Welcome to Impact Factor, your weekly commentary on a new medical study.
I’m Dr. F. Perry Wilson of the Yale School of Medicine.
For those of you, like me, with young kids, summer vacation has started.
It’s a very different summer vacation than what we are used to – with camps across
the country closed and many of us still working from home.
But it’s time we turn our sights to the school year to come.
It’s clear to me that the lynchpin of any type of economic recovery rests with getting
kids back to school – it simply is not feasible for many of us to work while our kids are
at home.
And no, I’m not an economist, but Emily Oster of Brown University is and she has been
sounding this alarm for months now.
And while we’ve all gotten better at remote learning over the past few months, I’d be
hard-pressed to find anyone willing to argue that the quality of education is as high via
zoom as it is in person.
So how do we get kids back to school?
I have been somewhat disappointed by the guidance put out by the CDC and even the American Academy
of Pediatrics, which uses relatively broad and sometimes vague language – providing
a lot of wiggle room.
The CDC for example says that when transmission in the area is minimal, schools should “Work
with your local health officials to determine a set of strategies appropriate for your community’s
situation.”
Fine.
I get it.
Big agencies don’t like to be prescriptive.
But that doesn’t stop us.
I have been reading guidelines, opinion pieces, essays, and manifestos from a variety of sources
this week and have cobbled together this list of a dozen ideas that can help schools open.
Are they good ideas?
I’m not sure.
But right now ideas are what we need.
And we have about two months to weigh the pro’s and cons.
I present these in no particular order, though as you’ll see some ideas sort of piggyback
off of others.
Let’s get started.
Idea 1: Kids don’t move – teachers do.
Kids enter the classroom and stay there.
We avoid walking through hallways and the socialization that might occur.
Teachers, wearing masks, rotate through the classrooms to address the different subjects.
Idea 2: Batch testing of classroom cohorts.
I don’t see a way to make any of this work without a lot of testing.
I think batch testing is a great option here.
Basically, an entire classroom of kids will do a nasal swab, and combine results into
a single test.
If negative?
Great, you’re good to go.
If positive, the classroom does remote learning for 2 weeks while everyone gets tested.
I think these tests should occur weekly.
There are 55 million school-age kids in the US.
So that’s, say, 5 million classrooms.
That’s about a million tests a day.
We are currently doing around 700,000 in the rest of the country.
We should ramp up to achieve this goal.
Idea 3: Get outside.
A lot.
Staying in the classroom all day leads to a lot of pent up energy.
We need more recess.
Not 15 minutes twice a day.
A couple of of hours a day at least.
Transmission rates are lower outside.
Where and when feasible, teaching can happen outside as well.
Idea 4: Get creative with classroom orientation.
Consider putting kids in a circle, as opposed to a rectangle, maximizing the distance projected
droplets will travel.
And speaking of droplets, let’s vent classroom air to the outside – using simple fans in
the windows if nothing else.
Idea 5: Let’s see how masking works.
I was pessimistic that kids would comply with wearing a mask when this all started, but
mine don’t honestly seem to mind that much.
That said, we need to be understanding that depending on the child, masking effectively
may not be possible.
Teachers, on the other hand, can set a good example by masking up.
Idea 6: Institute a “no sniffles” policy.
I’ll admit I’ve sent my kids to school with worse physical ailments, but given the
mild nature of COVID-19 in kids, we need to be pretty cautious here.
Any symptoms – however small – means a kid should stay home – and do remote learning
if possible.
Idea 7: Remote learning needs to be a flexible option for all children.
There are kids who are at risk who would be best-served staying home.
There are kids who live with at-risk adults who may want to stay home.
I think these decisions should be left to the parents, but regardless of the decision
they still need to learn.
Schools need to have an online parallel curriculum of some kind.
Idea 8: Protect teachers.
Teachers, being adults with more impulse control, are in a much better position to protect themselves
than children, but are clearly at higher risk.
Teachers who feel unsafe at school might be the perfect ones to run the parallel remote
curriculum.
Teachers need a clean school, kids who understand the risk, and personal protective equipment.
And if I hear one story about a teacher spending money out of his or her own pocket to by masks
or cleaning equipment I am going to lose it.
Idea 9 – Teach the kids what is going on.
We don’t need to scare them, and we need to make the education age-appropriate.
But it is just as important to teach WHY we are washing our hands as HOW to wash our hands.
Idea 10 – Get the kids to school safely.
Parents who can drop their kids off should be encouraged to do so to thin out the busses
and public transport options.
Kids should wear masks when traveling to and from school.
And, sorry cool kids, school buses should have assigned seats.
Idea 11 – Smaller classroom cohorts are better.
This can be achieved by using non-classroom space in the school as classrooms – since
we don’t want the kids walking through the halls to go to gym, art, or music anyway.
Of course, with more classrooms we’ll need more teachers.
It may be time for an initiative to recruit a crop of teachers that may not have the standard
credentials (typically a Master’s degree).
Think teach for America.
On steroids.
Idea 12 – Clean.
We need more custodial staff too.
One thing you can’t keep kids from doing is using the bathroom.
Disinfecting should be frequent.
These are not all the ideas there are, and they may not be the best ideas – but we
need to start this dialogue now.
Some things, like keeping kids in a single classroom, is not a huge lift.
But some things, like a nation-wide school-child testing strategy would be an enormous effort
– a Manhattan project for our children.
But I, for one, can’t think of a better way to spend our effort.