It is clear that it’s time to get all of our kids back to school, full time, now.
I come from a family of NYC public school teachers and I am a product of those schools, so I have always been a big supporter of public education and teachers. However, I am also a parent of four and have coached many of our community’s kids over the years, so I find myself needing to advocate for the students.
Finally, I am a medical doctor and an assistant professor, so it is hard for me to not “follow the science.” Reopening plans are a welcome sight, but I hope that even more can be done, faster.
Medical professionals, parents and teachers agree that in-person school is the best model, and the American Academy of Pediatrics has been calling for a return to in-person school since last summer. The longer we are out of school, the bigger the impact on our children, and every moment counts.
Kids not being in school is itself a public health crisis. The long-term detrimental social, mental health and emotional effects of in-person school loss will take years to measure but some data does exist.
In Clark County, Nevada, there have been more than 3,100 alerts regarding youth mental health issues and 18 youth suicides. There was a 10% increase in youth suicidal ideation visits in an Oakland, California, hospital.
FAIR health just published that there has been a 100% spike in mental health claims for teenagers during the pandemic. CDC data shows a 31% increase in mental health visits for children 12 to 17 years old with an increase in psychiatric admissions. Pediatricians have expressed concerns that this generation will have increased risk of heart disease and diabetes.
Further, we know that school absence leads to a decrease in reading and writing skills. Based on historic data, economists from Stanford University believe the loss of school for our kids during this pandemic will lead to $25 trillion to $30 trillion of lost economic output over the next century and 6 to 9% lower-than-expected lifetime household incomes for affected students. Lost remediation for special needs students may never be recoverable.
The great news is that we know that mitigation works. We see that every day in hospitals and schools. Physical distancing, with masking, can safely be 3 feet, as recommended by the state and the WHO, rather than 6 feet, which creates unnecessary space constraints for schools and busing.
In fact, a study of Massachusetts schools just released shows there is no difference in COVID-19 rates in schools with 3-foot or 6-foot minimum social distancing rules with the added bonus that COVID positivity rates in schools are lower than the community rates.
Data from around the world show that in-school transmission rates when masks are worn is near zero. Data from England showed that only 0.02% of students tested positive for COVID and only 0.7% of the total number of positive COVID cases in the country during the study period were in students or school staff despite increases in community cases.
In North Carolina, during a high community COVID-19 infection rate period (7 to 40%), there were only a handful of in-school transmissions noted when 800 to 900 would have been expected and there were no transmissions from students to staff.
Similar findings for Wisconsin were published in the CDC’s own publication. Despite widespread community transmission, there was a 37% lower incidence in the in-school population than the general population with no cases of student-to-teacher spread. Additionally, in some studies, many cases of the in-school transmissions were traced to not following more rigorous masking protocols.
Arguments to stay hybrid or remote because of difficulty with creating cohorts to help contact trace seem reasonable but the point of using mitigation techniques is that it presumes that everyone is already infected.
It is no different than handling blood in medical settings using universal protocols. In fact, Ohio showed that COVID positivity rates were the same in a group of students (wearing masks in school) that had a close contact to a COVID positive person in school when compared to another group that did not have a known close contact, indicating that transmission was happening outside of school and that masking works, even when near another masked person that is COVID positive.
As it turns out, the choice between having all students go to school five days per week to maximize social, mental health and educational benefits, and supporting the health and safety of the students and teachers related to COVID-19, is not mutually exclusive — it is one and the same.
The safest place for students and teachers appears to be in school. It is time to “follow the science,” support the teachers and students, and get everyone back to school, full time, immediately.
Dr. Joshua A. Baumfeld of Newburyport is associate director of sports medicine for Lahey Medical Center and Hospital, Beth Israel Lahey Health, and is an assistant professor of orthopaedic surgery at Boston University Graduate School of Medicine.