Many schools are still closed. But we have learned a lot about SARS-CoV-2 and how it spreads since schools closed last March. It is time to adapt based on what we know now — including modifying infection-control policies that are unnecessarily stringent, are no longer informed by the best available evidence and keep students out of classrooms nationwide.
A growing body of evidence from around the world strongly supports the notion that, with appropriate mitigation measures in place, schools can open safely for both students and staff. Until now, though, a major gap in our knowledge has been whether it’s as safe for students and staff if students maintain three feet, as opposed to six feet, of social distance in classrooms where schools are open. Previously available data on the “right” distance was based on out-of-date research, rather than real-world evidence on SARS-CoV-2 transmission in schools. Different guideline-issuing bodies interpreted the science differently. The U.S. Centers for Disease Control and Prevention recommends six feet of distancing between students, which many school districts have adopted as their own policy accordingly. Meanwhile, the World Health Organization recommends one meter (or about three feet), and the American Academy of Pediatrics recommends a range of three to six feet.
The difference between three feet and six feet sounds relatively small, but it’s crucial. School infrastructure has limited square footage. The vast majority of school districts simply cannot bring all students back to the classroom for full-time, in-person education if they need to keep students six feet apart. In many cases, that limit has capped classroom capacity to about half of a usual class. Three feet of physical distancing between students makes bringing all students back far more feasible, given the available space and resources.
We wanted to see whether the six-feet guidelines are really necessary for public health. Our multidisciplinary team of researchers compared the case rates of SARS-CoV-2 among students and staff participating in in-person learning between districts that required three feet and those requiring six feet of distancing between students. We examined the 16-week period after schools reopened this fall across Massachusetts, where there is a universal masking mandate, among various other mitigation requirements, including hand-hygiene programs, symptom screens, stay-home-when sick policies and opening windows. Our statewide study found that case rates were similar among students and staff in both types of districts; the extra three feet made no difference in terms of reported cases of viral infections. We also found that coronavirus rates among students and staff alike (at both distances) were lower than rates in the corresponding communities, suggesting that schools that require masks are a safe place for students and school staff.
Our study provides additional data suggesting that keeping students three feet apart instead of requiring them to stay six feet apart won’t make students or teachers and staff less safe. Policymakers should also recognize that if they don’t allow students into school buildings full time, that’s not guaranteeing that those kids will maintain perfect distancing, mask-wearing and small cohorts of contacts when they’re learning remotely. Children who are not in classrooms may engage in riskier behaviors than those who are in school, where mitigation measures can be observed and enforced.
It is crucial to place this research in the larger context of the debate about schools as essential services. Coronavirus cases are not the only important outcome when it comes to opening schools. Keeping kids out of full in-person learning also has consequences, and evidence about the harms to children increases almost every day. We have mounting data showing the mental health harms of keeping children out of their normal environment, including soaring reports of isolation, anxiety, depression and suicide. We have seen a decrease in the detection of child abuse cases, concerns about increasing rates of childhood obesity, and worsening food security among students who depend upon school meal programs, as well as learning loss and increasing educational disparities.
Educators, parents and policymakers have to apply a public health lens when making policy decisions, and they need to weigh the risks and benefits of both action and inaction. For students or for staff, the risks of contracting SARS-CoV-2 in elementary and secondary school settings are low when mitigation measures are in place, even when the distance between students is three feet. And the risks of keeping students out of full-time school are great.
Under typical circumstances, there is a years-long lag between evidence generation and adoption of that evidence into practice. But now that we have mounting evidence of harm on the one hand and safety on the other, can we do better? Early in the pandemic, infection-control plans for schools and other settings were developed based on the limited evidence available at the time and focused on only one outcome: preventing the spread of SARS-CoV-2.
Kids have been out of school for more than a year — and the harms to them are mounting. We now know that a distance of six feet is not significantly safer than three feet, and we know that six feet keeps kids out of school unnecessarily. Now is the time to leverage the science to guide updated, evidence-informed policies to get our children back where they belong: in the classroom.