Reopening Primary Schools during the Pandemic

It is inexcusable to open nonessential services for adults this summer if it forces students to remain at home even part-time this fall.

 

As communities and families navigate the complicated issues around reopening schools, experts argue that children returning to primary school is essential, not only because of the educational, social, and developmental benefits for kids themselves, but also for the longterm economic and civic health of the country.  Every effort should be made to reopen them full-time in the autumn, according to an article in the New England Journal of Medicine co-authored by Meira Levinson, Muge Cevik and Marc Lipsitch.  Doing so safely will require reducing or eliminating community transmission while ramping up testing and surveillance.

Authors recommend that any region/city with moderate, high, or increasing levels of community transmission “should do everything possible to lower transmission” including closing nonessential indoor spaces such as retail establishments, movie theatres, restaurants and pubs.

The authors — Meira Levinson of the Harvard Graduate School of Education; Muge Cevik of Scotland’s University of St. Andrews; and Marc Lipsitch of  T.H. Chan School of Public Health; emphasise that “school closures have brought social, economic, and racial injustice into sharp relief, with historically marginalized children and families — and the educators who serve them — suffering the most and being offered the least.”

Until elementary school children physically return to school full-time, “many will lose out on essential educational, social, and developmental benefits; neither the economy nor the health care system will be able to return to full strength given parents’ caretaking responsibilities; and profound racial and socioeconomic injustices will be further exacerbated,” the authors wrote.  They added, “It is inexcusable to open nonessential services for adults this summer if it forces students to remain at home even part-time this fall.”

The authors argue that “children, families, educators, and society deserve to have safe and reliable primary schools should not be controversial.”  Primary schools should be recognized as essential services, school personnel as essential workers — and that school reopening plans should be developed and financed accordingly.  “Schools are more like grocery stores, doctors’ offices, and food manufacturers than like retail establishments, movie theatres, and bars.”  “Like all essential workers, teachers and other school personnel deserve substantial protections, as well as hazard pay.  Remote working accommodations should be made if possible for staff members who are over 60 or have underlying health conditions.”

The authors specifically emphasise opening primary schools as a priority although they also acknowledge that “fully reopening schools for middle and high school students should be a national priority, but given the more challenging transmission dynamics at older ages, we confine ourselves here to elementary schools.”

According to the literature review conducted by the authors (Goldstein E, Lipsitch M, Cevik M. on the effect of age on the transmission of SARS-CoV-2 in households, schools and the community. July 28, 2020 https://www.medrxiv.org/content/10.1101/2020.07.19.20157362v1) children aged under 10 years have lower susceptibility to infection compared to adults, but the susceptibility increases with age, especially over 15 susceptibility and infection rates reach similar to adults.  Authors argue that “opening secondary/high schools is likely to contribute to the community spread, and greater safeguards to reduce transmission is needed while opening secondary and high schools”.  The authors suggest that “compared to secondary/high schools, opening primary schools and daycare facilities may have a more limited effect on the spread of SARS-CoV-2 in the community, particularly under smaller class sizes and in the presence of mitigation measures.” Every effort should be taken to avoid crowding in the classroom and other mitigation measures should be implemented, to the extent possible, when opening primary schools.

This highlights that different approaches are needed when opening schools for different age groups.

For many reasons, decisions about school reopenings will remain complex and contested as the authors argue that school openings “is not just a scientific and technocratic question.  It is also an emotional and moral one.  Our sense of responsibility toward children — at the very least, to protect them from the vicissitudes of life, including the poor decision making of adults who allow deadly infections to spiral out of control — is core to our humanity.”