Thursday, May 6, 2021

Collateral damage of closed schools is worse than the risk of the virus

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Functioning schools are the backbone of society. Especially for younger children and for lower socioeconomic groups, schools are at the center of mental health care, nutrition, vaccination compliance, and even making sure that child abuse is being reported. The shuttering of schools across the country has a deep impact on the psyche of not just students, but also teachers and parents. Solo online learning has disrupted everyone’s lives. 

Teachers across the country have resisted the call to return, afraid for their own health, concerned that proposed plans to ensure physical distancing, masking, COVID-19 screening and rapid testing have not actually been instituted. Their concern is legitimate, if a plan to protect them is not in place. Several physicians have told me their teacher/patients are already asking for doctor’s notes in August.

Multiple going back to school plans 

In New York, the United Federation of Teachers Solidarity caucus has opposed Governor Andrew Cuomo and Mayor Bill de Blasio’s plan to reopen New York City Schools two to three days a week and asked for the immediate resignation of School Chancellor Richard Carranza. This is wrong. New York City has few new cases and is trying very hard to put an effective plan in place.

Meanwhile, across the country, from Nebraska to Tennessee to Georgia to Alabama, school closures have followed students and staff becoming infected. These responses are based more on fear than science. Better to reform practices if possible than to quickly close schools.

Elementary school on Aug. 20, 2020, in Bristol, Virginia.
Elementary school on Aug. 20, 2020, in Bristol, Virginia.

Consider that multiple studies conducted in South Korea, Europe and Australia have shown so far that younger children are much less likely to spread the virus to adults, and have a very low percentage of severe illness and death themselves. In fact, according to the Centers for Disease Control and Prevention, less than 600 children under the age of 18 were hospitalized since the beginning of the pandemic to the end of July. 

Fear of the virus combines with fear of lawsuit and leads to consideration for school closure if even one student gets sick. But the collateral damage of school closure is far greater than the risk of the virus itself. In fact, the CDC studied mental health problems the last week of June, and found that 40% of U.S. adults (especially younger adults) are suffering from mental health problems and substance abuse associated with COVID-19. For children the problem is even worse. School closures are part of the reason, placing a heavy weight on our society.

Schools and COVID-19: School reopening debate shows power of local school boards

Horace Mann School in the Bronx has devised an elaborate system to prevent the spread of COVID-19. First, they will begin with tents outside for the initial weeks in September, where physical distancing is easier and where the virus (if present), will be much less likely to spread. They will have regular mask wearing, nurses to screen students and faculty, testing capabilities, and a plan to isolate possible cases.

Of course there is no guarantee that any of this will work if the coronavirus returns in great numbers to the New York City area. My son, Sam, in high school at Horace Mann, said to me, “At least we are getting to meet our teachers and they are getting to meet us. So even if we end up online, we will know them and they will know us.”

Universities and their reopenings

Universities have an advantage. They have built-in quarantine situations, and can isolate patients and even quarantine the entire university if necessary. Unfortunately, many are too fearful of COVID-19 to remain fully open. Cornell decided to open for in-person classes, determining that most of the students wanted to return, but then all of a sudden cancelled its quarantine option in mid August, which had students scrambling for accommodations

Notre Dame started off with a positive paradigm. They tested close to 12,000 people before allowing students on campus, and just 33 tested positive, less than 0.5%. Unfortunately, over one week in early August, 29 cases were positive (about 8% of 348 tests). But by Aug. 17 they were reporting a 19% positivity rate and 147 cases total. The university reported that many of the cases were traced to an off-campus party where students were not compliant with masks or physical distancing. Notre Dame felt compelled to go to fully online, at least for two weeks. I am not optimistic that they will return to in-person classes any time soon.

Meanwhile, the University of North Carolina at Chapel Hill has echoed the Notre Dame experience, with four clusters of cases in the early going. And on Aug. 17 they capitulated to the pressure and went fully online only. They have reported 324 cases, with 279 of these among students and 45 among staff. Their quarantine center is full as they too have now gone over to online classes. 

CDC has strict guidelines in place, but these are difficult for colleges to enforce, and unfortunately it now seems inevitable that most if not all of our universities will end up online if case clusters continue to occur. 

Harvard went to an online model early, despite the fact that Massachusetts had few cases. Brown and Columbia and many other colleges across the country have followed suit, motivated by fear. Many students have taken gap years rather than pay full tuition for online classes and plan to travel around the country, potentially spreading virus from one hot spot to another. 

Open the schools: Reopen schools and let parents decide how to educate their children in COVID-19 pandemic

Some schools say they will only fully reopen once a vaccine becomes available. But will this be the magic bullet that schools need? Or will fear of the virus be replaced by fear of a rapidly manufactured vaccine? We will certainly need a majority of people to take the vaccine to create enough “herd immunity” to satisfy the schools and protect society.

The mental health of our children is at stake, but we are not nearly as afraid of their damaged psyches as we should be.

Dr. Marc Siegel, a member of USA TODAY’s Board of Contributors and a Fox News medical correspondent, is a clinical professor of medicine and medical director of Doctor Radio at NYU Langone Health. Follow him on Twitter: @DrMarcSiegel

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to [email protected]

This article originally appeared on USA TODAY: COVID-19: It’s difficult, but necessary, for schools to reopen

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