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.
Twitter: @IrwinRedlenerMD
With all due respect, the vaccines for children have not been properly tested – the Pfizer clinical trial was a joke with a tiny sample size. Most pediatricians and research scientists that I have consulted told me not to vaccinate my five year old and wait until long-term and short-term side effects of Covid-19 vaccines on kids are revealed. All the adults in my family have been vaccinated and this is the first vaccine for kids that I am hesitant about. Had the FDA given full approval rather than emergency authorization, I would have been more inclined to inoculate my child.
Amazing to see that the Russian disinfo operation would extend all the way to a modest neighborhood blog. “Mike Peccavi”–sure.
In the meantime, it’s a pleasant change to read a column from someone who recognizes that the school opening issue is not straightforward and that different groups of parents and kids may have competing needs.
Not sure why the WSR is publishing comments spreading misinformation, but the vaccine has been extensively tested and given to MILLIONS of kids ages 5-12 without problems. Also, EVERY pediatrician I know does recommend vaccinating kids as soon as possible, especially with Covid hospitalization rates for kids rising.
WSR felt it was important for any misinformation to be revealed and rebutted, by other commenters or Dr. Redlener.
I’m curious how many parents are keeping their kids out of cars and swimming pools. Because if you “follow the science”, (and of course heaven forbid) kids are more likely to die in cars and swimming pools then they are from Covid. Yet, parents are still driving their kids around and throwing them into the pool, which of course they should. We’re also learning that cloth masks are ineffective. Ok, if that’s the case, and these kids have been wearing cloth masks and haven’t gotten Covid, then take them off! That’s science too. It’s math folks, do the math and we can get back to “normal”, whatever that is anymore.
If cloth masks are not very effective against Omicron, your answer is to not wear masks at all? If cloth masks aren’t cutting it for students, the answer is not to abandon masks but to provide students (and staff) with masks that ARE effective. All students and staff should be issued, and required to wear, KN95 or N95 masks.
Importantly, the issue is not just the effect on individual kids, but the community as a whole. Leviticus says “love the neighbor as thyself.” So other people’s kids and their families are as important as our own. A child who drowns in a swimming pool does not risk the likes of others, other than maybe those who choose for themselves to jump in and save the child. But students infect other students, who in turn infect their families. Now we have the possibility of a student, who may have little to no symptoms, who passes the virus to someone who then dies because of it. We must look beyond just our own lite bubbles and pushing the false information that Covid is just like a cold. Almost a million Americans have died of Covid in less than two years.
At this point in time the very vast majority of deaths from Covid are in unvaccinated people. Children are not causing the deaths of vaccinated people because vaccinated people are not dying. Rather, children are being irreparably harmed by school closures and other restrictions on their lives. It is time to prioritize the mental and physical well being of children.
My hope is that after we give children their third or fourth booster shot sometime this year we can put this all behind us.
Thank you Dr. Redlener for consistently offering practical advice, including the necessary alerts about “curveballs” to factor into our decision making. Thank you for your appearances on TV, where you reach a much wider audience. You are a voice of reason, an oasis, if you will, in a churning sea of information AND misinformation.