Colorado doctor says to reopen schools ‘without exception’

He and others point to research studies abroad and in the United States that show a pressing need for students to be back in the classroom.

The case to reopen schools for full in-person learning “without exception” received the support of an infectious disease specialist in Colorado who said research findings show that children not only were less likely to suffer ill effects from COVID-19 but also were less likely to spread the virus.

Dr. Sean O’Leary, a professor of Pediatrics and Infectious Diseases at the University of Colorado School of Medicine who is affiliated with the Children’s Hospital Colorado, based his opinions on several studies, including one done in Germany of elementary schools and childcare facilities. He recently penned a commentary on the subject that was published in the Journal of the American Medical Association’s JAMA Pediatrics.

German researchers showed that children through age 10 play a far smaller role in spread of COVID-19 than adults and are far less susceptible to the effects of the disease if they contract it. Based on that research and a number of other findings done in Norway and the United States, O’Leary said it’s time to bring students back to classrooms.

“The question we should be asking now is not do or do not children spread SARS-CoV-2; rather, we ought to be asking what we should do with the knowledge we have accumulated since the pandemic began regarding acquisition and transmission of SARS-CoV-2 in children,” O’Leary wrote. “The answer to that question could not be clearer: we must prioritize the reopening of childcare facilities and elementary schools to full-time, in-person learning without exception.”

Big questions still remain for many who are in COVID-19 hot spots or in areas with older populations or in underserved communities where elders might be within households: Is it truly safe? Are children at risk for acquiring or spreading the disease? Do mitigation strategies really work in preventing spread? Could different strains of coronavirus present different outcomes?

“While we’re still learning more about this new more contagious variant (B.1.1.7), current evidence suggests that the mitigation measures in place in schools, especially among elementary students, should also work against this variant (wearing face masks, physical distancing, hand hygiene, cohorting, etc.),” O’Leary wrote. “As with everything with this pandemic, we must constantly re-evaluate the scientific evidence as it emerges, and we will be watching the spread of this variant and any potential impact on schools closely.”

The urgency of a return

From his research, O’Leary said the best option for children is to have them attend school in person. So too believes Dr. Allison Eckard at the Medical University of South Carolina, who spent weeks culling data from Charleston County School District that showed a 1% positivity rate with face-to-face instruction and strong indications from the data that virus spread was not happening in schools. She said mitigation strategies were essential in keep those numbers low.

One of the limitations of the German study is that it was done from April to May 2020, when the country was in lockdown. Still, of the nearly 2,500 students and their parents who were tested for COVID-19, only two participants who came back positive in turn gave it to a parent. Though a smaller sample size, the study also showed that children who were in childcare facilities had a lower incidence of seroprevalence – or prior infection – than those who were at home.

Based on these studies and a number of other factors, school systems are reconsidering the impacts of remote learning, especially on those in disadvantaged areas and for students who are struggling in a virtual environment. Some large school districts, including two in Florida for example, have issued notifications to parents on students falling behind and being at risk for further learning loss or potential retention if they don’t return to in-person learning.

One of O’Leary’s colleagues, Heidi Baskfield, vice president of Population Health and Advocacy at Children’s Hospital Colorado, says schools must look at the overall burden on their students when making those tough decisions.

“We know that closing schools has a profoundly negative effect on students, impacting everything from brain development to mental health and wellness to food security,” Baskfield said. “Evaluating the scientific research against the impact of closures is important to ensure that the most rational decisions are being made, which will help mitigate long-term harm to our children.”

Baskfield cited research studies rthat have shown the negative outcomes of shutdowns on students – “depression, isolation, hunger, child abuse and suicidal ideation among children and teens due in part to COVID-19, and a decrease in academic progress, physical activity and socialization.”

A report published by the New York Times on Sunday highlighted the tragic fallout of some schools that operate remotely and the pressures being felt by students – there have been 18 suicides in the Clark County School District that serves greater Las Vegas this academic year alone, prompting schools there to reopen in person.

In parts of Colorado and other locales, however, schools remain shuttered. That goes against the guidance presented in the studies, leading O’Leary said. “We have already seen short-term consequences of these closures, and the potential longer-term consequences of a missed year (or more) of learning are dire.”

One potential caveat that might allay fears for all parties is the rollout and dispensing of vaccines for educators. Many states – on the advice of hospitals such as Children’s Colorado – have pushed teachers and staff into the Phase 1B category, alongside first responders in getting vaccinated. With vaccines comes more assurance for parents and additional piece of mind for those who are instructing.

School districts looking for guidance, also can like Charleston and districts in Colorado, pair up with health providers in their community to decide their best options for when and how to reopen safely.

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