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Today I read @paulmromer thread - particularly the part about schools (I recommend it!).
And we need to talk about #SchoolReopening, from a scientific perspective.
So here goes, with thanks to @sarita @ambilinski @RobinCogan @abuttenheim & others: https://twitter.com/paulmromer/status/1279070990954311685
And we need to talk about #SchoolReopening, from a scientific perspective.
So here goes, with thanks to @sarita @ambilinski @RobinCogan @abuttenheim & others: https://twitter.com/paulmromer/status/1279070990954311685
1) First, there is so much we still don't know about the science of #SchoolReopening. So it's tough to say "you will be safe" given that we still aren't sure.
For instance, we aren't sure whether kids spread #COVID19. We THINK they don't spread it: https://www.npr.org/sections/goatsandsoda/2020/06/20/880983822/coronavirus-mystery-are-kids-less-likely-to-catch-it-than-adults-are
For instance, we aren't sure whether kids spread #COVID19. We THINK they don't spread it: https://www.npr.org/sections/goatsandsoda/2020/06/20/880983822/coronavirus-mystery-are-kids-less-likely-to-catch-it-than-adults-are
.... but this goes against the science of MOST respiratory outbreaks, where kids are MOST likely to spread the virus.... so a lot of us are scratching our heads on this one.
For more details, check out this great piece by @HelenBranswell https://www.statnews.com/2020/06/18/how-likely-are-kids-to-get-covid-19-scientists-see-a-huge-puzzle-without-easy-answers/
For more details, check out this great piece by @HelenBranswell https://www.statnews.com/2020/06/18/how-likely-are-kids-to-get-covid-19-scientists-see-a-huge-puzzle-without-easy-answers/
2) We HAVE seen outbreaks in some schools in some countries that have re-opened.
BUT that may be due to *staff* transmission, or due to general re-opening of the economy and normal community transmission. https://www.miamiherald.com/news/coronavirus/article243670537.html
BUT that may be due to *staff* transmission, or due to general re-opening of the economy and normal community transmission. https://www.miamiherald.com/news/coronavirus/article243670537.html
And other school systems report virtually NO transmission - suggesting, again, that maybe it isn't the kids. https://www.reuters.com/article/us-health-coronavirus-denmark-reopening/reopening-schools-in-denmark-did-not-worsen-outbreak-data-shows-idUSKBN2341N7
... again, the evidence is still out. https://www.technologyreview.com/2020/06/30/1004625/is-it-safe-to-send-kids-back-to-school/?truid=af9467d346f17dc79c971b984c377d70&utm_source=engagement_email&utm_medium=email&utm_campaign=site_visitor.unpaid.engagement&utm_content=07.01.non-subs
3) Ideally, we'd keep sick kids & teachers home. (But symptom-checkers aren't perfect.)
Ideally, we'd test everyone weekly to catch asymptomatic infections. (But there aren't enough tests.)
Ideally, we'd trust people to self-isolate if they've been exposed. (hah.)
Ideally, we'd test everyone weekly to catch asymptomatic infections. (But there aren't enough tests.)
Ideally, we'd trust people to self-isolate if they've been exposed. (hah.)
Some schools are trying #digitalhealth to fill the gap - but this requires honesty; awareness of who you've been exposed to; & access to testing if you screen positive. https://www.wired.com/story/schools-surveillance-tech-prevent-covid-19-spread/
I think it's a great idea, but the jury's still out on its efficacy.
And at the end of the day, we need more testing.
And at the end of the day, we need more testing.
4) Ideally, all kids & teachers would be masked and at 6-foot distances from each other.
But let's be honest: in the US, we've underfunded public #school for decades... they don't have resources or space. (Some private schools might be able to do this!) https://www.washingtonpost.com/world/2020/06/05/coronavirus-countries-reopening-schools/
But let's be honest: in the US, we've underfunded public #school for decades... they don't have resources or space. (Some private schools might be able to do this!) https://www.washingtonpost.com/world/2020/06/05/coronavirus-countries-reopening-schools/
3) Additionally, we're weighing the very low risk of serious #COVID19 consequences in kids, vs very real negative educational & social effects of "no school", vs the large risk of severe infection for older teachers, vs a huge negative effect of school closure on working parents.
This is a moral judgment. Some may say "I will tolerate no risk." In which case, we should shut down schools.
Some may say, "Our economy cannot work without school." In which case, we should reopen and accept the risk.
How to assign value to one scenario vs another? #bioethics
Some may say, "Our economy cannot work without school." In which case, we should reopen and accept the risk.
How to assign value to one scenario vs another? #bioethics
4) The evidence IS clear, though, that shutting schools hurts kids.
And I'll go further: the evidence is FAR clearer about shutting schools hurting kids, than about shutting bars & movie theaters hurting adults. https://www.cmi.no/publications/7214-impacts-of-school-closures-on-children-in-developing-countries-can-we-learn-something-from-the-past
And I'll go further: the evidence is FAR clearer about shutting schools hurting kids, than about shutting bars & movie theaters hurting adults. https://www.cmi.no/publications/7214-impacts-of-school-closures-on-children-in-developing-countries-can-we-learn-something-from-the-past
... especially for kids who are already at a disadvantage: https://slate.com/human-interest/2020/04/online-school-remote-learning-inequality-falling-behind.html
(NB: This is why @AmerAcadPeds came in strongly on the side of re-opening -- they feel that the risk of infection & transmission among kids is far lower than the risk of impaired education, food, safety, & social-emotional development. Full recs here:
https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/ )
https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/ )
5) All that said (I'm running out of space here): In the absence of clear answers or definitive science, though, we MUST MAKE CHOICES. Because September is coming, whether we want it to or not.
And, as a working parent myself, let me be transparent: I desperately want my kids to go back to school.
So, I will try to addend more references later in the day, but based on reviewing the literature gathered by many, many people, if we are going to TRY to go back to school, here is what we MUST do:
6) First, and most importantly, we MUST REDUCE THE OVERALL RATE OF #COVID19 IN THE COMMUNITY.
That means #MaskUp, close bars & movie theaters, maintain physical distancing.
Do it this summer, for our kids in the fall. https://www.washingtonpost.com/outlook/2020/07/01/reopen-schools-close-bars/
That means #MaskUp, close bars & movie theaters, maintain physical distancing.
Do it this summer, for our kids in the fall. https://www.washingtonpost.com/outlook/2020/07/01/reopen-schools-close-bars/
7) Second, schools should plan now to keep kids in stable, small groups, with physical distancing as much as possible, to minimize mixing and exposure.
Open the gyms, the libraries, etc to minimize class size.
(see https://www.inquirer.com/opinion/commentary/coronavirus-schools-reopen-plan-pennsylvania-covid-19-20200604.html for more by @abuttenheim )
Open the gyms, the libraries, etc to minimize class size.
(see https://www.inquirer.com/opinion/commentary/coronavirus-schools-reopen-plan-pennsylvania-covid-19-20200604.html for more by @abuttenheim )
8) Third, we should all work to #GetMePPE for *teachers*, who are most at risk and seem to be most likely to spread the virus.
Face shields for teachers while teaching may also be an option - so kids can see their teachers' faces
And kids should #MaskUp when/where possible.
Face shields for teachers while teaching may also be an option - so kids can see their teachers' faces
And kids should #MaskUp when/where possible.
Teachers should have safe spaces where they can take their masks off and eat/drink, while maintaining physical distance
Kids should most likely eat in their classroom, rather than in cafeterias
Kids should most likely eat in their classroom, rather than in cafeterias
9) Fourth, we should be planning now for likely distance learning once respiratory virus season hits. Everyone will be symptomatic, all the time.
(In an ideal world, kids get a couple months of in-person & teachers get time to plan engaging & accessible online learning.)
(In an ideal world, kids get a couple months of in-person & teachers get time to plan engaging & accessible online learning.)
10) Lastly, we NEED TO HAVE FUNDING. This is looking at you @BetsyDeVosED --> the schools can't do this without $.
It costs $$$$ to test, to hire teachers, to create small classrooms.
***I can't emphasize this enough. Without money, the schools will stay closed.***
It costs $$$$ to test, to hire teachers, to create small classrooms.
***I can't emphasize this enough. Without money, the schools will stay closed.***
I've run out of threads on this tweet...there's SO MUCH more to say. But this is a start.
At the end of the day: We must keep our kids' interests first, & invest in their safety. I hope we get definitive studies on safe reopening. In the meantime, we'll muddle through together.
At the end of the day: We must keep our kids' interests first, & invest in their safety. I hope we get definitive studies on safe reopening. In the meantime, we'll muddle through together.
