I am sick of COVID, too! But it’s not done with us, so keep on masking up and spacing out. Avoid hanging out in groups, despite how badly we all want to. And for the gals, get super comfy in an OOMBRA.

About a month ago, I suddenly found myself a convert to the burgeoning movement to open schools. The people close to me reacted as if I had lost my mind. But the data is increasingly clear: because grade schools follow coronavirus safety protocols better than almost any other institution, cases don’t spread on these campuses. This is true across the globe, and as a result, all over Europe, schools are open while everything else shuts down.
 
This ideological shift was nothing short of radical for me. Back in the spring, like every other pediatrician I knew, I was an active voice for shutting down schools for safety’s sake. No sooner did that happen – basically in one giant fell swoop across the country during the second and third weeks in March – all of us pediatricians volunteered to help our kids’ schools figure out future reopen plans. It’s not that we didn’t want our kids back on campus, but how was it possible to protect them – not to mention the higher-risk teachers, administrators, and staff – from COVID? Lists emerged chronicling the dozens of mitigations that would need to be put into place before even considering reopening: mandatory masking, distancing, ventilation upgrades, de-densifying, and on and on.
 
By now, we all know that the initial relief of remaining ensconced in our home bubbles has been offset by a laundry list of hardships, everything from isolation-associated depression to the undereducation (or in many cases, non-education) of millions of kids across the country. Back in the spring, there existed a large group of underserved, overly vulnerable Americans who suffered immensely, largely in proportion to their socioeconomic status; today, it feels fair to say there’s no one who isn’t suffering, it’s only the arenas and degrees of intensity that vary.
 
And so I am going to take a moment in this newsletter to preach the case for school reopening, fully recognizing the insanity of the timing given that our country’s average new case load is well north of 100,000 per day. Yes, most of my own state of California is planning an overnight curfew beginning tonight in an attempt to curb the spread of disease. (I know, the whole curfew thing seems an odd strategy – there’s more on whether it really works here.) And yes, we are heading into a holiday season with every public health guru and agency pleading with people to stay put, even though 50 million Americans plan to travel for Thanksgiving and many more are going to gather around a table, mixing germ pools and driving numbers upward. But still, I am going to make the case for opening schools.
 
  • In case you don’t feel like reading the rest of the bulleted list below, chew on this: in cities where schools are closed, you can still work out at the gym, treat yourself to a mani/pedi, grab a drink in a bar, eat out at a restaurant – maybe even all in one day if you’re up for it. Yes, restrictions have begun to tighten everywhere, but no state in the US is willing to prioritize school over business. How are we debating whether restaurants should operate at 50% capacity or close at 10pm when tens of millions of kids are denied any version of normal academic, social, or emotional experiences? This is bananas!
  • In Europe, cases are rising but schools are open. The upshot? Data shows that schools are not super-spreaders. In fact, they aren’t even really spreaders. Closing most everything else and opening schools works.
  • Why? Because schools follow the rules. These rules, of course, have varied widely by county and state. But in order to open, they didn’t just list what needed to be done – they did it. And they enforce compliance. Masks. Distancing. Hand washing. You all know the drill… schools live it.
  • In the US, we chose to close schools quickly, and many cities have been terrified to reopen them. But not all, which has led to a completely fractured approach across the country.
  • The discoordination has been made worse by competitive sports. Some schools offer sports conditioning that meets COVID safety standards (this is safe); others have ignored pandemic concerns and proceeded with interscholastic play (this is not). It is clear that certain sports shouldn’t be played, such as indoor basketball. But like reopening rules, school sports policies are all over the map (literally), and the foreseeable spread of illness only drives the more risk-averse school districts to withhold opening even further.
  • Allow me one aside that isn’t directly connected with schools but certainly impacts them: club sports. Many club sports teams travel out of state in order to compete. Kids working their tails off to rise through the ranks of club sports now face a cruel paradox: if they do the right thing and decline the request, they get punished with less future play; but if they travel with their teams in order to remain in good graces, they become part of the problem of surging COVID spread… which ultimately will shut down more schools.
  • Teachers and teacher’s unions are driving some of the school closures. Initially, it came from a very reasonable place – all of us thought keeping kids and adults on campus in a school swarm would result in catastrophe. That’s why every doctor I knew backed closing schools at first: to protect the adults who work there. But the data seems very clear now that kids, especially younger ones, don’t present risk to adult educators, In fact, the most common way coronavirus spreads in a school is now thought to be from teacher to teacher, a by-product of the teachers’ choices off campus, not what’s happening at school (Why? Because safety mitigations work!)
  • Finally, there’s the social media elephant in the room: all those pictures of kids gathering at parties, unmasked, swapping coronavirus. Teenagers’ immature brains find it hard to make smart, consequential decisions – this explains the choice to attend parties, toss masks aside, and then post pictures of all of it. While I am deeply annoyed by these kids (okay, some days I am downright pissed), I have a growing soft spot for them because, over the past eight months, they’ve watched our society prioritize normalization for their parents over them. At a certain point, when it’s easier to work out at a gym, shop at the mall, or join a big card game than it is to get an education, who doesn’t start to sympathize with them? That said, kids you all need to knock it off if you want to get back onto campus.
 
Closing schools is not a victimless crime. It’s a choice, and one that some scientists predict will result in years of life lost down the road. That’s right: closing schools is more likely to result in loss of life than keeping them open, especially with safety measures in place. So, while the promised winter surge arrives and we ratchet down in all other respects, it is high time we prioritize getting our kids back into school ASAP. By the way, if you want to read similar ideas from really smart, thoughtful people, look at this by Aaron Carroll or this piece in Now This or check out Emily Oster’s website where she has collected data from schools in the US that have reopened to prove why more should follow suit.
 
The return to school debate will rage on. Hopefully, scientific breakthroughs will help get kids on campus much faster. Like this rapid test coming to a home near you. Or one of the vaccines in development – this week, two posted amazing results. Turns out we have Dolly Parton to thank for the Moderna vaccine, and a lot of people on social media to thank for the riff on Jolene… Vaciiiine. Feels like the perfect place to end this week.
 
I needed something beautiful today instead of a meme. Found it.