Without a Vaccine, Should Parents Send Their Kids Back to School?
If things were normal, planning for a new school year would mean buying notebooks and pencils and finishing summer reading assignments. But these are not normal times. Schools around the country moved to distance learning models this spring as part of an unprecedented shutdown amid the COVID-19 pandemic and saw varied results.
Since then, states have begun phased reopenings, also to varying results. But though restaurants and stores may be back in business, is it safe for parents to send their kids back to school without a COVID-19 vaccine?
"Right now, it does not look like we will have a vaccine for the children for the fall," says Sharon Nachman, M.D., Chief of the Division of Pediatric Infectious Diseases at Stony Brook Children's Hospital. "So, what can we do?"
For one, parents may be able to choose not to physically send their kids to school. But that can come with risks, too, including learning losses. A pair of experts weighed the risks and benefits of sending your kids to school without a vaccine.
Risks of Sending Kids to School Without a Vaccine
The most obvious risk of sending a child to school without a COVID-19 vaccine is that they'll contract the virus. "I think it's important in any of these conversations to acknowledge that when we reopen schools, there will be some cases of COVID," says Emily Oster, Ph.D., a professor of economics at Brown University and author of Expecting Better and Cribsheet.
Children are at a relatively low risk for getting seriously ill with COVID-19. In New York, once the epicenter of the virus, 1 percent of the hospitalizations have been patients under 20 years old. A rare but scary illness, pediatric multisystem inflammatory syndrome, made headlines in May. Symptoms included a rash and trouble breathing, and 94 percent of patients in New York, where the syndrome was first reported in the U.S., tested positive for COVID-19. But so far, there have been 231 reported cases and two deaths in the state.
Parents of immunocompromised children may have more concerns. The Centers for Disease Control and Prevention (CDC) says people of any age with certain conditions, including asthma and Type 1 diabetes, can be at an increased risk for severe illness from COVID-19.
And many children can be asymptomatic. "There's a risk of kids getting it and then spreading it to more vulnerable populations," says Dr. Oster. These vulnerable populations include teachers and family members living at home who may be immunocompromised.
Keep in mind: While there's not currently a COVID-19 vaccine, there are immunizations for contagious diseases like measles. The problem is that, during stay-at-home orders, children fell behind on some of these regular vaccinations, according to the CDC. This leaves children at risk for serious illnesses. "They need to get caught up," says Dr. Nachman, "so they can prevent the preventable."
Risks of Not Having Any In-Person Instruction
Sticking with a remote-only option also comes with some risks. During the summer months, students in third to eighth grade usually lose 15 to 30 percent of the learning gains they made in math and 5 to 15 percent in reading, according to the NWEA. Using this data, the organization, which creates academic assessments for students from pre-K-12, forecasted that students who stopped receiving instruction on March 15 could lose 50 percent of learning gains in math. What's worse, fifth graders could return to school almost a full year behind.
Of course, children did not stop receiving instruction entirely—but some practically have, and it is often students in lower-income families who may not have access to reliable internet or less home support. Only 60 percent of low-income students are regularly attending online instruction compared to 90 percent of high-income students, according to data from Curriculum Associates, an education company founded in 1969 that provides teachers tools and resources to help with student growth. Imagine an entire year of remote learning. It could have devastating long-term effects on their ability to seek higher education and get well-paying jobs.
Dr. Nachman also worries about the loss of social interaction. Children who experienced isolation and school closures in China reported higher rates of depression and anxiety symptoms, according to a survey published in JAMA Pediatrics.
"Children need to be in a social environment," says Dr. Nachman. "Doing stuff on computers does not allow them to mature socially, and some of the things we're seeing now is a fair amount of depression and anxiety in children, and that will get worse."
What Should Schools Be Doing?
Many parents will soon receive a letter from their child's school (if they have not already) with the safety precautions they are taking for in-person instruction. It will likely include things like social distancing, lunch policies, and hand-washing. Some schools may have students stay in one classroom all day.
But realistically, it's hard to get a 5-year-old to social distance. Meanwhile, high school students might be able to understand what it means to stay six feet apart, but it won't be any easier to group teens in one class. One student may be in Advanced Placement (AP) everything, whereas someone else may be in honors English, but a more general science course. This makes it difficult to keep everyone in the same class.
Schools are exploring different models, including having some students come in the morning and others in the afternoon, as well as two-week in-person, one-week remote routines. Dr. Oster believes there will need to be some form of remote option as some students have compromised immune systems or live with someone who does, and there will likely be a need to quarantine as cases will occur. Some school districts, including New York and Philadelphia, also announced they are offering students the opportunity to opt for remote-only classes if they wish to avoid in-person instruction.
The most important precaution schools can take, says Dr. Oster, is to have a clear policy on how to monitor sick student attendance. "Does your school have a protocol for temperature checks? What are you going to do if a kid spikes a fever in the middle of the day?" she says.
Wearing masks can help reduce the spread of COVID-19. Experts recommend that people over the age of 2 wear one, and Dr. Nachman suggests parents look for one in a school's policy.
The CDC also offered guidelines to help stop the spread in schools, pointing out that full sized, in-person classes pose the highest risk. Small, in-person classes with students at least six feet apart and not sharing objects is less risky while virtual-only classes pose the lowest risk.
The guidelines suggest schools teach and reinforce hand-washing, encourage cloth face coverings, and post signs that promote protective measures. Importantly, the CDC encourages kids and employees who are sick or have been in contact with someone with COVID-19 to stay home without repercussions. It also recommends schools are prepared by cleaning and disinfecting surfaces and buses, ensuring ventilation systems work properly, modifying classroom layouts, especially with desks at least six feet apart, and adding physical barriers when possible.
Making a Decision
Dr. Oster hopes summer camps will track cases, and that data will be available to parents by the end of the summer, but concedes that may not happen. "Camps are another form of kids getting together, in larger groups, with non-family," says Dr. Oster. "They will give us a first peek at what school might be like."
In the meantime, parents can track cases around the country by using resources like the Massachusetts Institute of Technology (MIT)'s COVID-19 projections database, which offers an interactive map showing data like the number of cases in each state and the positivity rate.
Ultimately, parents will have to weigh the risks and benefits and think of their living situations, including immunocompromised family members. Like so many aspects of parenting, there's not going to be a perfect answer. "Parents need to recognize that whatever decision they make, they're never going to be 100 percent sure this is the right thing," says Dr. Oster.
But we're all in this together, meaning parents will have to play a part in keeping others safe. "Teach your kids that masks work," says. Dr. Nachman. "Show by doing. Encourage them to talk about the medical benefits or reasons to wear a mask."
Again, it's more important than ever to try and keep kids out of school when they are feeling ill. "Mostly, what parents can do is keep their kids home if they are sick," says Dr. Oster, "and encourage others to do so as well."