School Reopening Guidance for Families and Teachers
written by a multidisciplinary team that includes scientists, physicians, parents, and educators
written by a multidisciplinary team that includes scientists, physicians, parents, and educators
EndCoronavirus.org
August 10th, 2020
How do we safely reopen schools?
Eliminate community transmission.
When COVID-19 is no longer being transmitted within a community, schools can begin to reopen safely. It is not safe to reopen schools for in-person schooling while community transmission is still present. In-person schooling increases the risk of rapidly escalating case numbers throughout the community, placing health and lives at risk and possibly requiring further lockdowns to contain transmission. Before a community can safely begin to reopen schools (primary, secondary and higher education), they must bring new cases to zero and have safeguards in place to keep cases at zero. We can stop COVID-19 community transmission. All it takes is five weeks. We know how to get there, and we can all start now.
Risks of reopening Early
From the beginning of the COVID-19 outbreak, we were told that children were unlikely to catch or transmit the virus. However, as the virus has spread around the world, we have learned that children can get infected with the virus and can become severely sick with COVID-19. Recently, we have learned that children can be infected as often as adults and can even have significantly higher levels of virus in their bodies. We do not yet know how effectively children transmit the virus, but many examples already show that it is possible for children to transmit COVID-19 and that schools can have a large impact on its spread (see below). While there is still much unknown about COVID-19 in children, the health of the entire community is at risk. We must be cautious about our next steps.
COVID-19 infections occur in schools and can lead to outbreaks
Outbreaks of COVID-19 are becoming increasingly common in schools, camps, and child-care facilities. In many cases, these have substantially contributed to the spread of the virus. To give a few:
Israel
Mid-May: <20 new cases per day, nationwide.
June 3: 130 cases reported in a single school, only 2 weeks after schools fully reopened.
July: 1000+ new cases per day nationwide, roughly matching per capita case rates in the US and erasing the progress gained from strict containment measures. Discussions of another lockdown are in progress.
In the US, safety guidelines around testing typically suggest that positivity rates must be below 5%. Israel was well below 0.5% in May.
UPDATE: Israel recently released an Analysis of Data on Coronavirus Morbidity in Children.
England
Nearly 20% of outbreaks from June 15-21 were from schools.
Indiana, US
In Greenfield, Indiana, a junior high school opened for in-person learning on July 30. They reported their first positive COVID-19 test the first day.
Georgia, US
Sixes Elementary, in the Cherokee County School District, began in-person classes on August 4th. On August 5th, 20 students and their teacher were asked to quarantine after a second-grade student tested positive.
One day after reopening, 260 school employees were asked to quarantine in Gwinnett County.
Days after reopening, North Paulding High School (pictured) reported that 6 students and 3 staff members tested positive for COVID-19.
Texas, US
May 15: 53 childcare facilities reported 59 total cases among children and staff.
July 6: 883 child care facilities reported 1335 confirmed cases (894 among staff and 441 among children).
As the number of cases in a community increase, so does the likelihood of a school outbreak. This puts the health and lives of our children, teachers, families, and neighbors at risk, and poses further risks to communities that are already struggling to contain the virus.
See a spreadsheet which details more than 400 articles about Covid-19-related school closures, cases, and deaths in the K-12 school system in the US (as of 14 Aug. 2020).
Who is at risk?
Children are at risk.↓
A common misconception is that children are rarely infected. CDC data indicates that as of May 30, 5.3% of confirmed cases are children (≤19 years old). However, since schools closed in spring, children have been largely sheltered from public spaces where they could be exposed to the virus. Additionally, children often experience mild or atypical symptoms, so it is possible that infected children are less likely to be tested than infected adults. A recent study analyzed contact-tracing data and found that children aged 0-14 are 34% as likely to be infected, compared to people aged 15-64. However, further studies have found that children may have comparable risks of being infected as adults and may even carry higher levels of virus in their respiratory tracts.In the last two weeks of July, COVID-19 cases in children have risen 40%, with over 97,000 children testing positive.
Another misconception is that children rarely become severely ill. However, 3% of confirmed cases in children required hospitalization, with a third of these needing intensive care. The hospitalization rate is lower for children than adults aged 20-60 (8%); however, children are still at a significant risk. Children are also at risk of the rare, but life-threatening, pediatric multisystem inflammatory syndrome that can occur even after resolution of COVID-19 infection. Even so-called ‘mild’ cases of COVID-19 can cause long-term debilitating illness. While most cases of long-COVID have been reported in adults over 18, children may also be at risk of protracted respiratory, neurological and circulatory symptoms.
In-person education is important for children and their families. Education is generally better for students and teachers in-person, so there is reluctance to change to distance learning. However, it is important to realize that we are not comparing distance learning against normal in-person learning. In-person learning in a pandemic requires precautions to limit transmission in the school, creating a highly unique (and less effective) version of in-person learning. Physical distancing prevents the close interactions between students and teachers that enhance learning. Face coverings make communication and emotional connection between students and teachers much more difficult. Many teachers also believe that many of the needed precautions will be difficult or impossible to implement. When they have been tried, student adherence decreased over time, increasing the risk of transmission within the school.
Compared to standard in-person learning, it is hard to provide the same educational value in distance learning. Many students need the structure and support of in-person learning and many families depend on in-person schooling for child-care support. These are challenges for schools and governments to address. However, as long as we are in the middle of the COVID-19 pandemic, traditional in-person schooling is not feasible. While returning to in-person learning is of high importance, it is not worth risking the lives and long-term health of our children, families and communities. Instead, each community should focus on getting to zero new cases of COVID-19 so that we can get back to safe, in-person schooling as quickly as possible.
Teachers and school staff are at risk.↓
Teachers and school staff are also at a high risk, both of catching and transmitting the virus within the school. As of 2019, 28% of public school teachers in the US were over 50 years old. The risk of life-threatening COVID-19 illness increases with age and for those with underlying health conditions. Even with the use of personal protective equipment, school reopenings put the lives of teachers and staff at risk.
Communities are at risk.↓
COVID-19 outbreaks in schools will lead to transmission in families and in communities as students, teachers, and staff return to their lives outside of school. In addition, many teachers and staff travel from other communities; consequently, an outbreak at one school can threaten multiple communities. This puts a large number of people at risk, including the most vulnerable members of the community (those over 70 or with pre-existing health conditions).
Colleges and Universities pose a special risk.↓
In addition to all the risks outlined above, the reopening of colleges and universities poses further risks of virus transmission affecting the health and lives of students, teachers, staff and communities. Many students travel from different communities, or even different states, to attend colleges and universities. This raises the risk of introducing the virus into the community from areas with high viral transmission. Additionally, many students, teachers and staff travel to campus from multiple different communities, further increasing the risk of virus spread. Typical college and university students (under 30 years old) also represent the largest COVID-19 positive demographic in many countries. There have been reports of lower rates of precautionary behaviours, with instances of large COVID parties that have resulted in fatalities and large scale viral transmission. As students travel back to campus after (in many cases) experiencing lockdown restrictions with their families, the social environment of reopened colleges and universities may result in many outbreaks that pose risks to everyone on campus and their local communities.
Colleges and universities, unlike primary and secondary schools, tend to have many more shared living and communal spaces that increase interpersonal contact (e.g. dorms, elevators, communal eating areas and washrooms). In addition, many universities have very large student populations with high numbers of students per classroom, increasing the risks of transmission. Even with robust testing and contact tracing, controlling transmission will still require adherence to physical distancing, wearing face coverings, and using proper hand washing. It is questionable if these precautions can or will be maintained by the student body, especially with the low rate of COVID-19 precaution taking in that demographic. College and university reopening plans can be seen at the College Crisis Initiative.
While the exact degree of transmission among children and the precise impact of school openings are still unknown, recent school openings have shown just how dangerous they can be. Schools, camps and day-care centers have already caused many super-spreader events, and further reopening will likely cause many more. School closures minimize the risks to communities and are correlated with reductions in COVID-19 case numbers and fatalities. Rather than returning to the traditional in-person school setting, many school districts are creating virtual learning options and many families are joining together to create safe spaces for their children to socialize. It is clear that these options are not available to all families, and that there are children and families who depend on schools and in-person learning. These families need extra support from their government and community in the event of school closures. However, the best solution for everyone is to be able to fully reopen our schools as soon as safely possible. The quickest and safest way for schools to reopen is for our communities to get to zero and eliminate local transmission of COVID-19.
Is it safe to reopen schools in your area?
The reopening of schools is context-dependent; only in areas where there is no local transmission of the virus can schools be reopened safely. Areas without local virus transmission are called green zones. These areas have no new cases of COVID-19 in the last 14 days. Imported cases (e.g. travelers from other areas) do not count to this calculation, as long as they have been isolated and their contacts identified. If your school is located in a green zone, surrounded by neighboring COVID-free zones, and has plans in pace to keep cases at zero, then it is safe to cautiously reopen schools.
To determine your local transmission risk and see if you are in a green zone, you can look at county-level data for cases and trends.
What to do if your school is opening in an unsafe area
If you live in an area where schools are planning to reopen despite community spread, you can take action to protect your community and stop schools from reopening. In many cases, schools are following the local city and state guidelines, so speaking with your elected officials can be highly effective. If you live in the US, you can easily call your elected officials (Mayor, Governor, Congress) and receive a custom script of what to say at EndCoronavirus - Speak Up America. The script can also be adapted for international use.
When advocating for schools to remain closed to in-person teaching, the experts within EndCoronavirus.org are here to help. If you have a phone call arranged and would like an EndCoronavirus.org representative to participate and provide guidance, please contact us.
Next steps for families
During this challenging time, families are faced with many difficult choices. The best path forward is to eliminate community transmission and then safely reopen schools. However, some schools are planning to reopen before that goal is met. This pandemic also has a disproportionate effect on some families. These families may be in a position where schools are remaining closed but the child or family needs in-person learning and support. Both of these circumstances can be difficult for families and children, and there are no easy solutions. Below we offer some suggestions for supporting children and families, but we know that not all families will be able to implement these solutions. We will continue to update this guidance and resource as the situation changes in the hope of continuing to provide support to all children, families, teachers, staff and communities.
If your child is enrolled in a school, consider first exploring their distance learning options. Most school districts are offering a distance learning option, by which your child can stay enrolled and complete their coursework 100% virtually. As you explore this option, ask your school leadership about their specific plans:
What are the time commitments if I choose distance learning? Will the schedule be flexible to meet our family’s needs?
How will the school track and assess my child’s learning?
What kinds of digital tools, resources and assistance will the school provide to support equitable access for all distance learners?
How will the school support my child’s social and emotional needs through the virtual platform?
If your child has special needs, how will the school continue to provide specialized services remotely? Will the school continue to provide speech, language or occupational therapy and support through their virtual platform?
If your family is committed to 100% distance learning and you are ready to build connections with other families, consider creating a distance learning pod. Pods are a way that a small group of families can share in the responsibilities of distance learning while also allowing children the in-person connection that they need. If you feel it is necessary to get together physically with another family on a regular basis, everyday behavior needs to be adjusted accordingly to keep everyone as safe as possible.
For more information on learning pods, please see our Pod Guidelines. We know that not every family will be able to implement a learning pod, but platforms are also being developed in some communities to help support families in pod formation. Organizations such as the COVID Tutoring Initiative are also providing free tutoring support services for students.
Next steps for teachers
As teachers consider the options for returning to work in the fall, they must consider their own health and well-being, as well as that of their students, families, and co-workers. Teachers have the power to help their communities get to zero before returning to school. This can be done through advocacy to your elected and appointed officials, as described above. In addition, teachers can work with their local unions to advocate for the closure of schools.
If you are in a position where you need to return to in-person teaching, ensuring you have the needed personal protective equipment (PPE) is essential. It is recommended that teachers follow front-line worker recommendations and wear medical-grade masks and eye protection (such as goggles or a face shield). Recently, clear face shields with integrated masks have become available and could facilitate better communication between teachers and students. Protective gowns or coats and gloves can also be used to provide added protection. Guidance for PPE recommendations, including instructions for how to put on and take off PPE, has been provided by the CDC. Continue to practice physical distancing and frequently wash your hands with soap and warm water.
Consider also asking your school leadership:
Will teachers, staff, and students be required to wear masks?
Will hand sanitizer be provided and widely available?
Will there be training on safe behaviors and risk mitigation?
What is being done to provide good ventilation and air filtering/purifying of indoor spaces?
How will physical distancing be ensured?
Will communal areas (including cafeterias) be closed and, if not, will efforts be made to reduce the number of people present at any time?
What is the contingency plan if someone is diagnosed with COVID-19?
Next steps for school administrators and officials
If you are a school administrator or local official who has control over school opening decisions, we strongly urge you to keep schools closed until there is no more community transmission of the virus. There must be no more transmission of the virus in your community and the surrounding areas for 14 days. If you would like more guidance on why reopening schools is dangerous and how to talk to students, teachers, parents and staff, EndCoronavirus.org is here to help.
Please contact us for more information.