July 12, 2020 Liz Borkowski, MPH 0Comment

Shutting down schools to limit the spread of the novel coronavirus has taken an enormous toll on children’s development and parents’ ability to work. It was a necessary but costly measure that helped us “flatten the curve” and prevent widespread overwhelm of hospitals during what would have ordinarily been the end of the academic year.

As we approach what would ordinarily be the start of a new school year, school districts face difficult decisions in an environment that’s much worse than it should have been. If the nation as a whole had been able to control the spread of COVID-19 and the federal government had provided extensive guidance and support, schools could conceivably have felt that they could reopen in ways that would minimize risks to staff and students. That’s not the situation we’re in right now.

Without strong, consistent, science-based federal leadership, we’re seeing rising COVID-19 case numbers and hospitalizations in several states. As of July 10, the Harvard Global Health Institute’s COVID Risk Levels Dashboard showed 17 cases per 100,000 people (the 7-day moving average), with state numbers ranging from 1 case per 100K people in Maine and Vermont to 44 in Florida and 49 in Arizona. The shortages of personal protective equipment that were never sufficiently addressed are in the news again, and workers can’t rely on the government to safeguard their health. Public schools, which even in pre-pandemic times didn’t get adequate funding, are facing financial crises. It’s no wonder that teachers are “fearful and angry” at the prospect of being sent back to schools when the virus is spreading rapidly and schools lack the necessary resources.

Given this dismal situation, the Trump administration could have decided to prioritize science and exercise stronger, evidence-based leadership. Instead, President Trump and Vice President Pence doubled down on denial of just how severe the situation is, and pushed for schools to reopen regardless of conditions.

White House displeasure with CDC advice

Back in May, after a White House-imposed delay, CDC released a detailed “Considerations for Schools” document and an accompanying K-12 Schools Readiness and Planning Tool. The Considerations document states in the opening paragraph, “Implementation should be guided by what is feasible, practical, acceptable, and tailored to the needs of each community. … These considerations are meant to supplement—not replace—any state, local, territorial, or tribal health and safety laws, rules, and regulations with which schools must comply.” It then moves on to Guiding Principles, which note that virtual-only classes are the lowest risk; small in-person classes and activities involve more risk; and full-sized, in-person classes and activities without spacing are the highest risk.

The four following sections – Promoting Behaviors that Reduce Spread, Maintaining Healthy Environments, Maintaining Healthy Operations, and Preparing for When Someone Gets Sick – offer bulleted lists of recommendations, including actions like teaching proper handwashing, spacing seating/desks six feet apart, and “Add physical barriers, such as plastic flexible screens, between bathroom sinks especially when they cannot be at least 6 feet apart.” Some will require major changes to the way most schools operate – e.g., “Have children bring their own meals as feasible, or serve individually plated meals in classrooms instead of in a communal dining hall or cafeteria” and “Stagger arrival and drop-off times or locations by cohort or put in place other protocols to limit contact between cohorts and direct contact with parents as much as possible.”

Following this guidance would take a lot of resources, which would need to come from the federal government. Senate Majority Leader Mitch McConnell has refused to hold a vote on the HEROES Act, which contains $90 billion for schools and has passed the House of Representatives, and has not proposed any alternative legislation that would take meaningful steps toward meeting schools’ needs. The Trump administration, rather than offering resources or encouraging Congress to appropriate funds, responded instead by suggesting CDC should base its guidance on what the president wants, rather than what evidence and experts indicate is needed.

On July 8, President Trump tweeted: “I disagree with @CDCgov on their very tough & expensive guidelines for opening schools. While they want them open, they are asking schools to do very impractical things. I will be meeting with them!!!”

At a White House coronavirus task force briefing later that day, Vice President Pence told reporters, “The president said today we just don’t want the guidance to be too tough. And that’s the reason next week the CDC is going to be issuing a new set of tools.”

Many of us were alarmed by the initial response from CDC Director Robert Redfield, who stressed that the guidelines were not requirements and said, “It would be personally very disappointing to me, and I know my agency, if we saw that individuals were using these guidelines as a rationale for not reopening our schools.” The next day, though, Redfield told ABC’s George Stephanopoulos that CDC would not be revising its guidance to schools and that the new forthcoming material was “not a revision of the guidelines, it’s just to provide additional information to help the schools be able to use the guidance that we put forward.”

I hope Dr. Redfield will remain committed to science and support hardworking CDC employees, rather than giving in to pressure to weaken evidence-based guidance for schools. The Trump administration seems determined to deny the severity of the COVID-19 pandemic and the extent to which the US response has fallen short, which suggests they’re more interested in poll numbers than people’s lives. It’s now up to others to demonstrate the judgement, responsibility, and respect for science that our president has failed to exercise.

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