them at significant risk of a wide range of negative health outcomes. A huge body of research before the pandemic showed when children are out of school for summer or holidays, they are less physically active, less cardiovascularly fit, have irregular sleep patterns — which can lead to a range of other health issues — and have worse nutrition, a particular issue for children who rely on schools for food. The negative outcomes of excessive screen time are well documented. Depression and anxiety have increased among young people during social isolation, and may be worse for children of color. We have every reason to believe children who are socially isolated during a pandemic are at even greater health risk, particularly as sports leagues, swimming pools, summer camps and other recreational facilities remain closed, and interaction with peers is unavailable.

What is also clear is reports of child maltreatment have dropped significantly since kids have been out of school, in large part because teachers, counselors, coaches, bus drivers, and other mandated reporters aren’t seeing them. Given that unemployment, family stress, and even natural disasters increase domestic violence, it is probably the case that many children are much worse off at home than they are at school, even during a pandemic. As parents return to work, there are no plans for how children who are home from school will receive care or supervision. This could lead to increased risk of accident and injury as well.

We also know children’s learning suffers when schools are closed. Studies show for low income children in particular, an American summer without covid will cause a loss in academic achievement equal to one month of education. The gap caused by remote learning in the spring has, estimates suggest, set children back even further.

Simply looking at the pre-covid data from districts that moved to instruction four days a week instead of five shows what a bad idea school closures are — even partial ones. Eliminating one day of instruction caused measurable drops in academic achievement for low-income kids, with some indication the drops are worse for boys. Kids with special needs also suffer. Several studies show reduced time in school also increases juvenile crime. One study found shifting from a five-day school week to a four-day week led property crimes and larceny to increase by as much as 73 percent in one rural Colorado county. Given many districts are proposing hybrid models that might include as little as two days a week of in-person instruction — half that of these districts — we can anticipate such issues might worsen.

Even as we acknowledge all of this, there are still reasons for concern. One is that teachers and staff are at higher risk of covid-19 morbidity by virtue of being adults — with that risk increasing with age. Just as other essential workers have had to make decisions about work and employers have had to enact policies to protect those workers, we should stop talking about “health and safety” in broad terms and hone in on the very specific goal of protecting adults who work with children. Work accommodations for staff and teachers who are high risk must be made. High quality protective personal protective equipment is clearly an important step. Mandating students to wear masks is another way to protect everyone, but especially adults who are most vulnerable.

Second, some families continue to rigorously socially isolate due to concerns for at risk family members. They may decide their children’s return to school is too dangerous. These families deserve access to online schools taught by teachers who have actually been trained in online instruction and who are not attempting to teach in multiple ways across a variety of settings each week.

There are real questions about to what extent children in schools will be vectors of infections and sources of risk to adults in the community. Although data now available suggest these risks are modest, children are indisputably one source of potential spread. Yet, one might reasonably argue that so long as adults are back at bars, heading to work, getting haircuts and returning to gyms, kids should not be asked to sacrifice their present and future social, psychological, educational and economic well-being to protect adults who are sacrificing far less.

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