On January 21, Governor Hogan, in conjunction with the state Health Department and Superintendent updated school reopening guidance and called for districts to reopen. And on January 26, CDC research concluded schools aren’t big coronavirus spreaders and can reopen. Within hours countless governors agreed, stating they have found schools are, in fact, the safest places for students and teachers during this pandemic. These announcements reflect the public health consensus that schools can reopen safely when mitigation protocols are in place. Parents across the state breathed a sigh of relief as their children would no longer have to be isolated, sedentary, struggling academically, learning less, failing their classes, and condemned to their screens. They could once again resume the high standard of instruction many of us sought out when deciding to live in Montgomery County.
Despite the accumulated evidence, the change in scientific opinion, and the change in state policy, the teachers’ unions continue to fan the unease of their membership and insist that schools remain closed. Three claims are at the heart of their groundless fear: there is an essential tradeoff between life and educating students, school buildings are not safe in the pandemic, and that vaccination is the only way to safely provide live instruction.
To address the union’s concern about death, we need to understand the risk of getting infected at school as well as the risk of death from infection.
A study performed by the CDC in Wisconsin showed that over a 13 week period, 0 staff members got infected in school as well as very few students. In fact, rates within the schools were remarkably lower than surrounding communities, some of which had incredibly high infection rates. This echoes several other studies around the world indicating there is minimal in-school transmission when mitigation protocols are enforced.
While COVID-19 has victims of all ages, death upon infection has overwhelmingly been amongst the elderly and those with underlying health conditions. Staff members that fit those categories should have a way to opt out of in-person learning, but for the majority of staff, the risk of death is low. The average age of a public school teacher is about 43 and, in this age group, the probability of death among those infected is 0.068%, similar to the rate of accidental fatalities. This low fatality rate combined with minimal risk of in-school transmission, makes the risk of death to staff very small.
Evidence from Europe confirms these calculations. Despite surging cases and the emergence of a more transmissible variant, teachers in the UK, unlike restaurant workers and taxi drivers, were at no higher risk of death than the general population. Studies from Sweden, the Netherlands, and Norway draw similar conclusions from occupation-level breakdowns of hospitalization rates.
Countless schools around the world have been open prior to the introduction of vaccines. Data collected by the CDC since the spring of 2020 have shown that schools around the country have very little transmission. Many of our country’s top medical and epidemiological experts, even those skeptical at the beginning of the school year, such as Dr. Anthony Fauci, Dr. Ashish Jha, and physicians at the Children’s Hospital of Philadelphia, have concluded that the scientific evidence supports that school reopening can be done safely, even in the absence of vaccines.
As essential workers that can only effectively do their jobs in person, we hope that teachers are soon vaccinated. However, given limited vaccine supplies, a slow rollout, and the six-week wait between the first dose and full immunity, waiting would be a recipe for remaining closed for the remainder of the school year and possibly through next fall. Given that vaccination is not actually necessary to reopen safely, and that we are in the midst of a full-blown educational disaster from remote instruction, waiting for full vaccination is a luxury we just cannot afford.
Cheryl Bost, president of the Maryland State Education Association, "There's nobody who wants to go back to school more than our educators and work with our students, but we have to do that in a healthy and (safe) environment,"
We cannot make everyone feel safe, but we do know what is required to be safe. While hucksters may peddle expensive solutions to make schools safe, they are unnecessary. COVID-safe schools simply require masks, social distancing, and cracked windows.
Much concern has been focused on ventilation upgrades of school buildings. While many districts in Maryland have upgraded HVAC systems, less sophisticated methods also suffice. Dr. Joseph Allen, director of the Healthy Building program at Harvard University has said that even old buildings can reopen. He has developed a handy Healthy Buildings tool that has information and detailed protocols to help schools upgrade any classroom, no matter the state of the building. Short of HVAC improvements, opening two windows, even only 3 inches, will provide sufficient ventilation. In the absence of windows, windows that do not open, or dated ventilation systems, portable air cleaners with HEPA filters can be purchased in different sizes to fit various classroom dimensions. These less expensive alternatives have similar efficacy in purifying the air of lingering viral particles.
While ventilation improvements can help, the cornerstone of any safety protocol during the COVID-19 era is consistent wearing of masks. Researchers at UCLA have found a 70% reduction in risk for those that consistently wear masks. Two studies demonstrate that when everyone is masked, the exposure to respiratory droplets is reduced by 99%. Masks don’t just work in labs, COVID-19 cases grew twice as fast in Kansas counties without mask mandates as those with them (where cases actually fell). Similarly, hospitals in Massachusetts only started to see a decline in staff cases when both staff and patients were required to wear masks. With universal masking, some additional distancing (just 3ft is sufficient) and inexpensive improvements to ventilation, the risk of catching the virus in school is amazingly small.
The data are clear and it is time to work to quickly reopen schools. We cannot allow those that deny the scientific evidence to set policy. We must implement these well-established protocols and safely return our kids and teachers to classrooms.
Margery Smelkinson is an immunology and infectious-disease expert who has advised local nonprofits in novel coronavirus-related public health strategies. Her research has focused on many pathogens, including influenza and SARS-CoV-2 (website: https://sites.google.com/site/margerysmelkinson/home)