Reading, Writing, and Protocols: Back to School in the Time of COVID-19

Martinez-Hussein: My name is Julia Martina-Hussein, I graduated with a Bachelor of Science in Public Health at the University of Michigan in April 2020 during COVID. I really got involved with Northville public school’s task force just by reaching out to my daughter's principal. I have a daughter who's entering kindergarten, and the superintendent and just kinda ask if there's any room for me to be involved or how I can help.

Within this task force there's numerous teams. I'm actually a part of the safety, health, and wellness and then even that team is divided into two sub-groups. So it's a very large task force of various professionals, very inter-discipline, a lot of collaborating. The overall goal just to evaluate safe solutions for the return to school and mitigate risk.

A lot of times we had to make up hypothetical scenarios and try to weigh in. So like if scenario one happens, we plan to do XYZ. If scenario two happens then we plan for ABC. So it was a lot of creating your own scenarios because we were still waiting for guidance. Separating your personal thoughts and trying to be practical, we're very tricky, a lot of ideas seem good on paper, but they're not sustainable.

We had a situation with a board member. He kind of stated some dehumanizing comments about older populations and COVID and was very political on his social media, which unfortunately was a setback for us because we had to not only take time away from planning, but we had to address the issue, because it created a mistrust within the community, and we wanted to really address that to ensure share families that they can feel safe with our planning.

So the first of the month of September, we will be online, virtual learning, only with very close monitoring of not only our district in our area, but other schools. We did a lot of literature review, we looked at a lot of other schools and camps and programs that opened and CDC recommendations, so we're gonna continue to do that. And then as of now, the plan is to return back to school in October in a hybrid learning option. So there'll be alternating days where when students aren’t at school they’ll be learning from home, but of course, that's subject to change. And then all of our changes are based off of any state mandates and then what phase our state is in. 

I'm very nervous. I'm not really sure how I feel about it. I personally like to have a lot of organization and structure and routine, so for me, I did personally choose the all virtual option all year to make it easier as a working mom, as a student, and then I do have another high risk child at home who's younger than my kindergartener, so that is a big concern for me as well.

Speaker 1: As late August turns it to September across the country, children and their parents are at the beginning of new school years during this unprecedented COVID-19 pandemic. To get us here, school district officials and community members have spent the summer working to create plans for a safe return to education. One thing that everyone can agree on is that we want our children to be healthy, safe and learning. What that looks like in practice varies widely by state, county, and even city to city.

Hello and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. This episode is part of a series of special editions of our podcast, focusing on the ongoing coronavirus pandemic.

Aubree Gordon is an Associate Professor at the University of Michigan School of Public Health. She's an infectious disease epidemiologist specializing in respiratory viral diseases like COVID-19. We asked her if it's safe for kids to go back to school and what sorts of issues are at play when it comes to a safe return.

Gordon: I think it can be safe for children to go back to school in Michigan. We should think about when we talk about children, that children have different risks depending on their age. Particularly for young children, if we concentrate on it and really try then we can send our young children back to school. To do that in a safer manner, we're gonna need some interventions, controls in place, and it's also gonna be very important that we keep the levels of coronavirus very low in the local community or at least low to moderate in order to reduce the chances that somebody will come into that school with an active COVID infection.

There are a few different reasons that it's harder for I think high school age students to go back to school now. And I'm not saying it couldn't be done, it's just a little bit more challenging. One thing is that young children, the evidence, at least the preponderance of the evidence right now, would suggest that they are less susceptible to COVID-19, meaning not only do they get less sick, but we've seen lower levels of infection in young children. That's not the case for older children. I would say the majority of the evidence supports that young children are also less likely to transmit COVID-19 than either adults or older children. Once again, not true for older children. They look as likely, particularly teenagers, to transmit as adults are.

I think the other issue with elementary age kids versus older children, is that when you think about an elementary school, although they do go off to specials, generally speaking, they're in one classroom with one teacher for a majority of the day and it's feasible to set the school up that way and not have the children mix and move about. For high schools, and even for junior high, we move to different classes. And what you end up getting then is a lot of mixing that goes on. And so it's going to be incredibly difficult to pod off those children into one group of 10 or 12 or 15 children that don't mix with the other children in the school.

You always have to balance risk and benefit, right? And when we think about younger kids, to be honest, they get a lot less out of distance learning, out of online learning. They need to be supervised. It's harder on their parents. That's harder on the community. And so the risks are lower for having them in person and the benefits are greater for having them in person than when you look at older children.

Certainly older children have a lot of benefits from being in school in person, that's no question. And the social side of things is incredibly important, but their risks are higher. They're just as likely to get COVID-19 as adults. Teenagers look like they're just as likely to transmit COVID-19 as adults are. If they get COVID-19, they're likely to get sicker than young children but not as sick as adults or older adults would get, right, that tends to increase with age, but their risk is higher from the virus itself. On top of that, certainly there are some children who prefer all online learning, but for the most part, in person is going to be a better experience for the kids. Still, older children could kind of supervise themselves. They can get a lot more out of online learning. They have longer attention spans. And so the benefit for them being in-person isn't quite as large as for younger children.

You have to remember the economic impact is also a public health impact. Particularly for lower income families, right? When you think about this and kind of think about this supervision, allowing parents to go to work, this is going to put parents in a very difficult position, particularly for those that can't work from home. Either financially is going to be impossible for their families, potentially, particularly if they're lower income, or they may have to leave their children in situations that are less than ideal, or put them into child care anyways where they may not be getting the education they would be in schools.

Speaker 1: With the race on towards developing a safe and effective vaccine, we wonder about the likelihood of one being available soon and how that might affect schools and the families that rely on them.

Gordon: Everybody is very optimistic that we will have a licensed vaccine hopefully in the United States by the end of this year. That's not guaranteed though. We're optimistic, things are looking good, we've got multiple candidates that are now in phase three trials throughout the world. The thing to remember is that not only do we need a vaccine that works, but we're gonna need to deliver that to people, and that's going to take some time. Cepi which is a vaccine group recently analyzed the situation and they said that the world should be able to produce, given a vaccine, 2 billion doses of a COVID vaccine in 2021.The problem is that a lot of the vaccines require two doses - it's a prime-boost that we're looking at - and we have what I think it's 78 billion people in the world. And so when you start to think about us vaccinating the entire world, it's quite clear that even if we have a vaccine and even if it is perfect, we're still going to run into shortages in 2021.

I'm very optimistic that we're going to have a vaccine, and I'm certainly proceeding forward with the hope that we will have a vaccine and we will have a vaccine soon. However, we have to kind of think carefully about how we think about that and how we message it as public health professionals, because there's definitely no guarantee. Part of what I think happened in a way this summer, at least for some people, is that last spring, people got it into their heads that the virus was going to disappear in the summer, right? They only had to make it to June. And if they could make it to June and if they could social distance till June and they could stay home until June, then everything would be fine and their normal lives would return. And I'm a little bit fearful that given the messaging that's been out around getting a vaccine, and I think there's amazing progress, that people are kind of starting to get it into their head like, “Well, I just need a wait until there's a vaccine and there's gonna be a vaccine so soon”. And magically, if we do have a vaccine that's licensed in the fall, that it would just instantaneously return life to normal, and it's not gonna happen that way, unfortunately.

Putting all of our eggs in that basket and imagining that the second the vaccine appears, that everything will be fixed and that a vaccine is appearing very quickly is probably not the best idea in the world. And so I see it with a lot of school plans, even our local Ann Arbor schools, I think they partly do put in that like, “well, when there's a vaccine school will return to normal”. That's fantastic if there's a vaccine in December and we're able to vaccinate everybody in the US and the three months following that. Whether or not that's what it's gonna look like is harder to say. And I also just fear that there will be, I think it happened this summer, people kinda got burnt out on all the social distancing because they (and I'm not a psychologist), but you have this kind of in your mind, “If I could only make it to this point”, right? So now I feel like I hear my parents saying, I hear other people saying, “If I can only make it to December, then everything's gonna be okay.”

I’m a little worried about what December will look like if we're not able to vaccinate everybody in the United States by then, or everybody in the world by then. And it's pretty much 100% guaranteed that we're not gonna be able to vaccinate everybody. In fact, it is 100% guaranteed. We will not be able to vaccinate everybody in the United States or everybody in the world by December even if things go perfectly.

Eventually I think it will save the day, but it's gonna be a process. It's not gonna be instantaneous. And we're gonna have to keep using the tools that we have for a while, even after a vaccine is licensed and available. So we'll have to keep social distancing, we'll have to keep you using masks. Thinking about this as a longer term problem, I think for schools, it's gonna last through this entire school year probably. And I think a lot of them are taking a very short sighted like, “we’ll wait out  the first few months and then we're gonna see what will happen”, maybe not realizing that they are kind of making a decision for the entire school year. Whether or not the decision they're making right now is the decision they would make for the entire school year if they knew it was gonna be the entire school year, I wonder. Maybe it is, but maybe it isn’t.

Speaker 1: This has been a special edition of Population Healthy, a podcast from the University of Michigan School of Public Health. During the ongoing coronavirus pandemic, we’ll work to bring you analysis from our community of experts to help you understand what this public health crisis means for you. To stay up-to-date in between special edition episodes, be sure to check out our website publichealth.umich.edu, subscribe to our Population Healthy newsletter at publichealth.umich.edu/news/newsletter and follow us on Twitter, Instagram, and Facebook @umichsph.