Back to School Special!

Several of you have asked me about the safety and wisdom of sending your kids back to school – all the way from daycare up to college. I wish I had the answers, but I can offer you some ways to think about it. Like most things in life this involves the calculation of risk and reward. What are the risks of going to school and what are the risks of not going to school? What are the rewards of going to school and what are the rewards of not going to school?

 Here are some of the factors to consider:

1.  Is your child completely healthy and not at any increased risk of major illness from Covid-19? Illnesses such as asthma or compromise of the immune system would add to the risk.
2.  Are the other members of your immediate family at any increased risk of major illness from Covid-19? Since there will be some risk of your child bringing the virus home, how bad would it be for your family? Does anyone have a major illness such as diabetes, heart failure, kidney disease, emphysema or even significant obesity which is a very real risk factor.
3.  There are clearly different considerations for a kid going to daycare or school and coming home every day versus an older child going off to college and not coming home until perhaps Thanksgiving.
4.  Some states are mandating that children wear masks in school. I am very skeptical that this will work. Teachers are busy on a good day and will not and should not turn themselves into the “mask police”. Children, especially elementary school age and younger, will not be likely able to comply with this. I’m not sure older children will be able to comply either.
5.  Teachers will be understandably reluctant to subject themselves to potential Covid-19 virus every day. It will be interesting to see how public school, private school and college teachers will respond and adapt.
6.  School nurses will be totally overwhelmed unless school systems add healthcare providers. I hope schools and colleges are already planning to do this.
7.  “Social distancing” may be no more than an aspirational challenge for younger children at school. I would say it is close to impossible to expect elementary age school children and younger to stay away from each other. I think it will remain challenging to achieve social distancing for older children and college age kids as well.
8.  Will schools have adequate masks, cleaning supplies and staff to wipe down surfaces every day? This may turn out to be less important ultimately as most transmission occurs via aerosolized droplets that are exhaled by the infected person and inhaled by the next person nearby.
9.  Checking temperatures seems like a lost cause. It is too cumbersome and is not likely to happen on a regular basis. Also, because people are often infected and transmitting virus before they develop any symptoms or a fever, this strategy is of minimal utility.
10.  Students with disabilities or on an Individual Education Program (IEP) may need extra attention to make certain they are staying as safe as possible.
11.  Your child’s risk of getting the virus will be in large part proportional to the prevalence of Covid-19 in your own county and town or the location of your child’s college. The new updated map put out by Harvard Global Health Institute at --  new interactive map and dashboard -- could help you understand the real-time risk. I would suggest keeping an eye on the trends of cases in your town. Many towns have a website with updated data.
12.  I am entirely sympathetic to the argument that children need to go to school for both the learning and the socialization with peers, friends and teachers. Other than the small minority of parents who can successfully home school their children, most children benefit from school. There is a definite downside to missing school for progressively long periods. I think the jury is still out as to the efficacy of distance learning for children via Zoom. I suspect it is more successful as children get older. The American Academy of Pediatrics is supporting the physical return to school.
13.  Food insecurity is a real issue for many children, and physical access to school can help ensure that these children are served breakfast and lunch.
14.  What about the school bus? The risk of transmission will be much higher on a bus with closed windows and poor airflow.
15.  What about the classrooms? Again, the risk will be higher if the windows are all shut and airflow is poor. It is possible that some schools and colleges can have more open windows at least until the weather gets cold in our climates that have cold winters.
16.  Behavioral health issues will likely be more prevalent and prominent in the Fall given all the stress children and their families are under. Hopefully, schools and colleges will be able to enhance their counseling services.

I realize this short piece may have raised more questions than provided answers. Hopefully, I have at least given you some better ideas as to how to even go about thinking about this problem.

With all best wishes for a safe July 4th Holiday—