Right now, being a school leader is like walking a tightrope over a massive chasm. The rope behind me is anchored by the emerging science of COVID-19 as researchers attempt to understand how the virus impacts kids and the grownups around them. The anchor point ahead of me is defined by the emerging guidance coming down from the Department of Education and the Department of Public Health. And of course there’s this deep, dark chasm below which represents the very real possibility that someone in my school community -- a student, staff, or parent that I know and care about, maybe even me or my kids -- will get COVID-19 this school year.
The key word here is “emerging”. New scientific discoveries are being released at a breakneck pace. Studies sometimes contradict one another. And there’s a thousand unknowns. Actually, make that a million. Similarly, the guidance we are receiving from various state and federal agencies is constantly changing. Weekly. Sometimes daily. “Hey! Can you please NOT move the anchor points while I’m standing on the tightrope trying to walk across. Thank you very much.” And no matter what our school chooses to do or not do -- distance learning, smaller class sizes, temperature checks, masks, physical distancing, cohorting -- there will be a group of unhappy parents who don’t like it and may leave our community.
The rest of this article will look at some of the key scientific discoveries that have caught my attention and how that has impacted my thinking as a school leader and my school’s plans.
First, children get COVID-19 one-third to one-half as often as adults. Why? The answer seems to be related to how the virus enters human cells to infect them. On the surface of cells in our nose, mouth, heart, lungs, kidneys, and intestines is a protein called ACE2. This ACE2 protein is essential to the healthy functioning of our body, but it also serves as the doorway into our cells for COVID-19. Interestingly, a study by Bunyavanich, et al. 2020 showed that there is much less ACE2 in the noses of children ages four to nine (they did not test kids younger than four) than in adults. Ten to seventeen year olds had levels in between those of adults and young children.
This result grounds me. Knowing that the virus has fewer “doorways” to get into kids’ cells gives me a solid explanation for why we are even considering opening schools at all. Is the risk zero? Heck no! Even young kids have ACE2 receptors and can get sick, sometimes very sick, or even die. But if there are fewer “doorways” for COVID-19 in young children, and an intermediate amount in preteens and teens, then we can use this information as school leaders to reopen schools as safely as possible.
Do children spread the disease between each other or give it to the adults around them? The answer is probably not much, especially not kids under ten. An analysis of the first forty COVID pediatric cases in one Swiss town showed that in only 8% of families was the child was the first to contract the virus versus 79% in which an adult got sick first and then transmitted it to the child (Posfay-Barbe et al, 2020). In fact, there was one fascinating case study of a 9 year old in France who had both influenza and COVID-19 at the same time. This child transitioned between 3 different schools and had 80 close contacts. While several contacts got influenza, none got COVID-19 (Danis, et al. 2020). Yet preteens and teens may be a different story. Contact tracing in South Korea found that kids under ten years old transmit COVID-19 to only 5.3% of their close contacts, but 18.6% of the close contacts of preteens and teens eventually test positive, a transmission rate actually higher than that of adults (Park et al. 2020).
Great… now I’m worried again. When I learned about this, I said “Yay! I feel even better about reopening my elementary classrooms, but what about middle school? Yikes.” Of course the last study in South Korea was done when schools were closed and the teens were at home around their parents. I’m left feeling unsettled. Nervous. Not least of which because my son is a middle schooler. A question bubbles up in my brain, “What happened in countries that have already opened schools?”
A wonderful article in Science magazine by Couzin-Frankel, et al. 2020 summarized the data on school reopening around the world. The authors “suggest a combination of keeping student groups small and requiring masks and some social distancing helps keep schools and communities safe, and that younger children rarely spread the virus to one another or bring it home.” That sentiment is echoed by evidence in the United States on emergency case centers. Both in YMCA sites that served over 40,000 kids and in child care centers surveyed by Brown University, there was very little spread of COVID-19. The few cases that were identified were almost entirely in the adults, not the kids. But it appears that how prevalent COVID-19 is within the community matters a lot. This summary by Gutherie, et al, 2020 suggests that in countries with low community spread, schools have reopened successfully with health and safety measures. In countries with moderate community spread, COVID-19 can spread between students, especially in middle and high schools, but staff can remain healthy with the right safety precautions. However, in countries with a lot of community transmission, there have been outbreaks.
Okay. I’m feeling better again. I’m really fortunate to be in rural Northern California where, currently, rates are super low in my county. I’m cautiously optimistic about reopening school in two and a half weeks. My top priority seems to be keeping my staff safe. That’s going to be hard, especially for my kinder and first graders who ask for hugs from me and the teachers in the morning. But at least I get to see them again.
Why is it even worth walking this tightrope? That at least is an easy question to answer. Because reopening schools is the best thing for kids. And yes, I say that even with the certainty that many, many kids across America will get sick when school reopens. The science there is clear (see this UNESCO report). Kids have been out of school since mid-March across most of the country and that is having a devastating impact on their academic, social, and emotional development.
For the parents out there, here are some final thoughts. The decision whether to send your kids to school or not feels really heavy right now and there are so many factors to weigh. My husband and I have had some long, tense, difficult conversations about this. Every choice before us parents brings fear, uncertainty, and questions. Just know that any choice you make in this moment can be changed later as more evidence emerges. Rely on your friends, school, teachers, principal, and community. We’re all struggling and making the best decisions we can in uncertain times. If all else fails, go with your gut, knowing that you can choose differently down the line. Learn the science. Talk to your trusted advisors and school leaders. We can walk this tightrope together.
If you want to read just 1 article about the science of school reopening. THIS ONE published recently in Science magazine is it.
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