Apoorva Mandavilli is an award-winning science reporter for the New York Times. She is a mother of two children. She lives in Brooklyn. In this article, she thinks through the pros and cons of sending her children back to school. To read the links, open the story. Yesterday, Mayor de Blasio and UFT leader Michael Mulgrew announced that the city’s public schools would open for blended learning on September 21. Orientation will begin September 16. Teachers will report to their buildings on September 8.
All summer, as information about how the coronavirus affects children has trickled in, I’ve been updating a balance sheet in my head. Every study I read, every expert I talked to, was filling in columns on this sheet: reasons for and against sending my children back to school come September.
Into the con column went a study from Chicago that found children carry large amounts of virus in their noses and throats, maybe even more than adults do. Also in the con column: two South Korean studies, flawed as they were, which suggested children can spread the virus to others — and made me wonder whether my sixth-grader, at least, should stay home.
Reports from Europe hinting that it was possible to reopen schools safely dribbled onto the pro side of my ledger. But could we match those countries’ careful precautions, or their low community levels of virus?
I live in Brooklyn, where schools open after Labor Day (if they open this year at all), so my husband and I have had more time than most parents in the nation to make up our minds. We’re also privileged enough to have computers and reliable Wi-Fi for my children to learn remotely.
But as other parents called and texted to ask what I was planning to do, I turned to the real experts: What do we know about the coronavirus and children? And what should parents like me do?
The virus is so new that there are no definitive answers as yet, the experts told me. Dozens of coronavirus studies emerge every day, “but it is not all good literature, and sorting out the wheat from the chaff is challenging,” said Dr. Megan Ranney, an expert in adolescent health at Brown University.
But she and other experts were clear on one thing: Schools should only reopen if the level of virus circulating in the community is low — that is, if less than 5 percent of people tested have a positive result. By that measure, most school districts in the nation cannot reopen without problems.
“The No. 1 factor is what your local transmission is like,” said Helen Jenkins, an expert in infectious diseases and statistics at Boston University. “If you’re in a really hard-hit part of the country, it’s highly likely that somebody coming into the school will be infected at some point.”
On the questions of how often children become infected, how sick they get and how much they contribute to community spread, the answers were far more nuanced.
Fewer children than adults become infected. But childhood infection is not uncommon.
In the early days of the pandemic, there were so few reports of sick children that it was unclear whether they could be infected at all. Researchers guessed even then that younger children could probably catch the coronavirus, but were mostly spared severe symptoms.
That conjecture has proved correct. “There is very clear evidence at this point that kids can get infected,” Dr. Ranney said.
As the pandemic unfolded, it also appeared that younger children were less likely — perhaps only half as likely — to become infected, compared with adults, whereas older children had about the same risk as adults.
But it’s impossible to be sure. In most countries hit hard by the coronavirus, lockdowns and school shutdowns kept young children cloistered at home and away from sources of infection. And when most of those countries opened up, they did so with careful adherence to masks and physical distancing.
Children may turn out to be less at risk of becoming infected, “but not meaningfully different enough that I would take solace in it or use it for decision making,” said Dr. Ashish Jha, dean of the Brown University School of Public Health.
In the United States, children under age 19 still represent just over 9 percent of all coronavirus cases. But the number of children infected rose sharply this summer to nearly half a million, and the incidence among children has risen much faster than it had been earlier this year.
“And those are just the kids that have been tested,” said Dr. Leana Wen, a former health commissioner of Baltimore. “It’s quite possible that we’re missing many cases of asymptomatic or mildly symptomatic children.”
In the two-week period between Aug. 6 and Aug. 20, for example, the number of children diagnosed in the United States jumped by 74,160, a 21 percent increase.
“Now that we’re doing more community testing, we’re seeing higher proportions of children who are infected,” Dr. Ranney said. “I think that our scientific knowledge on this is going to continue to shift.”
Children do become sick with the virus, but deaths are very rare.
Even with the rising number of infections, the possibility that panics parents the most — that their children could become seriously ill or even die from the virus — is still reassuringly slim.
Children and adolescents up to age 20 (definitions and statistics vary by state) represent less than 0.3 percent of deaths related to the coronavirus, and 21 states have reported no deaths at all among children.
“That remains the silver lining of this pandemic,” Dr. Jha said.
But reports in adults increasingly suggest that death is not the only severe outcome. Many adults seem to have debilitating symptoms for weeks or months after they first fall ill.
“What percentage of kids who are infected have those long-term consequences that we’re increasingly worried about with adults?” Dr. Ranney wondered.
Multisystem inflammatory syndrome, a mysterious condition that has been linked to the coronavirus, has also been reported in about 700 children and has caused 11 deaths as of Aug. 20. “That’s a very small percentage of children,” Dr. Ranney said. “But growing numbers of kids are getting hospitalized, period.”
Children can spread the virus to others. How often is still unknown.
Transmission has been the most challenging aspect of the coronavirus to discern in children, made even more difficult by the lockdowns that kept them at home.
Because most children are asymptomatic, for example, household surveys and studies that test people with symptoms often miss children who might have seeded infections. And when schools are closed, young children don’t venture out; they tend to catch the virus from adults, rather than the other way around.
To confirm the direction of spread, scientists ideally would genetically sequence viral samples obtained from children to understand where and when they were infected, and whether they passed it on.
New York City has delayed the opening of schools by 10 days to give teachers and principals more time to prepare and to avert a possible teachers’ strike.
Under pressure from schools and advocates, the federal government has agreed to make it easier for schools to feed poor children.
“I keep saying to people, ‘It’s so hard to study transmission — it’s just really, really hard,’” Dr. Jenkins said.
Still, based on studies so far, “I think it still appears that the younger children might be less likely to transmit than older ones, and older ones are probably more similar to adults in that regard,” she said.
Sadly, the high numbers of infected children in the United States may actually provide some real data on this question as schools reopen.
So what’s a parent to do?
That’s a tough one to answer, as parents everywhere now know. So much depends on the particular circumstances of your school district, your immediate community, your family and your child.
“I think it’s a really complex decision, and we need to do everything we can as a society to enable parents to make this type of decision,” Dr. Wen said.
There are some precautions everyone can take — beginning with doing as much outdoors as possible, maintaining physical distance and wearing masks.
“I will not send my children to school or to an indoor activity where the children are not all masked,” Dr. Ranney said.
Even if there is uncertainty about how often children become infected or spread the virus, “when you consider the risk versus benefit, the balance lies in assuming that kids can both get infected and can spread it,” Dr. Ranney said.
For schools, the decision will also come down to having good ventilation — even if that’s just windows that open — small pods that can limit how widely the virus might spread from an infected child, and frequent testing to cut transmission chains.
Teachers and school nurses will also need protective equipment, Dr. Jenkins said: “Good P.P.E. makes all the difference, and school districts must provide that for the teachers at an absolute minimum.”
As long as these right precautions are in place, “it’s better for kids to be in school than outside of school,” Dr. Jha said. “Teachers are reasonably safe in those environments, as well.”
But community transmission is the most important factor in deciding whether children should go back to school, researchers agreed. “We just can’t keep a school free from the coronavirus if the community is a hotbed of infection,” Dr. Wen said.
Here’s the running list I’ve been keeping, from various studies I’ve read or read about:
The virus is spread by aerosols–very, very tiny droplets too small to be seen with the naked eye.
Kids under 10 can have 10 to 100 times as much viral load in their upper respiratory tracts as adults with full-blown coronavirus disease and yet be asymptomatic.
Kids of these ages (under 10) with the virus are TWICE as likely to transmit the virus as adults are.
Kids 10 and older transmit the virus at the same rate that adults do.
The virus lingers in the air for a long time–for many hours.
The virus is spread by air conditioning systems.
The virus causes blood clots throughout the body in organs such as the heart, brain, kidneys, and liver. And it can cause long-term neurological damage, both in kids as well as in adults. This damage can happen in children who have shown no or only very, very mild overt symptoms.
The virus is transmitted by people who are asymptomatic. So, taking temperatures is no real protection against spread.
Masks and shields of the kinds available to teachers and students are only partially effective. Though wearing most masks is a good idea, only N95 masks or their equivalents provide close to complete protection.
The aerosalized virus can travel much, much further than six feet.
It’s a good laundry list to consider. If I were going into a classroom this fall, I would wear a mask and put on a face shield or wrap around glasses as the virus can also penetrate the eyes.
Good morning Diane and everyone,
I agree, Bob. How is it what we can have NO in restaurant dining in NYC yet we’re about to let hundreds of people into school buildings without the proper staff, equipment and properly maintained buildings? How is it the Saratoga Racecourse (in an area with under 1% positivity rate) in upstate NY cannot have any fans in the outdoor stands – even at a reduced capacity? Yet we’re about to let hundreds of people into school buildings using the same faculty rooms, bathrooms and common areas? Teachers will be sitting in classrooms with hundreds of people everyday or over the course of a week. Does this make sense to anyone? Last night, after a blissful 1 hour and 40 minutes of watching Britbox, I happened to turn on CNN where I saw Chris Cuomo talking about the symptoms he is still experiencing months after “recovering” from Covid and the suffering of other “long haulers.” If you or your child gets Covid, are you SURE you won’t suffer long-term effects of this virus which could severely impact you for the rest of your life? Even doctors just don’t know yet. It seems we know more now than we did 6 months ago. But still, we don’t know enough. Of course we can’t be safe from everything in life. But the lack of consistency in these situations just don’t make sense. Even adults on college campuses can’t control themselves enough NOT to attend large parties and gatherings. Yet we want children and teenagers to do so. I don’t see it. Covid spread is inevitable. It’s just a question of how many people we will accept getting the virus before we close schools. I’ve asked the question and received no answer.
I believe that I had Coronavirus Disease in February, though I have not had an antibody test. I think I contracted it from neighbors who had returned from international travel and were all gravely ill (the entire family) but recovered. I am experiencing long-term symptoms and need to see another doctor about this.
Covid spread [because of the school reopenings] is inevitable. Yes. And preventable by postponing reopening until we have a vaccine or have N95 masks for everyone in schools.
I am glad you got through Covid without life threatening symptoms.
I spent a week in bed, sleeping for all but 3 or 4 hours a day. I was EXTREMELY fatigued, experienced muscle soreness, had major respiratory symptoms, and emerged with tingling in my extremities and soreness so severe that I had to walk with a cane for weeks. I still have the tingling, which sent me to a doctor, but this was before Covid-19 was at all understood. I need to do follow-up with other medical professionals, but that in itself is a major undertaking now.
Bob,
I sincerely hope your current problems are only temporary.
Also, thanks for continuing to be a voice of reason and caution in a cacophony of confusion.
BTW, you are probably aware, antigen tests can be notoriously inaccurate, with a false negative rate that makes many of them no better than a coin toss.
Bob, you probably would be negative for antibodies since apparently they are absent after about three months. You still have protection–T-cells, but I doubt they have a test to see if you have T-cells with the ability to eradicate Covid-19.
The fact that NYC mayor will not allow indoor dining tells us all we need to know. It is outrageous that students and teachers will be exposed to the virus on a daily basis as the powers that be deemed it appropriate for children to eat breakfast and lunch IN THE CLASSROOM. We are the guinea pigs.
Mayor Says Indoor Dining Will Depend on How School Reopening Goes
Bill de Blasio confirmed what some restaurant owners have suspected for some time now
https://ny.eater.com/2020/8/27/21404598/nyc-indoor-dining-schools-de-blasio-coronavirus
These people are either idiots themselves or they just believe everyone else is.
Their policies are the very definition of oxymoronic.
Unfortunately, some scientists are predicting a surge in infections in cold weather states when the weather changes, and it will occur when the regular flu is also active.
Hello Retired Teacher,
This virus is more contagious than the flu. So, when we have hundreds of people in school buildings in the winter with windows closed, there is going to be spread mores than when windows are open. It’s common sense.
Common sense?
Some of the people deciding to reopen schools are the same ones who put Common Core in schools without any pilot testing to speak of.
How sensical was that?
Many (particularly newer) schools completely lack windows that open.
It’s somewhat ironic because many of these were designed for safety (so that students could not jump out and so no shooters could get in from the outside)
But I understand the rational for having windows that don’t open.
Once when I was substituting , I had a student jump out of a second story window. Not to hurt themselves (and luckily they didn’t) but just to be “funny”.
ah, so if teachers and kids are sick, some perhaps dying, it won’t be a good time to open up restaurants for indoor dining?
The Dining Safety Test
You use the public student
To test if it is prudent
To venture out to eat
Or even just to meet
If student passes test
You wine and dine with zest
If student ends up dead
You stay at home in bed
Not sure how much this helps parents.
It’s well and good to tell people “As long as these right precautions are in place, “it’s better for kids to be in school than outside of school” and that “Teachers are reasonably safe in those environments, as well.”
But the devil is in the details. Without an assessment of the safety of specific INDIVIDUAL schools (with regard to things like ventilation, daily sanitizing, PPEs, mask wearing policy and enforcement, distancing policy and enforcement, testing and test accuracy. Contact tracing, etc), how are parents supposed to know if the right precautions are in place?
I was listening to a discussion of “experts” on the radio yesterday that said the state policy is to limit the size of social gatherings to 25 people and in the very same program the experts discussed school reopenings with no mention of the 25 person limit for gatherings. . It obviously didn’t occur to any of the experts involved in the discussion that many public schools have classes with over 25 students (to say nothing of lunchroom gatherings)
These sorts of glaring inconsistencies are the sort of thing that make any rational person scratch their head and wonder what are these people smoking?
The devil is in the details for sure. Some states are working hard to ensure that safety protocols are in place. Other states are sending students and teachers in on a “wing, a hope and a prayer.” States should be following the science, not the politics.
There is wide variation between schools with regard to ventilation and other matters, so unless the protocols mandate assessment of individual schools and provide a detailed set of testing and requirements that each school must pass before reopening, the mere existence of protocols is not sufficient.
To a certain degree, I think all states are sending students and teachers in on a wing , a hope and a prayer because even with the best of circumstances, there is a great deal of uncertainty about the current status of the virus in communities (due to inaccuracies in tests, particularly high false negative rates) and the likely future development if schools reopen.
I think a lot of people are pretending (to others and themselves) that there is far more certainty than actually exists.
My son goes to an Independent Faith based school that is private and they are going back hybrid at 25% (down from 50%). Some of the other Independent schools decided late to go all virtual because of campus size and facilities. Archdiocese schools are opening 100% so I guess they will just be praying a lot! My son’s school has a large campus and will have event tents erected outside for lunch service and for learning assistance, the buildings are immaculate with windows that open, the HVAC systems are being upgraded with filters, masks are req, hand sanitizer galore and loads of other rules put in place. I feel OK with how they are handling it and our #s here are below 4%. The public school system is going all virtual likely until January and the parents are screaming mad…..most schools are over capacity with numerous trailers, old buildings with poor HVAC, rooms without windows/ventilation and parents will argue the mask issue. Yes, the devil is in the details.
This is how the science writer ended the article…
“We qualified for two days a week of schooling in person. My mother-in-law lives downstairs in a separate unit and may be more vulnerable to the virus. But my children, who are 11 and 8, need to learn in person and are desperate to see their friends. We’ve decided to send our children back to school.”
Hello Carol,
There is no reason kids can’t see their friends outside of school in small groups socially distanced and with masks. It’s very likely that they WON’T be able to see friends during the day because of cohorts they will be in for the entire day. So, it seems to me that the argument “kids need to see their friends” is a poor argument. But we will see when this whole experiment get started.
It blows my mind that anyone would think that it’s OK to experiment on kids and hope they don’t develop serious long-term complications from having had this disease and don’t spread it to their parents, teachers, other relatives, etc., some of whom will die. And then, ofc, some of the kids will die, too. That also seems to be acceptable to some. It’s not to me.
In Florida, new cases have dropped from a recent all time peak of 12K to 3K, a reduction by a factor of 4, which is a major drop. In Texas and California, new cases have dropped from 10K to 5K, a factor of 2. This seems encouraging to me. Will these highs be retested, time will tell, but one possibility is that was it.
Or could it be that the data is bypassing the CDC and going to HHS instead? It’s a free for all out there and no one can be trusted except for Dr. Fauci…..who has basically been silenced.
Yes. Reliable data is no longer available because Trump does not want testing. It makes him look bad. The protocols for reporting cases and who receives those reports has been changed and that only adds to the problem of “decision-making under conditions of uncertainty” but with no game-theoretic answer to that.
The writer asks: “So what’s a parent to do?
That’s a tough one to answer, as parents everywhere now know. So much depends on the particular circumstances of your school district, your immediate community, your family and your child.”
For low-income parents who have more than one child the answers are even more complicated. Add a layer of difficulty for parents who do not have access to the tech (devices, high speed internet) or those who work at home and cannot share that dedicated device.
One of my pet peeves is the widespread and unthinking use of phrases such as “remote learning,” “blended learning,” and “personalized learning.” All are a triumph of marketing lingo from a tech industry eager to conflate their schemes for instructional delivery with learning from living humans, classmates, and others who are fallible, often funny, can be self-correcting, but also know that there is more to learning than generating “correct answers.”
I like bob’s definition of remote learning: an interaction over the internet for which there is a remote chance that learning is occurring.
If you will allow me to provide my definition of blended learning: Common Core mixed with Hooked on Phonics in a blender
Pearsonalized learning speaks for itself.
Don’t worry, Ted. Schools are reopening in Florida, so we’ll soon have a massive surge in new cases, one so big that even DeSantis’s Health Department can’t hide the increase.
It seems that the answer is there really is no answer.
I never worked in a school with decent ventilation. The many portable buildings had horrible ventilation.
To me, it’s not worth the risk. How many children’s deaths is acceptable? To a politician or an economist, that seems not to be a factor.
Oh, why oh why do so many (like this award-winning science writer) avoid and ignore mentioning The Trump Factor when discussing this issue?
The country does not have a stable president, and the raging malignant narcissist behind The Trump Factor is responsible for most of the deaths in the U.S. from COVID-19.
What I also think, Lisa & Laura. Bad data collection, w/no correction…or no collection, period. Inside is out, outside is in. We’re in Larry David/Jerry Seinfeld “bizarro world” territory–but this couldn’t be less funny.
Example–in Iowa, just as I thought, the #s had “lowered” (after all, guv Dim Reynolds wanted the spotlight on her at the RNC, & speak she did). So now that that’s over, school districts that were originally denied waivers from opening schools were granted (now going remote: Iowa City School Board, for example, bought time by postponing the beginning of the school year for after Labor Day, & now they’re going remote {at least until October but, believe me, it will be extended}). Also, the storm damage (what storms-?!)
info. was finally released (the delay of which Dim blamed on the national msm–“They didn’t even cover it!” Of course not, because Dim didn’t release the info. until later).
& now, once again (or still!) Iowa has one of the highest rates of infection. & now, it was reported, that Iowa State U. was planning to have a fan-filled (capacity: 25K) football opener on Sept. 12th. It has since been announced that the Ames (which is a *covid-19 hot spot”) team will not allow spectators.
Oh, & Mets player & National Baseball Hall of Famer Tom Seaver, 75, died Monday “of complications of Lewy body dementia & covid-19.”
How a single wedding changed the contours of Maine’s coronavirus outbreak
Charles Eichacker
https://bangordailynews.com/2020/08/29/news/how-a-single-wedding-changed-the-complexion-of-maines-coronavirus-outbreak/
“It has infected at least 123 people and caused secondary outbreaks at a rehabilitation center in Madison and, more than 200 miles to the south, at the York County Jail in Alfred. One woman who did not attend the wedding has now died from the disease.”
// End quotes
The attendees had their temperatures checked and some who attended also had come up negative on tests that they had before attending.
While some might ask what relevance this has to schools, I’d have to ask ” isn’t it obvious?”
Schools are gathering places for many more than 62 people (the number in the wedding party) Some school classrooms alone have more than half that. Lunch rooms in schools probably have that many people eating at one time.
Schools are talking about using temperature checks like they used to screen wedding attendees (utterly useless if people are not showing symptoms and people are most capable of infecting others in the days before they show symptoms.)
Also, tests can have a high rate of false negatives, so when we see claims of “less than 1% positivity”, we should take them with a grain (or is it block?) Of salt.
Finally, children and teachers can be vectors for the virus, bringing it back to their families and other people in the community , just as the wedding attendees acted as vectors.
“Children and adolescents up to age 20 (definitions and statistics vary by state) represent less than 0.3 percent of deaths related to the coronavirus, and 21 states have reported no deaths at all among children.”
I am not saying that 500 dead children due to covid is irrelevant, but the statistics above is. What matters is
Of the 65 million grandparents in the United States in 2012, 7 million, or 10 percent, lived with at least one grandchild,
…
Grandparents who lived with a grandchild in 2012 were younger, had lower levels of education and were more likely to be in poverty than those who did not live with a grandchild.
Women comprised 64.2 percent of grandparents who lived with their grandchildren.
those who did live with a grandparent were more likely to have public insurance.
https://www.census.gov/newsroom/press-releases/2014/cb14-194.html
Sending kids to school will endanger the lives of these 7 million grandparents, many of whom are poor, mostly women and without solid health insurance.