ARIZONA — Will opening schools with COVID-19 cases still growing put kids in danger?

Maybe.

Will NOT opening schools put kids in even more danger?

Most likely.

So which path poses the lower risk?

Ah. That’s the million-dollar question.

A growing body of research has provided a treasure trove of information on how we can more or less safely reopen schools – especially elementary schools – even if the virus isn’t under control.

Here’s the quick summary.

Distance learning costs the average student months of academic progress – especially if they’ve got handicaps or emotional and mental health issues or come from low-income families.

Moreover, NOT going to school increases the danger to children from a host of other factors – including child abuse, hunger, social and emotional problems. And that’s not even taking into account the impact on the economy of harried parents trying to hang onto their jobs while supervising kids' studies at home.

But here’s the thing: Kids under 10 don’t catch COVID-19 easily, don’t spread it readily and mostly don’t develop serious symptoms when they do. However, they can still spread it to others – just not as easily. We’re not sure why – but it has probably has something to do with how their immune systems react to the virus. So elementary schools have proved pretty safe in countries that have reopened schools – at least for the students and to some degree to their teachers.

Teenagers rarely die from an infection, but they can apparently spread it almost as readily as adults. This could reflect changes in their immune system, but could also reflect the far larger number of people they interact with during a day at school and the way they socialize when they’re out of school.

The Centers for Disease Control has concluded, “The best available evidence indicates if children become infected, they are far less likely to suffer severe symptoms. Death rates among school-aged children are much lower than among adults. At the same time, the harms attributed to closed schools on social, emotional and behavioral health, economic well-being, and academic achievement of children are well known and significant. Further, the lack of in-person education options disproportionately harms low-income and minority children and those living with disability.”

A paper published in the Academy of Pediatrics concluded, “models show that community-wide social distancing and widespread adoption of facial cloth coverings are far better strategies for curtailing disease spread and that closing schools adds little. The fact that schools have reopened in many western European countries and in Japan without seeing a rise in community transmissions bears out the accuracy of the modeling.”

On the other hand, studies have also shown that schools can develop clusters of cases that can spread to many students and staff. That’s why many epidemiologists say schools should remain closed until the virus is under control in the community and school officials have the resources – including plenty of tests – to quickly identify an infection and test all the close contacts. The other countries who have safely reopened schools have generally met those two conditions.

So here’s a summary of some of the most recent research on the impact of closing schools to in-person classes, even with an alternative distance learning option:

• Children under 18 account for 7% of COVID-19 cases in the U.S., but only 0.1% of deaths.

• The CDC reports that between 37 and 187 children die from the flu annually and 358 died from the mercifully short-lived H1N1 pandemic. So far, only 64 children in the U.S. have died during the COVID-19 pandemic – fewer than have died from the flu in each of the past five years.

• Studies suggest that while some children contracted COVID-19 from exposures at school, most of the known cases came from family members. Even in families, the infection mostly goes from adults to children rather than vice-versa, according to the CDC summary.

• Studies suggest that the transmission of the virus in schools are not the “primary drivers” of infection in a community.

• During last spring’s shutdown, just one in three school districts continued to provide instruction, track student engagement and monitor academic progress. Wealthy school districts were twice as likely to track students as low-income districts.

• Student academic progress during the school shutdown dropped by half among 800,000 students using Zearn, an online math program, according to a study by researchers at Brown and Harvard.

• Students who feel connected to school have lower rates of depression, suicidal thoughts, social anxiety and sexual activity as well as higher self esteem, according to a three-year study of 476 adolescents.

• An estimated 21% of children 9-17 suffer from some type of mental health conditions – but only 16% receive any treatment. Of those who did get treated, 80% gained access to help through school. An estimated 7.4 million American children suffer from a serious emotional disturbance, which makes the absence from school dangerous.

• Teachers and counselors report 20% of all reports of abuse and neglect. A study found a 62% decrease in reports of child abuse during the school shutdown, even though emergency rooms saw an increase in cases and severity of child abuse, according to the CDC.

• Some 30 million children get free and reduced school lunches and 15 million get breakfast. Despite school efforts to maintain food programs during the shutdown, closures contributed to nutritional problems for the existing 11-million food-insecure children, according to the CDC research summary.

• Children rarely transmit the virus to others, according to a study of 39 Swiss children with COVID-19 published in the journal Pediatrics. Other children were the suspected source of the infection in just 3% of those cases, with the reset infected through household contacts.

• In a study of 68 children in China admitted to the hospital with COVID-19, 96% were infected as a result of household contacts with adults.

• In a French study, a boy who exposed his 80 classmates at three schools to COVID-19 didn’t transmit it to a single other classmate.

• In New South Wales, nine infected students and nine infected staff members in 15 schools exposed a total of 735 students and 128 staff to the virus. Only two secondary infections resulted – only one of them from a child to another person.

• In Sweden, an antibody test for past exposure found children had infection rates only a little lower than the general population. Sweden did not shut down its businesses or its schools and imposed few restrictions on schools, like curtailing recess, requiring masks, reducing class sizes or other changes. Overall, the country ended up with a per-capita death rate 12 times greater than Norway, seven times greater than Finland and six times greater than Denmark. The antibody screening test found 4.7% of children and teenagers had been infected at some point. Some 6.7% of those 20 to 64 had been infected and 2.7% of those 65-70. Overall, Sweden made little effort to track infections in schools.

• In France, a study found substantial spread of the virus in a high school after two teachers got infected and worked for weeks before they realized they were spreading the virus. Antibody testing showed 38% of students, 43% of teachers and 59% of non-teaching staff had contracted the virus – although most never knew it. However, in six nearby or adjacent elementary schools, testing turned up only three infected children – all likely infected at home. Those three children apparently didn’t pass the virus along to any classmates.

• In Israel, testing at a high school found infections among 153 students and 25 staff. Another study in Israel found few infections when schools first opened and children almost all wore masks, but an explosion in cases during a heat wave when school authorities gave children permission to stop wearing the masks.

• In Texas, cases have skyrocketed. Mass testing at 883 preschool facilities found infections among 894 staff members and 441 children – up from just 210 cases two weeks previously. The study suggests despite the resistance of children to infection, schools will still get caught up in a bad, overall community outbreak.

• In Germany, about 10% of total infections were among school-age children when schools were shut down. When schools reopened, children soon accounted for 20% of cases. However, the shift could reflect other factors – including increasing care taken by older people due to their far greater risk of serious symptoms.

Peter Aleshire covers county government and other topics for the Independent. He is the former editor of the Payson Roundup. Reach him at paleshire@payson.com

(1) comment

edfischer

This is the most comprehensive overview that I have read in the news so far, pointing out the reality of the known significant impacts on distance learning on a variety of determinants of health and development. The high risk of spread in the Georgia camp this summer may be thought by some to contradict the findings of low transmission from children. Before we cite the Georgia camp as a finding, we need to remember that that camp did not enforce mask-wearing, large groups slept in close quarters together (long periods and even mask wearers may have their mask fall off), and the camp even acknowledged there was a lot of singing and shouting. Thank you to all teacher and administrators who can acknowledge the detrimental impact of distance learning and search for sound, scientifically-driven ways to mitigate infection and spread in a classroom setting.

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