Why pediatricians are pushing for kids to go back to school in the fall
While the Trump administration is urging schools to open in the fall, many parents remain concerned about the safety of their children. Amid the coronavirus pandemic, is going back to school safe?
The American Academy of Pediatrics has some answers. The nation's top pediatrician group made headlines last month after releasing clinical guidance saying this year's goal should be for students to be "physically present in school."
The guidance highlights the negative impact on children since school closures. More time away from school can result in social isolation, abuse and untreated mental health disorders. Kids also experience food insecurity and less physical activity, and school closures can worsen racial and social inequities. Together, this could put children at higher risk of developing diseases.
"We absolutely need to open schools. There's no question school is important for children -- not just for education purposes, but for their development, for their mental health, for nutrition and even for health care," said Dr. Edith Bracho-Sanchez, a practicing pediatrician and assistant professor of pediatrics at Columbia University. She said that health care in schools is especially important for children that live in vulnerable communities or have complex medical needs.
Still, doctors acknowledge there are clear risks to sending children back to school amid the COVID-19 crisis. Without proper precautions in place, the virus could spread quickly in schools.
"While a laudable goal and crucially important for restarting the economy, reopening the schools cannot be rushed into, especially for political reasons," said Dr. Matthew Heinz, a hospital physician in Arizona, which is one of the states now being hit the hardest by the virus. "It is neither good policy nor good politics to recklessly push for reopening of states or schools on an accelerated, dangerous timeline that will result in many thousands of new infections and eventual deaths."
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While children seem to be largely protected from severe illness from the virus, there are reports of a rare multi-system inflammatory syndrome currently developing in children. Plus, schools are run by adults -- teachers, counselors and administrators -- who are much more vulnerable to severe disease.
Pediatricians recently advocated that schools open in the fall in a recent publication in the scientific journal Pediatrics. They acknowledged that despite the many unanswered questions, early evidence indicates that young children do not spread the virus as readily as adults.
Although data is limited, studies done in Switzerland and China suggest that children do not easily infect others with the virus, offering "early reassurance" that transmission at school could be a "manageable problem."
But when it comes to older children, particularly teenagers, the limited evidence we have seems to point to the fact that they are more capable of spreading the virus. Scientists are still working to understand how and why people of different age groups seem to have different capacities to spread the virus.
For now, pediatricians are urging schools to reopen, but with extremely well-thought-out infection control measures in place and a remote learning fallback plan in the event that an outbreak springs up.
For parents, weighing the risks and benefits of sending children to school can be daunting. Bracho-Sanchez encourages them to learn about the preventative measures their child's school is taking, and also whether the virus is under control in their community.
Dr. Tom Frieden, former CDC director and president and CEO of Resolve to Save Lives, stressed the importance of flexibility when reopening schools, discouraging a one-size-fits-all approach.
There are scenarios that should be considered individually, such as when children live with their grandparents, who are more likely to die if they become exposed to the virus, Frieden said at a teleconference briefing earlier this week.
Frieden also shared that the goal of the school should be to reduce risk, which may result in a different school experience. For example, schools may install hand washing stations, keep windows open for ventilation, suspend use of cafeterias and stop certain high-risk group activities such as assemblies.
Many pediatricians and public health experts have stressed that the steps adults take now will directly impact our children's ability to go to school in the fall. They encourage rigorous social distancing measures, mask wearing and abiding by other CDC guidelines to stop the surge of cases in many communities, most recently in Arizona, Florida and other sunbelt states.
"For states like Arizona, Florida and Texas, school reopening should not be seriously considered until early 2021, and the decision should be based on the best available public health data at that time," Heinz said.
Experts say schools will have a difficult time reopening if the virus in the local community is not under control. Frieden said the "single most important thing is to control COVID in the community."
"I don't think we get to say, 'Everyone back to school no matter what,' without taking into consideration some communities in this country really don't have these fires under control," Bracho-Sanchez said.
Bracho-Sanchez emphasized that children do not exist inside a vacuum, and the health of the adults in their community is very important when considering reopening schools. "It doesn't have to be school or their health, it can be both school and their health, if we get the [virus] under control in our community."
Sabina Bera, M.D., M.S., is a psychiatrist in New York, and a contributor to ABC News Medical Unit.
