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Should we go back to school during COVID-19?

As educators, we are constantly told to make data based decisions. The call to open schools as the number of cases continue to increase defies data and logic. When teachers are required to make everything we do data based, it’s reasonable to expect that those who lead us also make data-based decisions.The United States on the whole is not ready to open up schools to in person learning. Here’s a breakdown of why, considering COVID-19 by the numbers in schools.

Children and Teens Have Risk Factor Conditions

Calls for students to return to school include phrasing about how kids who don’t have pre-existing conditions aren’t at much risk from COVID. That’s perhaps reassuring for many families, but we need to think and plan for kids who DO have pre-existing conditions. Failure to take them into consideration in the planning stages is discrimination. As a special education teacher, I’ve worked with kids for whom COVID-19 could absolutely prove fatal. There are numerous diseases that may cause more severe COVID-19. Here are just a few of those diseases along with estimates of how many kids are impacted by them.

Many Kids Have Conditions that Increase Their Risk

  • Asthma (1 in 12 children) Source
  • Obesity (18.5%) Source 
  • Type 1 Diabetes (1 in 400) Source 
  • Type 2 Diabetes (3,700 new cases per year in kids) Source 
  • Sickle Cell Disease (about 1 in 500 in Blacks and 1 in 1,000-1,400 in Hispanics) Source 
  • Kidney Failure and End-Stage Kidney Disease (9,800 kids) Source 
  • Cystic Fibrosis (30,000 children and adults with an average life expectancy of 37 years) Source 1 and Source 2
  • Cerebral Palsy (about 500,000 kids) Source 
  • Down Syndrome (about 1 in 1,000 kids) Source 
  • Cancer (about 15,780 kids) Source 
  • Chronic Heart Disease (“As common as autism”) Source 
  • Pregnancy (18.8 births per 1,000 teen girls) Source 
  • Autism (1.6% of 8 year olds, may increase risk) Source 

Making Grim Predictions

When we teach reading, we ask students to make predictions. We build this skill in children with reading and math so they can make informed predictions when they are adults. Let’s use our prediction skills along with our data interpretation skills to get a better idea of what we are facing if schools completely open. This prediction is based on all schools opening up back to all students. I know many schools are giving virtual options, which is wonderful to help control the spread of this disease.

Known Facts

  • In normal circumstances, about 56,000,000 kids go to public and private school in the US.
  • In normal circumstances, there are about 3,700,000 teachers in the US.

Emerging Data For Children

  • The best information I could find indicates a 0.69% fatality rate in children who contract the virus.
  • This number may change as more children come out of at home social distancing and more data becomes available.

Emerging Data for Adults

We don’t know the true infection rate, so all these numbers in my chart are somewhat speculative. However they are based on available data. Case Fatality Rate is not a great number for understanding pandemics. The preferred measure is the infection fatality rate, but that number is not yet available. It’s estimated currently to be between 0.6% and 1%.

How Many People Might Contract COVID-19

There are different estimates of what percentage of the population will contract COVID-19 eventually, without a vaccine. I’ve seen the number estimated to be between 56 to 81%of the population.

  • Low Estimate: 56% of the population
  • High Estimate: 81% of the population

In my graphs, I have highlighted in yellow the data ranges I think are most likely based on current data and estimates from scientists. Based on currently available data, I think the most likely infection fatality rate (IFR) will be between 0.6%-1% for adults. Without a vaccine in place, I am using a range of 55%-80% to correspond with the estimates of 56% to 81% of the population contracting the virus. I’ve highlighted in red the worst case, which also isn’t likely. In green, I’ve highlighted the best case scenario which is also pretty unlikely. I included a full range of numbers to offer comparison and allow us to imagine various scenarios more easily. Unfortunately, we must use new data because the virus is so new, but that also means it isn’t yet reliable. That means our leaders should be considering ranges of outcomes.

Graphs to Examine the Key Question: Should we go back to school during COVID-19

  • * The 0.09% figure is from the CDC saying that the rate in children is “less than 0.1%.” I have not found data on a more specific number.
  • ** The .01% figure is an arbitrary number I choose for a low point of comparison.

 

Analysis

Best Case Scenario

In the unlikely best case scenario, my analysis predicts that 280 children will die and 1,110 teachers will die. During the 2019-2020 flu season, for comparison, 185 children died of flu. Even in the best case I can predict with only 5% of students contracting COVID and a low fatality rate of .01%, we are likely to experience more deaths in children than in a regular flu season.

Worst Case Scenario

Before you read the worst case, remember that this is very, very, very unlikely. These numbers assume every single teacher and student will contract the virus and that the fatalities are at the highest rate I could find. In this doom and gloom scenario, 386,400 students and 266,400 teachers die. Yikes, but remember, it’s not likely (just as the best case isn’t all that likely either).

More Likely Range

For students, I think the likely range of fatalities if we open schools completely in person is likely to be between 25,200-40,000 students. For teachers, I think the range of fatalities if we open schools is likely to be between 12,210 and 29,600 teachers. This is assuming an 0.6%-1% fatality rate for adults who contract COVID-19. It also assumes that 55% to 80% of teachers will contract the virus. These numbers are total. They aren’t over a specific school year, and they assume a complete opening of the schools.

Consider these numbers. Should we go back to school during COVID-19 if 280 kids and 1,110 teachers will die? Even under the best scenario, that’s so many lives gone.

Children and Teachers Aren’t the Only Ones in Schools

When children return to school, adults have to be on campus too, and not just teachers. Think about who children will be directly or indirectly exposed to at school.

  • Cafeteria staff
  • Custodial Staff
  • Nurses
  • Nursing Aids
  • Paraprofessionals
  • Secretaries
  • Bus drivers
  • Principals / Vice Principals
  • Counselors
  • Speech Pathologists
  • Specialists
  • School Psychologists
  • Physical Therapists
  • Occupational Therapists

My predictions don’t take any of these professions into account. Many of these professionals work in close physical proximity to students or to potentially infected surfaces. They will be impacted and will experience fatalities as well. We can’t leave them out of planning. They are not invincible, and they should not be invisible either. Should we go back to school during COVID-19 without thinking of how these professionals will be impacted?

Other Illnesses

When schools open back up, schools won’t be dealing with one illness. Kids and staff get colds, strep, flu, and stomach bugs. All of which share symptoms with COVID-19. The novel coronavirus is going to change how we respond to those illnesses too because of the necessity of protection. That response is going to be disruptive to learning.

More Questions than Answers

  • Are kids and teachers going to be kept home for 2 weeks if they have these symptoms?
  • Will everyone have to get a safe to return note for every illness?
  • Who’s paying for those visits?
  • What happens when a family doesn’t have insurance to go to the doctor?
  • If an elementary kid gets two colds a semester, does that mean they will have to miss 8 weeks of school?
  • How will parents navigate sudden weeks-long disruptions to their work schedules?
  • Who is going to substitute for low pay and high risk for sick teachers?
  • When subs aren’t available, how are teachers going to combine classes and maintain social distancing?
  • Are teachers going to get extra sick days to accommodate staying home if showing any symptoms? We know teachers often come to work sick because of lack of subs, etc.
  • What happens if the school nurse gets sick and is out for a long period of time?
  • How many cases in a school will cause the school to shut down? And for how long?
  • How are schools protecting the 24% of teachers who are higher risk with COVID?

Things We Don’t Know About COVID-19

COVID-19 hasn’t been around long enough to know the long term impacts. There are many possibilities without answers.. We do know that fatalities aren’t the only issue with COVID-19. Many patients experience long-term health problems as a result of COVID-19.

  • Will the virus cause birth defects (like Zika, rubella, CMV, and others can)?
  • Does the virus lay dormant and cause other problems (like Chicken Pox can cause Shingles many years later)?
  • Will the virus cause cancer (like HPV, Hepatitis  B, Epstein-Barr and other viruses do)?
  • Does the virus trigger auto-immune disorders (like measles, mumps, and rubella can)?
  • Will the virus reduce fertility (like flu and mumps can do, even temporarily)?
  • How long will lasting effects of COVID-19 take to resolve? Or are they permanent?

Things We Do Know About COVID-19

  • If our hospital system becomes overwhelmed, death rates will increase due to lack of care availability.
  • Masks help reduce spread.
  • Staying home helps even more.
  • Research is suggesting that immunity could be gone in months following infection. Multiple infections are looking possible.
  • Asymptomatic people can transmit the virus meaning once we know someone is infected, it’s already too late.

Things We Know About Kids

Kids need structure and routine. A school year interrupted by multiple quarantine periods is the opposite of structure and routine. While no situation is going to be great for parents, especially for parents in more difficult financial situations, scrambling to make last minute plans could be more of a detriment to the family than having the ability to plan for distance learning consistently. Kids, parents, and teachers will be spared the anxiety of wondering if and when their school will be shut down. They will be spared the constant anxiety of exposure to the virus.

Kids are germy. They lick weird stuff. They don’t always follow directions the first time. Then they test boundaries and limits. Young children don’t yet understand the finality of death and thus can’t comprehend the seriousness of the situation. They will not fully grasp the why of hand washing, mask wearing, and not playing with their friends. We can’t expect kids to be good at following life saving measures. Our youngest students start in PPCD at the age of  three. In my opinion, we are asking kids to take on developmentally inappropriate responsibilities.

Based on these numbers, many students will go through the loss of a teacher or peer. It will be traumatic for kids (not to mention the adults). Schools are already preparing form letters for such events. We shouldn’t be going back if a form letter like that is necessary.

So, Should We Go Back to School During COVID-19?

I’m not a doctor or an epidemiologist. That said, teachers are asked to make important decisions, even decisions on life and death matters for kids regularly. We use data to inform everything we do. Teachers and students aren’t just numbers. They aren’t expendable. It’s critical that leaders who control the opening of school be expected to use data and compassion to inform their decisions.

I’ve seen teachers online asking about making wills, and I’ve seen reports of HR departments offering training. I’ve had teacher friends describe their feelings like they have been drafted for war. Other teacher friends are looking to take a leave of absence to protect their health and that of their families.

Should we go back to school during COVID-19? Our country is in a long term emergency situation. There are no good options. So let’s pick a bad option where less people die.

 

 

PS. If you’re lucky enough to get to do distance learning, here are some Chrome Extensions to recommend for your families.