More COVID-19 research needed to guide decision making for reopening US schools

More COVID-19 research needed to guide decision making for reopening US schools
© Getty Images

As two working mothers, we each have children who, prior to COVID-19, were attending in-person school. The kids are now at home, like we all are, and hoping that schools will actually be able to reopen in the fall. The social distancing fatigue felt across America is matched, if not surpassed, by remote learning fatigue and impatience to return kids to classrooms. This is understandable.

While schools have made valiant efforts, without much notice, to launch distance learning programs and continue students’ studies, even the best of these programs cannot replicate the educational, emotional, and psychosocial benefits of in-person learning. Not to mention the fact that schools are central to providing free meals and other critical social, special education, and medical services to many kids and families around the country. 

Apart from a concern that school children are losing ground academically, there are adults who can only work outside the home and may not be able to if their kids aren’t back in school buildings this fall. There is also the undeniable fact that it’s quite challenging for parents to work efficiently from home with kids underfoot, especially young ones who need attention, food, entertainment, help with their school work, and technical support to troubleshoot the latest glitch with their Web conferencing connection. 

ADVERTISEMENT

But here is the rub. Much as we want nothing more than to see our kids reunited with their friends and teachers back at school, none of us want to put our children, their teachers, or our families in harm’s way. In light of gaps in scientific knowledge surrounding COVID-19 and the fact that children have been mostly at home all spring, we don’t know with confidence what levels of risk children with pre-existing conditions may face at school; nor do we know if otherwise healthy kids who have COVID-19 but are asymptomatic can efficiently spread the virus to families, teachers and school staff once learning resumes in school buildings.

This is in part why we see so much variability now in other countries’ approaches to reopening schools. Some countries plan to first bring back older students, who can more dependably observe the physical distance, to take important exams; others are betting, based on some early studies, that it’s safer to bring back primary school children first since the incidence and severity of disease in them appears lower than in older students. Countries are experimenting with 1-day, 2-day, and 4-day rotations of kids in and out of schools and contemplating a blend of remote and in-person learning. A plethora of guidance documents are coming out listing mitigation options for schools that include physical distancing, reducing the numbers of potential contacts during the day, avoiding mixing between classes, increasing ventilation, reducing access to high-touch surfaces, etc. The list goes on. 

Wouldn’t it be simpler if we had a better understanding of the risks so that we knew how best to assess them and manage them at school? 

While we know that healthy children don’t get severely sick as often, important questions remain: 

  1. How vulnerable to severe illness are students who have underlying health conditions, such as asthma, diabetes, or severe obesity?
  2. How safe is it for adults who themselves have serious underlying health conditions to send their children back to school without fear of the kids becoming infected and silently spreading the virus to others in the family?
  3. How safe is it for teachers and other school staff, especially those who are medically vulnerable, to return to school and interact with students who may be asymptomatic but infectious? 

What research needs to be done? Studies that reconstruct transmission chains using data collected from contact tracing and case investigations can help pinpoint whether children are a significant source of infection or if they rarely transmit COVID-19. Using cohort studies, researchers could gather more information about the role of comorbidities in COVID-19 adults and children who suffer severe outcomes. Rigorous policy evaluation could track the experience of communities who open schools using various approaches to try and ascertain whether the increased circulation of kids in schools results in increased transmission within families or school communities. 

ADVERTISEMENT

To make decisions about school openings with more confidence, we need to do our homework. There is an urgent need to fund and launch research to begin to fill in the blanks of our knowledge as much as possible before schools open in the fall. A national advisory group that includes pediatricians, public health experts, educational researchers, parents, and teachers, should be tasked with keeping track of research findings and issuing recommendations supported by the data. 

What are we waiting for? Decisions about opening school buildings for the next academic year will be here before we know it. Congress should make this a priority now so that we all can have more answers and hopefully reopen schools with confidence.

Anita Cicero is the deputy director at the Johns Hopkins Center for Health Security and a visiting faculty member at the Johns Hopkins Bloomberg School of Public Health. Dr. Tara Kirk Sell is a senior scholar at the Johns Hopkins Center for Health Security and an Assistant Professor at the Johns Hopkins Bloomberg School of Public Health. They authored the recent report, Filling in the Blanks: National Research Needs to Guide Decisions about Reopening Schools in the United States