Yesterday, the CDC came out with their first, comprehensive report of recommendations for opening schools. This came, in tandem, with a 18-page Handbook from the Department of Education entitled “Strategies for Safely Reopening Elementary and Secondary Schools”.
The two documents basically said the same thing:
Our priority should be to open schools in a safe manner. There are several examples showing that this IS, in fact, possible to do
Five key mitigation strategies are essential: masks; physical distancing; hand washing; cleaning and maintaining facilities; and contact tracing.
A decision tree was created so schools can systematically open in a data-driven manner. The CDC operationalized this decision tree using a coloring system that isn’t all that different from Harvards (that came out last summer), which a lot of epidemiologists (and interested school districts) have been using to guide policy.
Opening schools has become quite the debate. On one hand, you have teachers that are advocating for their own health. And they are right to do so.
The vast majority of studies found little-to-no COVID19 spread when schools opened safely (just search my blog with the key word: “children” or “schools”). There is VERY little research or even descriptive case studies on what happens when schools do NOT open safely. I think we all want to believe that school systems (and everyone involved- leadership, teachers, staff, students, and parents) have public health in mind, but this is just not the case. We live in two different worlds. And we need to recognize that.
Somewhat related, we know kids are particularly resilient to this disease. It’s odd for a pandemic, but it’s true in this case. I have yet to see a study, though, that operationalizes the risk of teachers (and people living with teachers when they come home after school) when schools are NOT opened safely. To me, this is a huge gap in research. How can we recommend policy without knowing this risk?
On the other hand, there are many groups (like the American Academy of Pediatrics) who are pushing to open schools. There is not only value in structured learning, but value in children’s health, safety, and long-term outcomes. There is also value for parents, which encompasses quality of life and financial implications. Women, single parents, and disadvantaged families have been partially hit hard by schools being closed.
These two camps have put the CDC in quite the difficult position. So, yes, the CDC came out with new school recommendations. Yes, it’s about time after 11 months (!!). And, yes, they stated the obvious: that it can be done safely. But we, as citizens, need to educate ourselves about what the CDC can and cannot do.
The CDC is a public health, bureaucratic agency with absolutely NO power to enforce. They answer to two groups: the Legislative Branch (for budgets) and the Executive Branch (for leadership appointments). I never realized what this tangibly meant until I went to go work for the WHO in Geneva (who faces similar challenges). The WHO is not an enforcement agency; they work for (and answer to) countries that invite their advice. So, all they can do is recommend. I’ll give you a concrete example. At the WHO, I was working on a project regarding HIV/AIDS medications. I found that Country X was charging their citizens 6 times the amount for pediatric HIV/AIDS medications compared to countries surrounding Country X. After digging in, it was obvious this system was in place so the Ministry of Health could pocket the difference. And we could do NOTHING about it. It was the most frustrating, scientific finding I’ve ever encountered because it wasn’t actionable. And, honestly, this was main reason I decided not to take my career to the WHO or CDC.
So, don’t be angry at the CDC- they’re finally doing their job. Be angry and frustrated at those that polarized public health, ultimately causing two realities where our schools reside. One reality where a pandemic is happening and 470,000 Americans have died. And another reality where a pandemic is a hoax and there is no sense in wearing masks. Harmonizing the realities will ultimately fix the pandemic and make it safe for schools to open in terms for everyone— for teachers, for students, for parents, and for the community at large.
Love, YLE
Also, I’m confused about the five key mitigation strategies. Why does Cleaning make the top 5, but Ventilation doesn’t? So if I have a certain about of money to spend on making my building safe, should I spend that money on deep cleaning instead of ventilation? (Assuming of course that the other 4 mitigation strategies have been met).
Our county has a 3.6% positivity rate and 119 new cases per 100K so we are both in the blue and red transmission categories. How does that data jive together and what does it mean for schools? Note, our state of CO uses a different level for cases per 100k. Under 100 is in the low transmission category.