Opinion | Back to school? Not so fast. A COVID-19 checklist for parents and teachers

As states around the United States weighed whether schools should reopen, children began testing positive for the coronavirus in alarming numbers. Across the country, there was a 40 percent increase in pediatric cases, according to a study looking at the last two weeks in July. Florida, a COVID-19 epicenter, reported a 137 percent rise in school-age children in July, including a 105 percent uptick in hospitalizations. On Monday, Florida teachers won a legal battle against Gov. Ron DeSantis, who wants to reopen schools by the end of this month. Under the ruling, school districts will not be forced to re-open en masse, even if they think the situation is unsafe.

In rationalizing this return to classrooms, Trump has falsely claimed that children are “almost immune” and DeVos has incorrectly called students “stoppers” of the virus.

It’s a small reprieve for Florida teachers. And yet, President Donald Trump, Education Secretary Betsy DeVos and Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, are still aggressively pushing for reopening schools with in-person instruction nationwide. In rationalizing this return to classrooms, Trump has falsely claimed that children are “almost immune” and DeVos has incorrectly called students “stoppers” of the virus.

With insufficient guidance for educators, the CDC supported this push to return to in-person classes, posting essays on the “Importance of Reopening Schools” in the fall and guidelines like this one. Redfield even made the push in testimony before Congress.

Even without a pandemic, public schools are a vital piece of the public health puzzle. Schools teach much more than reading, writing, history, math and science. Children learn to socialize and play sports, nurturing their emotional and physical well being. Many millions of students eat breakfast in addition to lunch there.

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Educators, like my mother, groom the next generation of workers. During the pandemic, many parents have gained a new appreciation of teachers as partners in raising children and allowing them to work. But balancing work and family when everyone is stuck at home is a massive challenge — and remote learning has become an additional stressor.

In other words, the stakes for reopening schools in the fall have never been higher. When can students go back to school safely? If so, how?

Answers to when and how begin with where you live. Is the transmission rate low in your county? Can you easily access rapid coronavirus tests and results? Does your health department have a robust system to identify individuals infected with COVID-19 and track down their contacts for testing and quarantine, known as track and trace?

Check your county at covidactnow.org. This website monitors community transmission using five indicators or numbers: new cases, infection rate, degree of testing, hospital capacity and contacts traced. The website also created a warning system building on an early monitoring system developed by the White House coronavirus task force. Government officials categorized areas from low to high rates of infection, known as green, yellow or red zone. Media outlets have also worked hard to create a variety of great tools. The New York Times, for example, breaks down hot spots by country.

This information is valuable, although some sites are volunteer run and not always 100 percent accurate — be sure to check how often and recently sites are updated. But this is part of the problem — there is no easily accessible, federal website that could provide up-to-date information for school districts and parents. Just as bad, the federal government is not tracking outbreaks at K-12 schools — some states are simply not acknowledging them at all.

There is no easily accessible, federal website that could provide up-to-date information for school districts and parents.

If infection rates are high in your area, schools should not reopen. If they drop, teachers and parents should still remain vigilant for signs of the virus. The CDC’s school reopening checklist is sadly incomplete. While it rightly includes information about social distancing and decontamination, it doesn’t address issues like how to stop the spread of air droplets. The checklist below is meant as an additional — although not comprehensive — guide for teachers, parents and administrators.

Masks. Teachers, staff and school employees should be fitted for KN95 or N95 masks. These masks block 95 percent of particulate matter when properly fitted. Students must always wear masks, except when they are eating or drinking. But teachers and parents need to emphasize the importance of keeping the mask on and not fidgeting with it. Taking off and putting on a mask throughout the school day may contaminate the mask and child.

Air flow. Like in hospitals, schools should install and use HEPA filters. Ideally, schools should keep windows and door open, letting fresh air reduce the concentration of indoor contaminants, such as virus particles. High-efficiency particulate air (HEPA) filters work in a similar way, but won’t create problems for children with allergies or asthma. Removing viruses from the air reduces the potential for exposure.

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Pods. Students should be divided into groups or pods of 10 to 15 students. The pod learns, eats and exercises together the entire school day. This way each student can stay 6 feet from their peers while seated at their desk. A pod also helps identify and contain a potential outbreak.

Drinking fountains. Schools must replace water fountains with bottled water. Using a water fountain brings hands, mouths and noses close to a high traffic surface. A student infected with COVID-19 may shed the virus on the on/off knob, water source and other parts of the fountain. Closing a fountain eliminates a potential source of contamination.

Outdoor education. Students should eat and exercise outdoors as much as possible. Intense activities require more inhales and exhales. This can increase the number of virus droplets in the air, leading to greater exposure to COVID-19. Conducting both activities outside allows fresh air to reduce the concentration of viruses.

Movement. Hallways are one-way corridors, moving students in one direction. One-way hallways reduce the chances of face-to-face contact, which increases the likelihood of transmission.

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Cleaning. Classrooms and buses are cleaned twice a day. Depending upon the surface, COVID-19 can live on surfaces for hours to days. Cleaning is necessary to destroy the virus in common space surfaces, such as bathrooms, lockers and buses.

Testing. Schools must be vigilant. Surveillance systems should be set up to periodically test sewage, heating air conditioning and ventilation systems and compressors to help in the early detection of an outbreak.

Extracurriculars. School should stop chorus, band, wrestling, football and other contact sports. Social distancing is impossible with these group activities. Singing and playing wind instruments aerosolize the virus. A two-hour choir practice with one symptomatic singer in Washington state resulted in 87 percent of the group becoming infected.

In sum, these protective measures require more space, equipment, teachers, cleaning staff and additional funding. Not every school will be able to do this.

And the stakes are high than some politicians would like you to believe. Although initially it was believed children could not spread coronavirus to adults, we now know this isn’t true. In a large study of pediatric COVID-19 cases in 82 health care institutions across 25 European countries, 3 out of 4 patients were healthy children without known pre-existing conditions before becoming infected.

Pediatric patients in the study experienced symptoms which resembled the flu or a cold. More than 6 in 10 children had a fever and over half had an upper respiratory infection. School age children frequently suffer sniffles and aches. Are parents prepared to test their daughters and sons each time they have one of these common symptoms? Do public health officials have enough tests to separate influenza or common cold patients from COVID-19?

As the rates of infection drop in cities around the U.S., it is possible for some schools to reopen safely. But this will only be possible if intense cleaning, social distancing and testing protocols are carried out. And if an outbreak does occur or rates begin to rise again, schools may have to close again. The process will be neither cheap nor easy. Will it be worth it?