Schools must be careful in reopening
The Lake Oswego Review published the article, "Rallying For Kids," October 7, where parents are pushing for county students to return to school. Currently, Clackamas County has 2,755 Covid-19 cases and 65 deaths. Reopening K-12 schools in-person during a pandemic can have dire consequences, as Israel found. Denmark's in-person education has been a successful model. Combining Denmark's strategy with the science of Covid-19 can help determine whether to choose online instruction or implement in-person schooling as a bridge until the risk of infection is reduced.
The problem is about 9.3% of Covid-19 cases are among children under age 18. Although many don't have symptoms, asymptomatic carriers are drivers of disease transmission. Among those children hospitalized, one-third require ICU care.
The outcomes of educational and social benefits should be weighed when considering in-person schooling. In-person and online K-12 education have comparable features; reading, writing, math, experiments, homework and testing. Teachers can talk to each student individually. A benefit of in-person learning involves advancing a student's social development. Still, it comes with peer pressure that can undermine academic achievement.
Covid-19 has high person-to-person transmission, remaining airborne for up to 14 minutes indoors. Coronavirus may spread as an aerosol in HVAC systems. While cloth masks mainly reduce transmission from the wearer to others, N95, surgical, or similar facemasks help protect the wearer from the virus. Adding a face shield further reduces transmission. Physical distancing, HEPA filters and frequent cleaning of high-touch surfaces with disinfectants can minimize spread.
In April, Denmark became the first European school system to reopen in-person. Because communities differ in disease prevalence and transmission rates (Rt), this should guide reopening in-person or online. Based on Covid-19 science and Denmark's success, we recommend the following guidelines.
High-risk children or children of high-risk family members should be educated online. All personnel within a school require Covid-19 testing before in-person education. Weekly Covid-19 testing should occur when school begins. Friday testing allows for result delays. Parents are not permitted in school, dropping off children at designated times. Initially, all children should wear masks, with teachers wearing surgical or N95 respirators and face shields. Students sit at least 6½ feet apart in classes of about 12 students. Disinfect high touch surfaces twice daily, and install an HVAC HEPA or portable HEPA filtering system. Each class should have a designated playground area.
A positive Covid-19 test closes in-person instruction. Infected students stay home, along with other household members. Students and teachers must have two negative tests 3-4 days apart before resuming classroom instruction. All contacts are isolated until a negative test. After school, children should only engage in activities with their classroom students.
Schools should spread knowledge and a healthy future for our children, not disease.
Linn Goldberg, M.D., is a professor emeritus at Oregon Health and Science University. He has been an Expert Panelist for the U.S. Department of Education, and implemented award winning school-based health promotion programs in schools throughout the United States.
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