Author: Sparhawk Mulder
Our takeaways from an interview with a nurse and teacher who is very tired of repeating the same things over and over again.
Most medical professionals are in favor of reopening schools in the United States now. Let’s learn why, and what precautions they suggest.
First, we must address the common question “If we closed schools at a few hundred cases last spring, why are we opening them now when there are orders of magnitude more?” The answer is simple: we didn’t have as much information as we do now. It’s easy to forget how little we knew of the virus just a year ago, given how closely we watch now. We didn’t know exactly how COVID-19 transmitted, how to protect against it, the fact that about half of infected people show no symptoms, and had no vaccines, testing, or treatments. The best thing we could do was quarantine everything to totally stop the spread of the virus. Unfortunately, though schools did do this, many people, businesses, and even whole states did not, drastically undercutting the power of the quarantine.
Now we know more about the virus. We know it transmits faster than we thought through the air, but less effectively than realized on fomites. We know COVID actually isn’t a respiratory virus, but rather infects the endothelium (the lining of your blood vessels). We know the short term effects can be more than just the classic “flu-like symptoms”: older people, obese people, and people with vascular, heart, or lung conditions often experience much more violent symptoms. Moreover, anyone can get strokes, kidney failure, blood clots, COVID Toe (vasculitis in the toes), and strange neurologic symptoms. Those can stretch into long term symptoms like Long-Tail COVID where you feel the minor symptoms for months afterward, frequent flare-ups of old injuries (such as muscular or connective pain), and brain fog and memory loss (independent of the strokes!). We knew none of this a year ago.
More importantly, we have new treatments, both pharmaceutical and not. Monoclonal antibodies (injected untargeted artificial antibodies) and Ramdecivere both work (unlike Hydroxychloraquin). Steroids, when their use is timed very precisely during the infection cycle, can help suppress the dangerous overactive immune responses which kill so many people. The benefits of masking, social distancing, cleaning, and good ventilation have all been quantified, too.
Ok, But Should We Reopen Schools?
In short, most medical professionals say YES, for a few reasons. Why? Because experts, including both the Department of Elementary and Secondary Education (DESE) and American Academy of Pediatrics (AAP) agree that the documented harm from staying online has become worse than the potential harm of coming back.
Regardless of what educational benefits can be preserved over Zoom, the most important parts of school cannot. Children of all ages are losing incredibly valuable socialization experience, along with many academic experiences which cannot be gained online. Young children are hard hit, being reportedly unable to learn almost anything well online; neurodivergent kids are in even worse shape. For example, kids with language based learning difficulties can barely learn to read, if at all, though online instruction. This is all without mentioning the terrible situation presented to children in turbulent or abusive homes, or children who relied upon public schools for meals.
The potential harm from coming back seems minimal, too. We now have quantitative specifics for in-person safety (more on that later). Even without those, young children are very inefficient COVID vectors, and statistics show that transmissions through schools are less than 1%, lower than almost every other establishment (especially bars and gyms).
However, the reopening requirements are different for every state and county. Counties “in the red” should probably hold on a little longer, but most schools should definitely go back to in-person classes soon. After all, physicians say, we should most certainly prioritize education over bars and clubs.
How Should We Reopen?
Hey, we’re a medical blog, not the CDC. Go look at their requirements here. And know that the DESE and AAP are pushing for schools to open even if they don’t quite meet the standards.
But here’s a little overview anyway. Masks should be required, and double masking is suggested (results in the lab show up to a 95% transmission reduction). Keep six feet apart, or at least three feet if six feet is impossible. Promote good hygiene, wash your hands. Classrooms should be thoroughly cleaned once a day and need good (but not perfect) ventilation (or open windows, if it’s warm).
The nurse should test batches of 25 students randomly with nose swabs, a cheaper and quicker way of testing for group exposure.
And that’s it. It’s very doable. We hope to see it happen soon.