Is it safe to send back to school?

Dear Ministry of Education,

I regret to inform you that schools cannot safely reopen in the fall if COVID remains as widespread as currently. I do not want to be alarmist, but as a physician, I think about the following things when I consider sending my children to camp or school, and I wanted to share them.

1. COVID affects kids. To be sure, fewer children have died from COVID than adults for reasons we do not yet know. However in areas with high burdens of the virus, children have ended up in the ICU both on ventilators and with post-viral inflammatory disorder. Further, since it is so new, we have no idea what the future holds for those kids who contract that virus and are either asymptomatic or recover uneventfully. Notably, it is still thought that the younger the child, the less likely to contract and spread the virus, but by grade-school that distinction becomes less relevant.

2. The virus is airborne. This means it travels in tiny particles in the air we inhale. It moves through rooms, air conditioning, elevators. This is why closed rooms with multiple people are the breeding-ground for COVID. Masks can help if they seal the nose and mouth, but face shields and plexiglass do little or nothing against a virus in the air. Even the famous 2 meter spacing is of lesser consequence when a group shares the same air.

3. Herd immunity is not possible. At this point in time, while being antibody positive does seem to provide some protection against re-infection, the immunity lasts up to six months only and then wanes. If catching COVID and building natural antibodies was a solution, then you would need to get sick with it at least twice yearly, risk being seriously ill for many weeks or months, and risk unknown complications. God Willing, a vaccine which is safe and longer-lasting will be developed, but it will not be for school’s opening in September.

Given this information, it is hard to see how schools can safely reopen in the current environment, as much as we all hope and need them to. Acting as if we can simply return our children to their previous classroom experience is wishful thinking.

Now, I believe that reopening schools should be the PRIORITY for the country. For economic reasons, mental health reasons, and social and educational reasons, we all need this to happen. But the answer is not to do something risky without plans beyond shutting down when the inevitable infections occur. The superficial measures of moving desks further apart, taking temperatures, or putting up plexiglass will do nothing to prevent the spread of the pandemic.

In order to reopen schools, the hard truth is that the virus needs to be under control in the community first. The formula that has allowed schools to open safely in other countries needs to be aggressively applied here: Test, Trace, Contain. When I know that there are only a handful of positive cases in my town, and that weeks have passed with only single digits of new cases, then the risk of sending my children into a den of previous-inhaled air is lower. We may not be able to build herd immunity, but we can rebuild a healthy community into which they can be safely released.

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