These Are the Measures Needed to Reopen Schools, According to an Infectious-Disease Expert

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By Cassandra Stone

August 12, 2020

Public health experts nationwide recommend communities have a COVID-19 positivity rate of 5% or less to resume in-person classes.

Schools across the country have spent the summer grappling with shifting state directives on how to reopen for the 2020-21 school year and how to bring students back into the classroom as safely as possible. Some, in fact, have already reopened and faced emergency quarantines within the first week after students and staff tested positive for COVID-19. 

When there’s no such thing as zero risk, how can schools protect everyone inside? According to Dr. Ravina Kullar, an infectious-disease specialist and spokesperson for the Infectious Diseases Society of America, many schools may not even be able to remain open consistently enough to find out.

“When positivity rates in a community rise above 3%, schools will likely have to close again,” she explained in an interview with COURIER. The COVID infection rate is the number of people testing positive out of the total number of people getting tested. 

Public health experts nationwide have recommended a cutoff of 5%. Yet, guidelines for reopening schools vary wildly across the country. 

In Iowa, for example, Republican Gov. Kim Reynolds has threatened school districts with licensure discipline and loss of state funding if they ignore her mandate that at least 50% of classes be held in-person this fall. Only one-third of the state’s 99 counties as of Tuesday, however, had a positivity rate of 5% or less.

“Schools that choose not to return to school for at least 50% in-person instruction are not defying me. They are defying the law,” Reynolds said last week after some Iowa districts voted to continue online-only learning.

RELATED: NC Schools Weigh Reopening With 13,000 Confirmed COVID-19 Cases in NC Kids

In Florida, the Department of Education is requiring all brick-and-mortar schools to open by Aug. 31, thanks to Republican Gov. Ron DeSantis’ insistence. He and Education Commissioner Richard Corcoran recently rejected a plan from the state’s third largest school district to hold classes online during the first four weeks of the fall semester, which is set to begin in less than two weeks. This, despite Hillsborough County reporting a 13% COVID-19 positivity rate on Monday.

Meanwhile in Michigan, Gov. Gretchen Whitmer has set a minimum health and safety standard to apply to all schools—including public, private, charter, and parochial—which require them to close if their region is in an area with the highest risk of COVID-19. Extracurricular activities and sports will not be allowed, online classes must be offered to families who prefer them, and for in-person instruction, face masks are required. 

According to a recent survey, only 16% of parents agree with President Donald Trump’s push to reopen schools fully. Most parents instead actually prefer a combination of online learning and reduced in-person instruction to keep their children and educators safe.

RELATED: I’m a Teacher. Mike Pence’s Visit to a Private NC School Sends the Wrong Message.

Even as school districts have been without guidance on a protocol for reopening from the Trump administration—many educators have leveled criticism at Education Secretary Betsy DeVos for her lack of leadership on the issue—it would be difficult to create a universal safety plan for schools nationwide to adopt during the pandemic for myriad reasons—namely, the vast variations in funding and school population.

Public health experts, however, have offered data-driven safety measures and suggestions. Dr. Kullar of the Infectious Diseases Society of America breaks down her recommendations for controlling the spread of the virus within schools.

Buses

One challenge facing districts is the issue of social distancing on school buses: More than 26 million students typically take the bus to school.

“The biggest thing with buses would be that those windows are kept open,” Dr. Kullar said, noting the importance of proper ventilation in relation to the virus. “Ideally, there would be plexiglass between the driver and the children. The children should be distanced six feet apart, which means there would be a staggered approach to this system.” 

Additionally, more buses would have to be implemented into the daily pick-up and drop-off in order to adhere to school start times. Dr. Kullar also recommends hand-sanitizing immediately prior to boarding the bus and upon exiting.

“This is where it all starts—the bus. There have to be fewer people on the bus,” she explained. “And everyone should be wearing a mask. Mask-wearing should be mandated in schools. They’re so important to combat this virus.”

Image via Shutterstock

Classroom 

Inside the classroom, creating a barrier between students is ideal. Dr. Kullar suggests plexiglass as an example. 

She also stressed the importance of masks. “Kids need to keep their mask on. I would even go one step further and recommend a face shield or goggles, because we’re seeing the virus entering through mucous membranes in the eyes. And with children, we have a tendency to rub our eyes, kids and adults, and that would be a reminder to keep your hands away from your face. Dr. Fauci even recently suggested wearing goggles or a face shield for full protection.” 

Dr. Kullar also recommends temperature screenings and symptom checks occur as often as possible prior to the start of each school day.

RELATED: Hispanic and Black Children More Likely to Be Hospitalized With “Severe” COVID-19 Symptoms

Hallways

Last week, viral photos from inside Georgia’s North Paulding High School showed a hallway crowded with students, few of whom were wearing masks. After reopening for just five days, North Paulding High School is now online-only after at least nine students and staff members tested positive for COVID-19. 

Dr. Kullar believes a staggered approach is the only way to combat overcrowding.

“If classes all end at the same time, crowding is what you’re going to get,” she noted, referencing North Paulding High School. “Switching classes will have to be monitored to ensure masks are being worn, that physical distancing is in place, and there’s only a certain amount of people allowed in the hallway.”

Lunch

Rather than pile students into the cafeteria for lunch, Dr. Kullar believes they should eat in their classrooms instead—particularly in larger school districts where staggering lunch times would significantly impact the school day. She also said masks should only be removed while eating.

Recess

“Outdoor activities carry a lower risk than indoors. There’s still a risk, but there can be a safe way to do it.” Dr. Kullar suggests small, supervised groups and hand-washing when they re-enter the building. “I think recess could also serve as a sort of ‘mask break,’ which might make children better able to adhere to mask-wearing while inside. It’ll give them a little break time when they go outside while practicing social distancing.”

Sports

Football, wrestling, soccer, and other contact sports should be abandoned this fall, according to Dr. Kullar. Democrats and Republicans have divided opinions on cancelling fall sports this year. For example, Pennsylvania Gov. Tom Wolf recommends canceling all sports until January 2021—GOP lawmakers in Pennsylvania believe fall sports can continue with “appropriate safeguards.”

“Contact sports are not safe.” Dr. Kullar said football in particular has the highest risk of coming into contact with someone who is asymptomatic and passing it on. She says non-contact sports like cross country running, single-player tennis, and golf aren’t without risk, but are much safer to participate in.

When A Teacher or Student Gets Sick

Through contact tracing, Dr. Kullar said schools can determine where the infected student or staff member has been and who they’ve come into contact with so those individuals can get tested as well. Anyone who has potentially been exposed to the virus while at school and has been tested should remain in quarantine for the recommended 14-day period, she said.

From there, depending on what contact tracers fine, schools can either choose to quarantine the class or grade in which the infected person is part of, or close the entire school down for two weeks. 

Image via Shutterstock

But First, Additional Funding

In order to implement these necessary precautions to lower the risk of spreading the virus, schools need adequate funding. This, however, simply isn’t feasible for districts in low-income communities.

In general, income is linked to COVID-19 risk factors; poorer people are less likely to be able to socially distance or work from home. In areas where implementing plexiglass barriers and providing protective gear isn’t possible, cases of the virus are on the rise. Many schools do not have the proper ventilation and filtration systems recommended by the Centers for Disease Control and Prevention for workspaces.

“The wealthier districts are going to have more money,” Dr. Kullar said. “But studies show that communities in poorer districts are at higher risk and they’re the ones getting the disease just from the type of environment they’re in.”

Presumptive Democratic presidential nominee Joe Biden has called on Senate Republicans and Congress to pass nearly $100 billion in funding to give schools the resources they need to reopen safely. Congress, however, remains at an impasse on how to move forward on another coronavirus relief bill.

RELATED: Biden vs Trump: How to Reopen Schools

Since schools in the U.S. have been closed since March, the data surrounding COVID and its effect on children, particularly in relation to children in group gatherings, is limited. This summer, however, in-person camps have shown that when children assemble, outbreaks occur.

“We do know what happens when children gather, because there have been reports of kids congregating together and there being outbreaks,” Dr. Kullar said, pointing to summer camps in Georgia and Missouri that were quickly shut down after dozens of children and staff tested positive for COVID-19 despite taking precautions. “Obviously, many children have been kept in quarantine with schools being closed, but we’re already seeing the impact of COVID children congregating.”

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