As the U.S. suffers surges in COVID-19 cases in states that have begun reopening their economies, it's fanned the flames of a growing debate: how schools should proceed with instruction in the fall?
Groups such as the American Academy of Pediatrics (AAP) have thrown their support behind the importance of reopening schools for the health of children while also urging caution. Other public health officials have raised alarm about the risks opening schools could pose in some communities.
The debate reached a new level of concern this week after President Donald Trump said he would pressure schools into reopening full-time for in-person instruction and indicated he might push the Centers for Disease Control and Prevention to revise its guidelines for reopening schools. On Thursday, CDC Director Robert Redfield, M.D., said that the CDC would not be revising the guidelines.
Speaking Thursday during a virtual event hosted by The Hill newspaper, Redfield said he believes keeping schools closed is a greater public health threat to children than having schools reopen.
"I am a grandfather of 11 children, nine of them are in school, I am committed to do this and to work with local jurisdictions to do this safely," he said.
Redfield said there is nothing in the CDC guidelines for reopening schools that should be considered cost-prohibitive.
'It's disappointing to me if the guidance was used as a rationale of the need to keep schools closed. That’s not it’s intent," he said.
So what should physicians be instructing their patients?
This week, President Sally Goza, M.D., told NPR that states shouldn't force schools to reopen in the fall in places where the virus is surging.
"We will be sticking to what our guidelines say—that if it does not look safe in your community to open schools, that we need to really have that looked at," Goza told Morning Edition host David Greene. "We also need to make sure that schools have the needed resources to reopen safely so that a lack of funding is not a reason to keep students home, which we're hearing in a lot of communities—to do what we're asking people to do to make schools safe is not really financially feasible in some of these communities.
Goza also sent a letter to members clarifying the organization's position this week.
"It’s unfortunate that our guidance is being politicized by some and misinterpreted to mean a universal return to school no matter what. That is not what we recommend," Goza said. "When public health expertise is reframed to fit political interests, it harms those who have the most at stake and least opportunity to advocate for themselves: children."
That being said, Goza stood by the AAP's first priority to advocate for students to be physically present in school when possible.
In the letter, Goza said pediatricians know children benefit from the emotional and social skills they gain at school, as well as healthy meals and exercise and mental health support that can't be provided in the same way through online learning. The pandemic has been disproportionately hurting families who rely on school lunches or have limited access to the internet. Further, she said, children do not seem to be as severely impacted by COVID-19 as other respiratory illnesses.
As part of the letter, AAP released updated guidance for pediatricians this week. AAP also released social media tools such as a list offering considerations for safely reopening schools, such as requiring desks be three to six feet apart, the teachers move classrooms rather than students, that outdoor areas are used as much as possible, that masks are worn regularly by staff and older students and that schools maintain flexibility to go virtual again if needed.
For physicians curious about how states around the country are handling reopening, Johns Hopkins University JHU eSchool+ Initiative also released a reopening schools resource, including a new education tracker on Thursday.
The COVID tracker examines state plans across multiple categories such as before and after school programs, building access and student transportation, as well as parent and employee choice, impact on children with special needs, or of poverty and transparency.