The Centers for Disease Control and Prevention (CDC) recently released new safety guidelines for reopening schools during the ongoing coronavirus disease (COVID-19) pandemic.
Lawrence Kleinman, a pediatrician and professor at the Rutgers Robert Wood Johnson Medical School, discussed the guidelines and the potential risks and benefits of reopening schools.
“The first thing to understand is that, in the current world, if there is (COVID-19) being transmitted in your community, it is a balance of risks and benefits because there is no way to congregate completely safely,” he said.
This balance involves weighing the risks of caring for and educating children at home against the risks of COVID-19 infection from attending school, Kleinman said, according to a press release. For instance, a recent CDC study found that 8 of 9 clusters of COVID-19 transmission in Atlanta elementary schools likely involved at least one probable teacher-to-student transmission.
On the other hand, mental illness has risen in children and families due to remaining at home, and children experience negative emotional and behavioral effects from lacking a normal environment where they can socialize with peers, Kleinman said.
While there may be no “one size fits all” approach to this situation given the different risks and benefits involved, he said if students are going to be at school in-person, it is critical that everyone follows the guidelines to ensure their own safety and the safety of others.
The main mitigation strategies for schools to prioritize are the proper use of masks and physical distancing of six feet or more, according to the guidelines. Other steps include frequent handwashing, facilities maintenance and contact tracing.
“The CDC appropriately acknowledges the importance of masking, and I would say double masking is even better than single masking, at least for older kids and adults,” Kleinman said. “The physical distancing is really important and ... I agree with that. I think it should never be less than six feet.”
Though, he said he still has certain concerns, such as students and faculty needing to remove their masks to eat and exposing themselves to COVID-19 in the process.
The guidelines also include a four-section, color-coded system that serves as both a community transmission indicator and a guide for what modes of instruction are recommended based on certain transmission rates.
For instance, blue and yellow sections suggest low to moderate transmission rates, where it is recommended that K-12 schools can open for full-time, in-person instruction, with social distancing guidelines in effect, according to the guidelines.
On the other hand, orange and red sections suggest substantial to high transmission rates, where elementary schools should opt for hybrid instruction, while middle and high schools should implement hybrid or virtual instruction unless mitigation strategies are strictly enforced.
Kleinman stressed the importance of having well-ventilated spaces in order to reduce the concentration of virus particles indoors and to improve air quality.
“You need modern ventilation systems or flow-through air from the outside,” he said. “This, of course, puts at (a) disadvantage lower resource school districts, and this is one of the horrible things about this virus.”
Other aspects of prevention recommended by the CDC include the use of COVID-19 testing and vaccination for students, faculty and their communities whenever supplies are available.
Overall, Kleinman said that infection mitigation is only as strong as its weakest link in that its effectiveness depends on each person’s willingness to apply preventive measures.
He said people need to understand the process of balancing risks and benefits during this time, with state and federal governments also helping schools to develop safe plans that take into account different aspects like space for social distancing and adequate ventilation.
“I think what's happening in the community matters, (and) I think the attitudes of families in communities … in terms of adhering to the guidelines is critical because if the guidelines are there, but they're not followed, then that’s a problem,” Kleinman said.