50% of Hillsborough County parents returned a letter of intent declaring how their children should learn on day that FEA files suit against Governor,
Jason W. Wilson, MD, PhD, CPE, FACEP
Professor & Founding Chair of EM, University of South Florida | Chief of EM, Tampa General Hospital | Research Director | Transitions of Care Medical Director | Emergency Medicine Physician, Medical Anthropologist
July 20, 2020: Today, the Florida Education Association (the teacher's union) filed suit against Governor DeSantis over the current plan to return to school in August (under pressure himself from the Trump Administration). This legal action occurred the day after district parents of Hillsborough County students were required to turn in a binding 18-week agreement letter selecting traditional "brick and mortar" school or e-learning.
Parents made that decision on a day that cases were over 45/100K/day (650 new cases/day) in the district and the rolling average prevalence reached 15%, reminding us that viruses do not follow human calendars or political will.
Half of parents have chosen eLearning, potentially decreasing the physical student population enough to allow for increased social distancing measures in public school that may help mitigate viral transmission after a mask ordinance was wisely added by the Superintendent two weeks ago. If the survey response rate was high, the decreased number of students may also extend hygiene supplies, a source of concern amongst many teachers and parents who recognize difficulties with adequate stock in pre-pandemic days. In reality though, only about 50% of the 206,000 students (n = 110,418) of families returned the survey, technically reverting them by default back to the brick and mortar option. In addition, state requirements likely necessitate full classrooms secondary to per pupil funding.
However, teachers are facing a return to school in the next few weeks (7/31) to begin planning and a return of students on 8/24. Hillsborough County Public schools is STILL holding in person meetings (even on 7/20) that could be held using e-technology, exposing staff and the public to potential transmission events.
Why are parents and teachers so concerned? Denmark reopened schools on 4/15. COVID-19 cases were 150/100K; new cases were 3/100K. Hillsborough County is reopening schools when current (7/20) Covid cases are > 10Xs that prevalence at 1650/100K; new cases 15Xs higher (46/100K) & projected to 2270/100K on school day 1 (8/24).
Given the current prevalence (proportion of disease in the community), the risk of an event with only 10 people present of having one other person present with a positive status is 48%. The risk at a 500 person to be exposed to virus is 99%.
There are certainly no easy answers and everyone - teachers, parents, students, district staff - would like for it to be safe to go back to school.
The American Academy of Pediatrics is right that school environments provide structure, stability, nutrition and safety for many of our community’s most vulnerable families. Public schools strive for equity across socioeconomic status and futures for children that would not otherwise be obtainable. In addition, allowing children to participate in peer social structures and having non-parent mentors and daily contact with caring adults outside of the household benefits childhood development. Parents working as members of a service economy (or those that have recognized that for them and their kids, home eLearning is not working) have been forced into making choices that work best economically but not necessarily for the safety of their children.
Structural and psychological development concerns can be separated (and are not necessarily solved) from hastily reopening schools. Underlying structural causes of poverty and differential childhood opportunities can be addressed even during the pandemic. Can the needs for childcare, nutrition, and mental wellness be addressed outside of a return to school while prevalence and incidence are both so high?
Feeding Tampa Bay and other community groups have ensured food delivery. Could other groups ensure appropriate wellness activities in other life domains as well for students that are eLearning? Will eLearning reproduce inequalities in our society where those who can eLearn do and those who have parents who cannot eLearn because of types of work, simply do not (potentially differentially placing some students and parents at higher risk for virus transmission than others, increasing health disparities). The Florida American Academy of Pediatrics President issued a letter last week confirming an adherence to science and emphasizing that while the structural and health issues raised by the American Academy of Pediatrics are indeed important, that does not mean that local school districts should be forced to reopen at a time that may be unsafe for students and teachers.
A new study from South Korea demonstrates that viral spread amongst middle school and high school children may be higher than originally thought even though we, fortunately, have not seen high volumes of sick kids even in the face of high prevalence of asymptomatic positive tests in children. Recent tests in pediatric patients have resulted in positivity rates over 30% potentially serving as a pool of intergenerational spread (although that appears to be less common from kid to parent, fortunately). Finally, viruses can have non-obvious effects outside of the acute stage. What are the downstream impacts of this virus on kids who become infected? Will there be unseen issues 10 years, 20 years, 40 years later? We simply do not know very much about this virus and are constantly learning new information. While having thousands of positive cases allows us to quickly learn, there are human subjects participation in place for a reason against this type of experimentation.
Kayleigh McEnany, the Press Secretary for the Trump Administration, has stated that 'science should not stand in the way' of schools reopening. Given the current trajectory, science may stand no chance.