Long School Closures Could Cost U.S. Billions, Cut Health-Care Capacity

Closing schools can be one of the most effective ways to stop the spread of infectious diseases. But for COVID-19, the respiratory illness linked to the highly contagious new coronavirus, research suggests school and public health leaders will have to weigh those potential benefits against the costs of keeping children’s parents home, too.

“If you close all schools, there’s going to be very, very large scale absenteeism for people who have to stay home with their kids,” said Joshua Epstein, an epidemiology professor at New York University’s school of global public health.

As of Friday evening, at least 46,000 schools nationwide have closed in-person classes for at least 26 million students—including scheduled statewide closures for Illinois, Maryland, New Mexico, Ohio, Oregon, Pennsylvania, Virginia, and West Virginia. If similar closures extend a month or spread nationwide, it could cost the U.S. economy some $50 billion, or nearly a quarter of 1 percent of the United States’ gross domestic product, according to a new analysis by Epstein and Ross Hammond, an associate professor of public health and social policy at Washington University in St. Louis and the Brookings Institution.

“It’s going to be very heterogeneous around the country. You know, it’s going to be radically different closing Manhattan schools than closing schools in Fargo,” N.D., Epstein said.

But regardless of the region of the country, the economic pain would fall hardest on poor and working-class families, the researchers noted. Not only are those in minimum wage construction, retail, and other fields unable to telecommute and less likely to have flexible leave policies, but their children are more likely to use school meals, campus wellness centers, and other school-based supports.

We know that some New Yorkers are going to lose work & even their jobs because of #Coronavirus.

NYS will immediately waive the 7-day waiting period for unemployment insurance for people who have been laid off due to virus.

— Andrew Cuomo (@NYGovCuomo) March 13, 2020

While district leaders don’t always have the choice of whether or not to close their schools—many so far have been advised by local health authorities to close in response to student exposure or community spread—schools can reach out to their communities in advance to find out more about parents’ needs in the event of a closure, including:

• Will the parent have the ability to telecommute or take off work, or will they be looking for care for their children? (“Since the swine flu, telecommuting increased by about 100 percent, but at the moment, still only about 3.4 percent of the workforce is telecommuting. And so that’s not going to change the impact,” Epstein noted.)
• If the school is moving to online learning, is there digital capacity in the home for both the students and working parents?
• Does the family rely on school meals, mental health services, or other supports that will need to be replaced while the school is closed?
• Does the student have elderly or medically vulnerable family members at home?

“One thing you don’t want to do is have the parents have no paid leave and they have to go to work—and so the kids go home and stay with their grandparents,” Epstein said. “That’s your most vulnerable group, right? So I think if there’s a way to offer people paid leave or relieve that pressure or find a way to avoid sending the kids home to elderly people, that would be very useful.”

Slowing Spread Versus Losing Health Support

In prior outbreaks of pandemic influenza, children were especially vulnerable to catching and spreading the disease, so closing schools helped slow the contagion and delay its peak, giving medical practitioners time to catch up. But the Centers for Disease Control and Prevention so far have found closing schools for less than four weeks has not been effective at either limiting the spread of the new coronavirus or hospitalizations related to COVID-19. Moreover, other efforts such as increasing hand-washing and isolating those exposed to the virus have been more effective than closing schools, even for more than two to four months.

If children do not turn out to be main vectors for the disease, Epstein said, then closing schools may even cause hurt the effort to slow outbreaks.

“One of the most affected sectors is health-care workers, because it’s predominantly women, many with school-age kids,” Epstein said. “Many of them are low- and middle-income—these are not white-collar workers—and you can’t really telecommute if you’re an ICU nurse or a nurse in general. I mean, it’s not the kind of job you can do over the phone. And so those are real losses to the health-care workforce.”

The new analysis updates a 2009 study of the economic effects of closing schools during the swine flu outbreak that year. During that outbreak, researchers estimated closing U.S. schools could strip 6 percent to 19 percent of key health care personnel. But that was when unemployment was closer to 10 percent, providing a cushion of temporary workers to replace those who had to leave to stay home with children. Today, with unemployment hovering at 3.6 percent, there’s a smaller pool of additional workers to compensate for parents who have to take care of their children—particularly in the most urgently needed fields.

Moreover, American Enterprise Institute fellow John Baily noted in Education Next that school closures won’t be effective at controlling contagion unless parents and children are willing to stay home:

During the 1918 pandemic flu, some communities reopened schools early, following extreme community pressure. That led to secondary waves of disease. Epstein said it is critical for district leaders and local governments to make careful decisions about closures, and help communities weather the closures for as long as it takes for the contagion to die down.

New CDC guidance recommends that districts limit school closures to:

• A few days to clean and trace the contacts of a school-based case of COVID-19;
• Two to four weeks in response to broad absences by staff or students; and
• Four weeks or more only as part of a broader community strategy to slow wide community spread of the disease.