Experts: Opening schools could mean classrooms become incubators for virus
Children returning to school should generally be less likely to get sick than adults, would often show no signs of illness when infected and face little risk of dying from coronavirus infection, according to health experts.
But the children may pose health risks to others by spreading illness among teachers, school staff and especially adults living with them, health experts warn.
So far in hard-hit New York State, there have been 10 fatal cases up to age 19, far less than the more than 18,300 adults who died, mostly over age 60
But medical evidence suggests that children returning to school can quickly become infected by others, serving as carriers of the virus, especially if they are “asymptomatic,” showing no obvious signs of disease like a fever or dry coughs.
“We think we know that kids tend to be more asymptomatic. That’s certainly what’s suggested in studies coming out of other countries that are ahead of us,” said Dr. Charlene Wong, a pediatric expert at Duke University, referring to the virus’ impact on children in China, Italy and elsewhere. “There are two groups I worry about [with children returning to school]. You have parents, family members and other friends in the home who are very vulnerable. Then there are the people working in the school to worry about — the teachers, the people who work in the cafeteria, the housekeeping staff.”
Wong said social distancing and other healthy precautions against the virus will be essential, but some basic safety methods may not be used, especially in elementary schools.
“Getting kids to wear masks is going to be next to impossible,” Wong said. “Having kids wear masks for prolonged periods while they're trying to learn is not going to be a very feasible approach.”
New York schools and colleges will remain closed for the rest of the academic year due to the coronavirus pandemic, Gov. Andrew M. Cuomo said Friday.
The order will affect some 4.2 million students from elementary school through college. A decision on summer school will be made by the end of this month, Cuomo said.
Many experts said sending children back to school is an essential part of the state’s economic recovery, especially for working parents. Many are desperate to return to their jobs, following Cuomo’s March 22 stay-at-home order, which is expected to last until at least May 15.
Yet doctors and other health researchers said the move back into schools, especially if done while hospitalizations rates are still high, could be a recipe for future trouble. Classrooms could become incubators for the disease, they said. Many worry about a resurgence of COVID-19 in the fall — what is called a “second wave” of new infections — if not enough precautions are followed.
“Schools are crowded places and children can be carriers with mild symptoms,” said Josh Michaud, an infectious disease epidemiologist with the Kaiser Family Foundation, a health policy think tank. “You have conditions for lots of transmission of the disease.”
To combat spread of COVID-19 in schools, Michaud suggests that districts might consider splitting school days in half — with morning and afternoon sessions — to reduce crowding in classrooms and also ramp up testing to identify who has the virus and those who may have developed an immunity after previous exposure.
Under its guidelines, the Centers for Disease Control and Prevention suggests keeping students’ desks 6 feet apart, serving meals in the classrooms rather than crowded cafeterias and shutting down playgrounds. Classes should be held outdoors when possible, and cleaning staff should disinfect surfaces like doorknobs, tables, desks and handrails regularly, the agency recommends.
Schools will be a bit less collegial. “Stop handshaking — use other noncontact methods of greeting,” the CDC advises, waving goodbye to high-fives in the hallways.
The CDC estimates the coronavirus incubation period ranges from two to 14 days, though the rate of infectiousness and its duration “are not yet known.” Infectious samples containing the virus have been found in respiratory, blood, urine and stool specimens, it said.
On Wednesday, top state Education Department officials said that “in the coming weeks” they will form “a statewide task force made up of educational leaders, including superintendents, principals, teachers, parents, school board members and other stakeholders, to guide the reopening of our schools.” The statement provided no proposed guidelines but underlined the importance of schools to the state’s recovery.
Teachers are also concerned about unknown health risks in returning to class. The New York State United Teachers, a union representing 600,000 educational professionals in schools and colleges around the state, including Long Island, calls for widespread testing “to regularly check that people are negative or have immunity,” spokesman Matthew Hamilton said.
The NYSUT proposes “an exhaustive tracing procedure that would track down and isolate those who have had close contact with a student or staff member who tests positive for the virus.” And each school building would have “rigorous cleaning protocols” and protective gear to avoid contact with the virus, Hamilton added.
Another affiliated union, the American Federation of Teachers, also suggests staggered lunch periods and different times of arrival for buses, adding portable classrooms to reduce overcrowding, and training staff, students and parents on the best protective behaviors. When students enter schools each day, there should be hand-washing stations to greet them, it said, with “isolation rooms” for students who are identified with COVID-19 symptoms.
Medical research is still catching up with the fast-moving, highly contagious coronavirus and its impact on young people, experts said.
One Chinese study published in April by the American Academy of Pediatrics, examining more than 2,000 confirmed or suspected cases, found that 90% of all young patients had “asymptomatic, mild, or moderate cases.” The average age was 7, and 56% were boys. “Although clinical manifestations of children’s COVID-19 cases were generally less severe than those of adult patients, young children, particularly infants, were vulnerable to infection,” the study concluded.
And in March, a study of Chinese youngsters in another well-known medical journal, The Lancet, underlined the spread from children to adults. It found that “the large proportion of asymptomatic children indicates the difficulty in identifying pediatric patients who do not have clear epidemiological information, leading to a dangerous situation in community-acquired infections.”
Here in the United States, experts like Michaud and Wong said schools must be ready to handle all of the health challenges that reopening schools will bring, working together with researchers and government leaders to find effective solutions. They said there’s little research so far looking at the health impact of reopening schools.
“It’s a huge outstanding question — kids should be a top priority for this [research],” Wong said. “We need for several school districts to band together and test out different strategies and actually figure out — using data — what is working. Who has the most cases popping up? And who needs to isolate and quarantine kids because their strategy didn't work.”
