With the delta variant predominating and no end in sight, it is a challenge to keep schools across the country open and functioning. In fact, many are already closing. With outbreaks among children increasing — nearly 29 percent of all cases being children, and with close to 250,000 cases last week alone — the challenge is increasing. Children were known to be inefficient COVID -19 spreaders with prior iterations of the virus, but this no longer appears to be the case with the delta variant.
Therefore, it is so important that all strategies be utilized, from 3 feet of distancing to improving ventilation, to masking. Political fighting over masks diverts everyone from the common cause, which is to keep schools open. A large majority of schools were closed last year, causing great psychological, physical and economic harm, especially in areas where families couldn’t afford the technology, teaching aides or teacher access to maximize virtual learning. Another year of remote teaching would be devastating.
Decisions need to be made at the local level, based on a number of cases, case positivity rates and the latest risk. State governors banning mask or vaccine mandates make as little sense as state governors arbitrarily imposing them.
One health official who has stayed above the political fray in his analysis of the school issue is former Food and Drug Administration (FDA) Commissioner Dr. Scott Gottlieb, who, in his new book, “Uncontrolled Spread,” criticizes the Centers for Disease Control and Prevention (CDC) for its lack of applying science acted on in real-time throughout the pandemic, making its guidelines — which form the basis for state and local rules and mandates — often out of date even as they were being released.
The CDC has a history of studying an emerging infectious disease trend for months, often by mathematical modeling (as with influenza) rather than with actual case numbers. This limits its ability to lead. This leadership vacuum applies directly to schools and has led to confusion and to lack of confidence or open distrust in the ever-shifting CDC guidelines, a reality that is deeply disturbing when it comes to needing to believe that our children are being kept safe.
Gottlieb points out that the problem extends beyond the CDC to all the federal agencies, including the post-Gottlieb FDA. (He left the agency in April 2019, before the pandemic started.)
The lack of leadership from the top down has also led to a lack of proper prioritization. By my estimation, the order of importance when it comes to schools should be vaccines, rapid testing, distancing, ventilation, then masking. Masks need to be surgical grade or better, and they need to be worn properly — but consider that they present the final inefficient barrier to spread, rather than the best overall strategy.
Rapid high-volume testing of entire populations, the way it has been done in several Asian countries (including China) is the only way — along with mass vaccination — to gain control over such a rapidly (and, often, asymptomatically) spreading virus. As Gottlieb writes, “the lack of testing created a false sense of security … the inability to field a reliable diagnostic, to deploy it in scale, and the overreliance on syndromic surveillance that was inherently flawed were historic failures that left us badly at risk.”
This flawed approach to testing has continued to be an eyesore in our COVID-19 response. The best way to keep schools open is to vaccinate everyone eligible (reports of vaccine side effects in our teens are grossly exaggerated, especially when compared to COVID side effects) while accounting for natural immunity with antibody testing for those who have had COVID-19. Also, and perhaps most importantly, we should be performing rapid home testing on every child twice a week before they come to school: If they test positive, then they stay home.
These home tests have been available for months, with many more useful ones in the pipeline awaiting FDA approval, and they should be fully paid for by the federal government and sent to every home in America immediately.
From early 2020 until now, our public health officials have grossly underestimated the amount of COVID-19 in the communities. The only way to get a better handle on this is with free rapid testing available to all children and their parents. Our children's future is at stake and nothing is more important.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, "COVID; the Politics of Fear and the Power of Science."