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Re-Opening Plans Should Continue with the Hypothesis that Children are Vectors

My children spend time in two households and this continued throughout the stay-at-home order in Massachusetts. In the beginning of May, I got a phone call from their dad saying that he thinks he may have been exposed to the coronavirus. Sure, I should have trusted this statement, turned my car around, and left my kids with him for the full two weeks. I didn't do that. I asked him to get tested and I drove my kids to get them tested. I was exposed in the car ride home.

My 8 year old was in the habit of moving her mask down to talk. I asked her multiple times not to, but also needed to not freak her out. I picked them up on a Saturday and their Dad tested positive on Monday. By the time my children's tests came back positive on Wednesday, both my husband and I felt like we had allergies and we were very tired. My results came back that Sunday.

I am not here to talk about my symptoms, I am just pointing out the timeline. We were able to limit additional exposure because the world was in a stay-at-home order, fortunately, but my children had to watch as their dad, step-dad, and mom battled through a potentially fatal virus all the while being asymptomatic themselves. I will say that it was the sickest I've ever been in my life and I never want this virus again. I will also say that the amount of fear I see in my kids eyes about the virus now is very concerning and something that weighs on me as I read parent after parent post on social media demanding a full return to school and demanding no masks. Also, just in case this needs to be said, you cannot leave your child at school for two weeks if they are exposed. This is why my experience mimics the risk all families would take in the Fall if we were in person.

In my experience, children are indeed vectors.

I am not an expert on viruses, but I do know that this virus is highly contagious. My Board of Health nurse was very explicit: when children have it in your household you can assume you will have it. It's surprising to me that editorial articles appear to be saying the opposite when the medical professional who checked in with me daily was clear and confident in this. A recent study out of Berlin explained that "it is obvious that children are under-represented in clinical studies and less frequently diagnosed due to mild or absent symptoms." The study found that while children are underrepresented in Covid-19 testing, children carry the same "viral load" of the virus as adults. This means that children with Covid-19 are equally as infectious as adults with Covid-19.

The Board of Health told me that it takes 2-5 days to show symptoms from the moment you are exposed if you are going to be symptomatic. Above is the actual timeline of events for my own family and this estimate checks out, but it also points out that unless you are 100% aware that you are exposed at the instant of exposure and isolate immediately, you will expose other people. Despite recent social media posts that argue children are not effected, my own two children were indeed vectors. Whether this is true for a larger group might be determined by the National Institute of Health's study that began in May, but I have yet to find scientific evidence that refutes my own experience.

When schools re-open, we have to prioritize safety over comfort.

I want schools to re-open, but the reality of my own experience and the implications in a school setting actually terrify me. Let's say that Adult 1 in the image above is a teacher attending a barbecue, unknowingly exposed to Covid-19 on a Saturday and then attending school with a class of 20 first graders on Monday. How do we guarantee that these six year olds wear their masks all day and not contract the virus? I don't know if we can, and its entirely possible that this hypothetical group of first graders will bring Covid-19 home to their families after spending two days in the classroom before Adult 1 even shows symptoms and self-isolates.

Let's say that Adult 1 is a child attending a youth baseball game on Saturday. On Monday, they take the bus to school with a group of students and then attend class with an entirely different group of students. Can we be sure that this child is consistently wearing a mask and that every surface they are coming in contact with is being cleaned in time to prevent transmission? This child might not show symptoms at all, so how many adults are we spreading the virus to in this instance?

The wild card in re-opening schools in the Fall is that it will be done while also simultaneously opening businesses and activity outside of the home. Below is my list of things that I believe need to happen to ensure that students, teachers, and their families are safe, allowing for some degree of in-person learning.

  1. There must be an option for at-risk populations to learn remotely - In a recent Education Week article, it was pointed out that "29 percent of teachers are aged 50 and older" and that "92 percent of deaths related to the disease in the United States were of people aged 55 and older." We also have to think about teachers and students that live with elderly family members in this formula. It is not okay to make students or teachers feel like sacrificial lambs for the sake of re-opening schools.

  2. Everyone has to wear a mask - Not a single person, student or teacher, should be allowed to enter the building without a mask. I find it entirely baffling that people would argue the contrary when the science is clear that wearing a mask saves lives. If you are still an anti-masker, maybe this article will help: Still Confused About Masks? Here's the Science Behind How Face Masks Prevent Coronavirus. Parents, you have weeks to train your children to wear masks safely to support your school's efforts to keep everyone safe.

  3. We cannot be full in-person - There are a number of factors that should force districts to take pause in planning for full in-person learning. The idea that all other business and spaces are being opened in phases, but yet schools should go 100% in the Fall is borderline absurd. For starters, many of our school buildings are overcrowded and unable to operate at 100% capacity while also adhering to safety guidelines. But the real reason we cannot go back to full in-person learning right away is time. In looking at the timeline for my own family above, we need to provide students and teachers with a buffer of time to prevent the spread of the virus. Just recently in California one in-person meeting at a school exposed dozens of administrators. This exposure triggered a two-week quarantine and, luckily, it was a small controlled group in an isolated moment in time.

  4. We have to continue to social distance - Opening up schools while also going back to our normal lives will prevent schools from being able to control any potential spread of the virus. According to a recent article, countries that have been able to re-open schools have "low levels of infection and a reasonably firm ability to trace outbreaks." I don't believe we have that in the US. I am also very concerned with recent data that points to spikes in cases across the US and that a common thread with "many of the most affected states is that they reopened indoor dining, bars, and gyms.” If we want our kids to return to school, we have to prioritize safety.

  5. We must prioritize student mental health - Again, it is not okay to make students or teachers feel like sacrificial lambs for the sake of re-opening schools. Do you know what it's like to feel responsible for infecting your family with the coronavirus? My kids do and I can assure you that it comes with a whole lot of anxiety and fear. I see it every time we leave the house and I watch as they are overzealous in hand washing and sanitizing. Every day I am asked at least a dozen times about things they've touched, how close someone was to them as they walked by, and how soon they can wash their hands to wash the virus off of them. I have heard many parents argue for student social and emotional well-being, but I have not heard any discussions about what happens if your children have to live with the burden of having brought that virus home to you.

  6. We have to embrace hybrid learning - ​A hybrid model can do a variety of things. For starters, it affords buildings the space needed to keep students and staff safe. Hybrid models will also give us the gift of time so that if students or staff are exposed to the virus we have the ability to keep cohorts home. A big fear of being fully remote is the lack of opportunity to build relationships, but if we are hybrid students will have the opportunity to build relationships with their teacher in person and online. Lastly, planning in this way allows for districts to plan for both in-person and remote learning simultaneously, meaning that if we have to we can pivot to full remote.

In order to re-open schools, we have to take safety seriously and understand that at any point in time we may need to shift to being fully remote. While I understand that learning in person is ideal, it should not be the case that we are forcing in-person learning for the sake of in-person learning with total disregard for the fact that we do not know enough about how this virus transmits in children to be truly safe. And while it might be popular to quote the American Academy of Pediatrics guidance that clearly says, "the AAP strongly advocates that all policy considerations for the coming school year start with a goal of having students physically present in school," nowhere in this guidance does it advocate for ignoring safety guidelines.

I wish it were different, I wish we were out of the pandemic and our kids could go back to normal, but I cannot wish away this virus and pretend that a lack of data on transmission rates among children allows us to make assumptions on student safety.

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