Sunday, July 12, 2020

The Corona Chronicles: National Anxiety over Opening School

As we begin to explore strategies to reopen school this fall, teachers across the country are experiencing anxiety about their own safety, that of their students, and that of their own families. It is an agonizing position.

Many teachers feel they must choose between their health, and the health of their family, or their career.

Teachers are collecting Lysol wipes, pricing room foggers for sanitation, and stockpiling gloves and masks. Some are collecting page protectors that can be sanitized and plastic pencil cases.

Let's be clear. If we are talking about putting pencils in individual plastic boxes so nobody else touches them, if we are worried about getting Coronavirus from a pencil, we have already lost this debate.

This back-to-school debate has exploded since the President spoke last week and said that schools must reopen or risk losing funding. I've been reading one article and study after another all week long, and they keep on coming.

Districts across the country are trying to figure out how to do this safely. It is a Herculean and perhaps impossible task and I do not envy these decision makers.

What absolutely must be done is that each community must decide if opening school is safe for them; to do this there must be low community spread of the virus. Currently, Louisiana has a 97% community spread.  As of this writing, cases are climbing as are hospitalizations.

Across the country, it is estimated that at least one-fourth of our teachers are 50 years old or older. Many teachers are themselves in a high-risk group and many more live with someone who is. While teachers are worried about their students, we are also worried about the health and safety of our own families.

For some teachers, a return to the classroom would also mean self-quarantine from their elderly parents to avoid risk of exposing them as well.

And yes, it is true that essential workers have been on the job for months. But unlike a grocery cashier, a delivery driver, or even a doctor or nurse, a teacher will be confined in a classroom with 25 or more students every single day for at least seven hours. Many of these classrooms are in older buildings with poor ventilation and windows that cannot be opened.

We are looking at returning to school with daily temperature checks of students and staff, seven hours in face masks, and a barrage of cleaning chemicals and heavy sanitation measures. Students will have to keep six feet apart (maybe three feet with masks, but I'd prefer six), there can be no sharing of materials like pencils or Chomebooks (what about library books?). Hand washing has been recommended every two hours. How many portable hand washing stations will that mean for a school with 1200 students or more?

And  all that hand washing goes right out the window once the kid pulls out his cellphone, doesn't it?

It's all very dystopian.

We can't let our overwhelming desire for a normal return cloud our better judgement for safety of all of us.

Teachers across the country have come up with some sensible strategies, and while they are not always easy to do, some of them make sense, like keeping upper grades virtual for nine weeks, or until this is under control, and using our buildings and classrooms for lower grades where kids are less at risk, and for kids needing special services. This would enable classes to be quite small and spread out.

Teachers have a lot of questions and here are just a few of mine:

1. Who is going to wipe down my room between classes every day? Where will all of these disinfectant wipes come from? I haven’t seen any since March. Will we use bleach? How will this affect kids with asthma?

2. Will my classes truly be 10 to 15 students? I normally have 25 or more and we are literally on top of each other in my small room.

3.  Under our proposed Phase 2 hybrid model students will be on an A/B schedule and attend every other Friday. If little Johnny shows up on the wrong Friday, are we sending him home? Keeping him? In class? Who will watch him?

4.  Will there be an isolation room for kids with fever or symptoms to stay until a parent comes to get them?

5. Will there be daily temperature checks? At the front door or in homeroom? Once an infected person is in the building, what’s the point? By the time he gets to homeroom he will have exposed many other people.

6. Who will be quarantined if there is a positive case of COVID-19 in a classroom? For how long?

7. If students have to eat lunch in the classroom, masks will be off and there will be much talking; exposure will still be high. When will the teacher get a break?

8. When the inevitable teacher shortage comes due to early retirements and illness, where will all of the subs come from? Subs are often in high risk categories themselves.

9. Will teachers be required to cover classes when there are no subs?

10.  If masks are required, what of the student who shows up without one, wears it improperly, refuses to wear it, takes it off, shoots it across the room, wears a bra cup on his face instead of a mask, etc. Are we to be mask police, too?

11. What will be done to improve ventilation in classrooms with windows sealed shut?

12. How do we ensure students are washing hands every two hours as the CDC guidelines, and the Louisiana Strong Start guidelines suggest? Will there be handwashing stations throughout the schools? Hand sanitizer stations?

13.  Will schools be provided extra personnel to manage all of this?

I feel like I work at the absolute best high school in the world and I work for the best administrators ever born -- no doubt. And our students? They are solid gold; they are loving, kind, wonderful kids and we all feel like family. I want normal school. Don't be confused. I want normal school. I want to look my students in the eyes, I want to be able to tell if they are okay, and I want to help them when they need me to. I want to keep that crate of snacks for the hungry ones, and I want explain a concept in class so that everyone understands what we are learning and why. I love my kids. I love the hugs in the hall, the high-fives, the ones that come stop in on their way to the bathroom or office just to say hi.

School gives me joy. But how can we have that if we are worried about dying from a pencil?

How?


Here is a short list of some of the things I've been reading this week; it's not homework, you don't have to read them. But I decided I wanted to collect them in one place, so here they are.

Further Reading:

Shut and Reopen: the role of schools in the spread of Covid-19 in Europe.  (A UK study whitepaper, 6/20/2020)
"A large-scale reopening of schools while controlling or suppressing the epidemic appears feasible in countries such as Denmark or Norway, where community transmission is generally low. However, school reopening can contribute to significant increases in the growth rate in countries like Germany, where community transmission is relatively high. Our findings underscore the need for a cautious evaluation of reopening strategies that ensure low classroom occupancy and a solid infrastructure to quickly identify and isolate new infections."


I Don't Want to go Back: Many Teachers Are Fearful and Angry over Pressure to Return. (New York Times, 7/11/2020).
"Teachers say crucial questions about how schools will stay clean, keep students physically distanced and prevent further spread of the virus have not been answered. And they feel that their own lives, and those of the family members they come home to, are at stake."

E-Learning is Inevitable for US High Schools Next Year (Medium, 7/10/2020)
"However, the only way to eliminate the risk of transmission during in-person school would be to know with certainty that no one who enters the building is COVID-19 positive. Unless schools can accurately test every person who enters the building every day with real-time results, the spread of COVID-19 in schools will occur and that type of real-time accurate testing capacity will not be possible by this fall for any school let alone all schools."

Epidemiologist: Schools Can Open Safely, and Here's How. (Sherman, TX Herald Democrat, 7/11/2020)
"The focus should be on protecting teachers. It begins with a robust testing program, so they feel safe in the classroom. We know that uncertainty about one’s health and the health of others makes it difficult to feel confident enough to return to work."

No One Wins, but No One Dies: What School Must Look Like... (The Suitcase Scholar, 7/9/2020)
Because no matter how much you want this school year to look like any other school year, it can not and it will not. If we want to accomplish all three of these goals, here’s how it can be done...

How to Reopen Schools: What Science and Other Countries Teach Us (New York Times, 7/11/2020)
"As school districts across the United States consider whether and how to restart in-person classes, their challenge is complicated by a pair of fundamental uncertainties: No nation has tried to send children back to school with the virus raging at levels like America’s, and the scientific research about transmission in classrooms is limited."

Nobody Asked Me: A Teacher's Opinion on School Reopening (Teacher Life Blog, 7/9/2020)
"Remote learning isn’t most people’s first choice, but it is a safer solution in the meantime, while we figure out this global health crisis. It is also hard to imagine how much learning would be taking place in the classroom anyway after they wait in their 75 foot long lines to wash their hands for 20 seconds multiple times a day. School days are already crammed full and now we will be adding in disinfecting constantly, monitoring for symptoms, sending kids to “quarantine”, trying to get ahold of parents, dealing with masks, giving “mask breaks”, etc."

Study of School Reopening Models and Implementation Approaches During the Covid-19 Pandemic (Covid-19 Literature Report Team whitepaper PDF, 7/6/2020)
"This document is a brief summary of the models and implementation approaches to re-opening schools that focuses on the approaches used in 15 countries for which we were able to identify data."

One in Four Teachers at Greater Risk from Coronavirus (CNN, 7/10/2020)
"Nearly 1.5 million teachers are at higher risk of serious illness if they contract coronavirus, according to an analysis released Friday evening. These teachers and instructors, about 24% of the total, suffer from health conditions such as diabetes, heart disease or obesity, or are older than age 65, which make them more vulnerable, the Kaiser Family Foundation report found."

These Arizona Teachers Shared a Classroom for Summer School: All 3 contracted Covid-19, 1 died. (USA Today, 7/10/2020)
"The educators decided to teach virtually while together in the same classroom, but took what they thought were extensive measures: They wore masks, they disinfected equipment and kept distance between each other."

The Case Against Reopening Schools During the Pandemic: by a Fifth Grade Teacher (Washington Post, 7/10/2020)
"Safety is the prerequisite for all learning. Ordinarily, we offer hugs and reassurance when a child is upset. We encourage students to walk their peers to the nurse’s office when they get injured on the playing field. We give high-fives and pats on the back when students achieve their goals. We provide private spaces for students to share confidential information, or to de-escalate from distress. In a social-distancing school setting, everything is inverted. Closeness and warmth are now dangerous. Students and teachers must remain hypervigilant, watching for face mask violations, friends too near, an uncovered cough, unwashed hands, and unsanitized surfaces."

Nation's Pediatricians Walk Back Support for In-Person School (NPR, 7/10/2020)
"The American Academy of Pediatrics once again plunged into the growing debate over school reopening with a strong new statement Friday, making clear that while in-person school provides crucial benefits to children, "Public health agencies must make recommendations based on evidence, not politics." The statement also said that "science and community circumstances must guide decision-making."

Covid-19 is as Deadly and Dangerous as Ever. (Medium, 7/8/2020)
"The idea that Covid-19 is becoming less dangerous or deadly is false, the latest data reveals. “The virus is as lethal as ever,” researchers at the Harvard Global Health Institute said in a statement. “Deaths and hospitalizations are rising in hot spots around the country. Exactly as public health experts feared.”

Mounting Evidence Suggests Coronavirus is Airborne--but Health Advice has not Caught Up. (Scientific American, 7/8/2020)
"Converging lines of evidence indicate that SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic, can pass from person to person in tiny droplets called aerosols that waft through the air and accumulate over time. After months of debate about whether people can transmit the virus through exhaled air, there is growing concern among scientists about this transmission route."

Large Antibody Study Adds to Evidence Herd Immunity to Covid-19 is Unachievable (FOX-17, "Nashville, 7/6/2020)
To achieve what epidemiologists call herd immunity, mathematical modelers suggest at least between 60% and 70% of people would need to be immune to SARS-CoV-2, the coronavirus that causes COVID-19. According to the Mayo Clinic, there are two paths to herd immunity for COVID-19: vaccines and infection. Vaccines would be the ideal approach, though experts say its effects can wane over time. Another path would be infection, but there's much still unknown about COVID-19, including if having the virus makes a person immune to future infection."

Spike in Cornavirus Cases Means some Schools Won't Open at all this Fall (EdSource, 7/10/2020)
"As coronavirus cases spike across California, some school districts are making the decision to keep campuses closed to most students and to educate them online next school year. Districts in Los Angeles County, which has more coronavirus cases than any county in the state, are preparing for the possibility of classes being completely online at the start of the school year. In neighboring San Bernardino County, its school district this week announced classes would resume next month online."

I'm an Epidemiologist and a dad: Here's Why I think schools should Reopen (Vox, 7/9/2020)

The same will likely be true in schools. The potential risk to teachers, therefore, goes beyond the classroom. Staff risk in schools likely looks similar to the risk of any adult working in a crowded indoor environment during the pandemic. School opening plans must consider teacher safety in addition to the well-being of students.



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