By Dr. Fawzia Mai Tung
As schools across the nation move gradually into reopening, administrators and teachers may wonder whether they have done everything they could have to do so safely. We can take a brief look at what other countries have done and what lessons we can draw from them.
What has transpired from school reopenings around the world?
The first encouraging fact is that countries that reopened schools after reducing their level of infection have not seen surges. The keywords here are “after reducing the level of infection.” The US so far is not anywhere near reducing the level of infection, though some states are doing better than others.
Internationally, open schools are actually the exception rather than the rule. They are open in Norway, France, New Zealand, Nicaragua, Taiwan, and Vietnam, while 143 countries have closed schools nationwide.
Staggering the reopening, with the youngest children first, has led to success. The greatest failure occurred in Israel, where all ages returned together, and mask requirements were dropped as temperatures soared. As a result, there were outbreaks and 125 schools, and 258 kindergartens were shut down again since May.
Another successful strategy was to bring back students in shifts or alternate days, as in Belgium. The availability of hand-washing and the cost of daily face masks are factors in a successful reopening.
When a case was detected, some countries closed the entire school again, while others sent students and teachers of an affected classroom into home quarantine for two weeks.
At this point in time, the extent of the role of children and teens in the spread of the coronavirus is not really understood. Yet, a very sobering study from MassGeneral Hospital for Children was published on August 20, 2020, in the Journal of Pediatrics. It concluded that children younger than five with the mild or moderate illness have much higher levels of virus than older children or adults, especially just two days into the infection. This means that although young children are less susceptible to getting ill, they are more likely to spread the virus.
The Covid-19 pandemic is not the first to sweep the globe causing school closures. It happened back during the 1918 Spanish flu pandemic too.
Lessons we learned from school reopening during the 1918 Spanish Flu
1. Invest in school nurses:
School nurses were vital in observing children’s health and educating parents and were specially commended by New York City Health Commissioner Royal
Copeland in 1918. Yet today, only 60% of schools have a full-time nurse and 25% of schools have no nurse at all.
2. Partner with other authorities:
“Planning that brings public health, education officials, and political leaders together” was identified as pivotal to successful responses in schools in 43 cities. In St Louis, political, health, and education leaders cooperated in designing a staggered school reopening with the high school first, resulting in one of the best outcomes in the country.
3. Tie education to other priorities:
Since the 1916 proclamation by the US Bureau of Education that “school is important, but life and health are more important”, school lunch programs, large, airy school buildings, built playgrounds, and outdoor play areas have become a mainstay of US schools. Today, we may need to add to these: ventilation of all indoor space; easy access to hand-washing for all.
What can you do with this information? Be pro-active.
How many students/staff do you expect are infected yet asymptomatic?
Here is how to calculate the level of infection in your state:
- Go to https://covid.cdc.gov/covid-data-tracker/, at the CDC website.
- Click on the tab: Cases per 100,000. The left-hand column will show the number per state. For instance, Arizona is now at 2,727 per 100,000 while Vermont is at 245.
- Divide this number by 1,000 to get the percentage. So Arizona has a 2.7% rate of infection while Vermont has a 0.2% rate.
What is the use of knowing this number?
Use it as a rule of thumb. If your school has 100 students in Arizona, you can assume that two or three of them are infected. You don’t know which two since they are probably asymptomatic.
Now plan accordingly.