Will Opening Schools Make the Pandemic Worse?
Will reopening schools cause the nation's already simmering coronavirus pandemic to boil over? While the picture from studies and reopenings in other countries is beginning to come into focus, it's unlikely school and district leaders will have a clear answer before they have to make their own decisions for this fall.
After relatively scant research on children and the coronavirus in the early months of the pandemic, there has been slowly building consensus around just a few findings: that children, particularly pre-adolescents, appear to be less likely to contract the disease; and that the majority of those that do have either mild or no symptoms. All told, the National Academies of Sciences, Engineering, and Medicine estimates that only 5 percent of all reported cases of COVID-19 have happened in children under 18.
While hopeful, none of those findings has been particularly helpful in planning school reopenings, as they mean that fewer children are tested and we don't know as much about how likely children are to spread the disease, compared to adults. In the absence of widescale testing, researchers have relied on case studies of existing outbreaks and comparing the relative amount of viral particles in children and adults to try to compare how much they may pass on.
The last several weeks have brought a flurry of new, more school-focused findings, including:
- One University of Texas-Austin analysis of the New York Times' pandemic tracking data suggested 4 in 5 Americans live in a county where the rate of COVID-19 infection in the community is high enough that at least one student or staff member at a 500-student school will show up with the illness if schools reopen in fall. However, epidemiologists pointed out that its projections likely overestimate that risk because they were based on what was likely a sicker-than-normal sample of children. (For a fascinating explanation of the limitations of this analysis, check out this Twitter thread by epidemiologist Whitney Robinson.
- Another study that tracked the timing of school closures and incidence of COVID-19 in U.S. communities from March through early May finds statewide school closures were associated—in time—with a 68 percent drop in the weekly incidence of the disease and 58 percent fewer deaths per week. Over a 26-day period, states that shuttered schools when their community infections were in the lowest 25 percent had nearly 130 fewer cases per 100,000 people than states that waited until their community infection rates were in the highest quartile—representing some 1.37 million fewer cases total during that time.
- By contrast, a research analysis by Canada's public health agency and McMaster University which looked at contact tracing and case studies of outbreaks found that children 10 and under didn't drive coronavirus outbreaks in schools or daycares; when they did occur, they tended to be traced back to adults in the school or the children's families.
- A forthcoming multi-study review and a separate study of children and adults in South Korea both suggested that high school-aged students may be significantly more likely to contract COVID-19 than elementary-aged children. Those findings aligned with a a separate U.S. case study tracking a high school teacher who tested positive for the coronavirus back in March (when social distancing in the States was still relatively new). Out of 21 students who had contact with the teacher, only five had really close interactions, and of those, one later tested positive and one tested potentially positive.
While the studies offer somewhat mixed evidence on how infectious children may be and what role they contribute to the spread of the pandemic, they do highlight one keystone for district leaders' decisions about school reopening: Community virus rates can make a big difference in whether a school's reopening improves access to learning or spreads disease.
The journal Science found, in a review of 20 countries' school reopenings, that while requiring face masks and social distancing, and keeping students in small cohorts (so-called "panedmic pods" among some U.S. schools and parents) did reduce outbreaks, the biggest factor was the overall rate of infection circulating in the community.
Countries that reopened schools with low community infection rates, such as in Denmark, have seen overall COVID-19 rates continue to decline even after schools and daycares opened. Others, such as Israel, reopened schools amid higher community infection rates and had to shutter them after significant outbreaks.
Building public confidence could be a major challenge. As a handful of schools around the U.S. opened up for in-person instruction in recent days, at least two districts reported positive cases of COVID-19—one in Mississippi, the other in Indiana.
Photo: Corinth Elementary School students have their temperature checked by a thermal scanner as they arrive for their first day back to school in July 27 in Corinth, Miss. District officials reported four days later that a high school student in the district later tested positive for COVID-19 Source: Adam Robison/The Northeast Mississippi Daily Journal via AP