Thread by @leorahorwitzmd

I posted earlier about the currently known state of the (limited) science on pediatric #COVID19 transmission. Of course, the question is how to apply that knowledge to schools. Many have already posted thoughtfully about this problem. Thread.

https://twitter.com/leorahorwitzmd/status/1281638107796910080?s=20

Harms of closing schools are enormous: e.g., loss of academic progression, worsening disparities, food insecurity, strain on working parents/impaired economy, delayed social/emotional development, social isolation, increased incidence/reduced reporting of domestic violence, etc.

But, harms of opening schools could also be substantial if they cause significant infections in staff/students, and/or increase community spread. @meganranney has done a great job outlining the stakes.

https://twitter.com/meganranney/status/1279775990563180544?s=20

I largely agree with @AmerAcadPed – decisions must be local, contextual, flexible, but school is so important for child development, disparities, and the economy that we should prioritize SAFELY reopening them in person as fully as possible. aappublications.org/news/2020/06/2…

BUT if not done well, opening in person could be worse than just doing online to start. In person 2 days a week? Ugh. Virtually all the risk (esp to teachers), not much better for learning, and none of the benefit to working parents/economy.

https://twitter.com/NYCSchools/status/1280898931317248002?s=20

If community prevalence high, I see no viable option but distance learning. So, first priority has to be to keep community prevalence low. Fortuitously, this is also the best long-term strategy for restarting the economy, keeping high risk population safe, etc. A virtuous cycle!

People, if that means that we keep everything else (restaurants, bars, shops, amusement parks, movies, churches, etc) closed or limited for longer, well then that’s what we should do. We have got to prioritize getting our nation’s kids back to school over eating in restaurants.

(not to mention dropping the prevalence of disease would save thousands of lives)

Where prevalence low, we should open all elementary and maybe middle schools fully: all students, 5 days/week. Use high schools, outdoors, school gym/library to maximize distancing. Aggressively cohort kids & stagger starts to minimize cross-exposure.

All learning, lunch, specials etc in one classroom. Teachers in face shields +/- behind Plexiglass so kids can see their face; kids in masks if they can tolerate. Frequent (weekly) pooled saliva testing if FDA approves. Revert to online teaching for 2 weeks if positive case.

Something like that would stand best chance of keeping most kids in physical classrooms for most amount of time. Is it ideal learning? No. But better than being at home and safer than just opening up for business as usual.

High school much tougher. Can’t cohort so easily, too much differentiation. Their risk of disease and spread more approximates adults. They each have more teachers: more staff risk. I am not optimistic about high school being able to fully reopen in person in that many places.

And I say this with great dismay, having 2 high school age kids who HATED online learning. But, at least they can do some independent learning, and working parents can leave them at home if necessary.

Lots of other countries have reopened schools. We can learn strategies from them. But, ultimately this is not about creative ways to distance at school. The way to keep schools open is to minimize spread in community. Isolate. Distance. Mask. Wash. Test. Trace. /End