By Dr. Irwin Redlener
From New York City to Los Angeles – and virtually every town and city between – the latest COVID-19 brouhaha has settled on schoolchildren and how to make sure they have the best possible educational experiences while staying healthy as the pandemic rages on.
At the core of the debate are two simple questions: First, whether our children — or in my case, my grandchildren, three of whom attend public schools on the Upper West Side — can continue to learn in person or will they be forced to learn remotely? And, second, can we keep kids in their classrooms and simultaneously ensure that they, their teachers and school staff stay healthy?
I’d like to say yes to both questions. But can I?
Let’s start with the fundamental coronavirus dilemma that has vexed doctors and scientists since before the World Health Organization declared the global outbreaks of SARS-CoV-2 to be a full-fledged pandemic in March of 2020.
We simply do not know enough about the behavior of the elusive COVID-19 virus, including precisely how it mutates and what makes it more or less infectious or deadly or vaccine resistant.
We also don’t fully understand why children originally seemed less susceptible to being infected than adults, or why pediatric COVID-19 admissions now seem to be soaring. Plus, as a pediatrician, I worry about new reports from the CDC that the incidence of diabetes in children is now seen as higher among those who have had COVID-19. (Even more reason to make sure our school-age kids are vaccinated!)
This insufficient understanding of the specific behaviors of SARS-CoV-2 limits our ability to predict where this pandemic is heading. No wonder it’s tough to make stable policy recommendations under such circumstances. And no wonder all of us who have children in the school system can’t help but worry about their immediate and long-term well being.
What else is polluting the discussions about what to do about children’s health and education in the age of COVID? How about raw politics and ideology even to the point of violence at school board meetings in many communities throughout the country? Fortunately, this phenomenon is not something we are seeing in our neighborhoods, nor, knowing New Yorkers, is it something we should expect to see.
We should not forget that we care about all of our city’s children. The fact is, some families have easy access to multiple resources, including high-quality day care, the full internet, and critical electronic equipment needed to learn remotely, if it comes to that. Other parents must work, but have extremely limited access to these resources. Some kids will roll right through a long stretch of remote learning; many others, especially those living in families with extremely limited resources, may fall even farther behind educationally than they were before the pandemic. Such realities must influence decisions about staying in the classroom or not.
Two essential principles:
#1 Children must, to the extent possible, be kept in their classrooms, learning in person.
#2 Everything possible must be done to ensure that children, teachers and staff in schools remain healthy.
To make this happen, here are some essential guidelines, many of which NYC has been leading the nation in implementing.
- Every teacher, adult school staff member and eligible child must be fully vaccinated to enter any school building.
- Regular testing is not an acceptable alternative to mandatory vaccinations (plus we are dealing with a significant shortage of tests across the country.)
- No religious exemptions should be allowed. There are, however, medical exemptions which must be formally reviewed.
- So-called, NPIs – non pharmaceutical interventions – like masking, distancing, eliminating contact sports, and so on may be instituted when deemed appropriate by high levels of Covid-19 in the community or other factors. Such efforts must be approved by local health departments.
- Other strategies, including the CDC recommended “test and stay” policy should be implemented to keep classrooms and schools from shutting down. This means if an asymptomatic child is exposed to someone who tests positive, but the child tests negative, they stay in school.
Here’s what else:
- There should be a working tablet or laptop available for every child that must stay home, with teachers assigned to help these kids deal with technical challenges.
- Every school needs planned strategies to deal with large numbers of teacher absences.
Dr. Redlener is founding director of the Center for Disaster Preparedness at Columbia; professor of pediatrics at Albert Einstein College of Medicine; cofounder of the Children’s Health Fund; MSNBC public health analyst; and Upper West Sider. Let him know in the comments what you think, and what you’d like him to address in next Tuesday’s column. Opinions are Dr. Redlener’s, not endorsed by the Rag.