For students in the Clark County School District, the start of the new school year will look much like the end of the last — with online education. As confirmed cases of COVID-19 have risen steadily statewide over the past month, the decision was made with student and faculty safety in mind.
For parents worried about sending their kids to school once in-person instruction is cleared to resume in some form, though, assistant professor of public health Brian Labus has some encouraging words, particularly for the youngest students.
What does the science say right now about kids going back to school?
There's different levels of risk depending on the age group. And so I think that's the piece that was really missing from the discussion. We talk about levels of risk. It's safer for the youngest kids as opposed to high school kids or college students.
At what age are kids the safest from coronavirus?
Studies do differ, but it’s up to about age 10. At the onset of puberty is kind of where you start to be more like an adult biologically and that includes disease transmission risk.
How do you manage that, considering kids are hitting puberty at different ages?
Well, that's an operational decision schools have to make. You treat elementary schools one way, you treat high schools the other way, and then you have to make some decisions about middle schools. It's OK to use those practical concerns if it's a combined middle school and high school or grade school and middle school.
For elementary schools, is it safe for those schools to be open? How much risk are kids at of contracting this and spreading it to other kids and teachers?
You can never look at it and say that there is no risk at all. I think one of the problems is parents want an environment that's completely safe. It's not achievable. There's always a risk of bad things happening when you leave your house, coronavirus or not.
We have to think about how you're going to mitigate that risk for different age groups. With your youngest kids, they have a low risk being infected to begin with. If they get infected, they have a much lower risk than an adult of being hospitalized or dying and they are a lot less likely to spread it to other kids or adults. It doesn't mean that they can't do any of those things. You can still get a kid who is very sick or dies from it, but compared to adults you're talking about a completely different disease basically.
What about on the staff side of things?
If you're concerned about the needs of the school, the highest risk group is going to be the teachers, especially those with underlying health problems. You have to think about how the kids could transmit that disease to their teachers and take steps to protect them. With high school kids there's a much greater risk than with elementary school kids across all school types.
One of the greatest risks is of teachers being around other teachers. In outbreaks that we've seen worldwide, that's where a lot of the transmissions occurred — among the staff through normal interactions at school facilities themselves.
Are schools by nature more prone to transmission than places like restaurants or bars?
It's all about density. So it depends on how you set things up and how much you can separate those teachers. It's not necessarily the building, it's how the people are acting inside that building. It's really that direct contact between people that is a high risk of disease. Environmental surfaces play a small role, but the real risk is being close to other people for extended periods of time.
What's the downside of keeping schools closed?
You have to think about what happens when we don't have school. There's obviously the educational challenges of distance education. For many people at the lowest end of the economic spectrum; they aren't going to be home with their kids as much because they can’t work remotely. They may not have the equipment, the internet connection, those sorts of things. All those things affect the child's future, including their health.
More immediate concerns are things like child abuse. We know child abuse reporting has gone way down over the past few months because teachers are not there to see it. In Clark County, one of the first things we dealt with was making sure kids get fed because the only meal some kids get is school lunch that day.
You can't think about what happens just with one disease piece without thinking about all of that because all of those things affect our health. You have to decide if closing the school is going to do more harm than good because of all those other reasons. It's not a simple thing to figure out.
How should parents, especially parents of children who are older, approach the decision about whether or not to send their kids to school?
It's an important decision to make at the individual child levels. We have to think about, unfortunately, what's going on in your community. You have to think about the risk to your child. They may have certain health problems that makes going to school a really risky proposition for them or for your family. And you have to think about what it means to their education as well. And then of course, there's all those logistical concerns. If you're working full time and can't be there to make sure your kids are actually doing the schoolwork. The logistics for some families are driving a lot of these decisions.
My point is don't base it on just emotion — the idea that “my kids are going to get sick and die.” Obviously there's a huge concern, but you have to have some context in what the real risk of disease, what's the real risk of serious problems, and be very logical about your decision.
How should schools approach it to keep faculty and staff safe?
We have to make sure they are taking the appropriate steps to protect their staff from each other and from the students, having the appropriate physical distancing and appropriate plans in place to protect them whenever possible to make it a safe environment so they're not putting their lives at risk by going to school.
They have to take into account the underlying health problems, especially of older teachers. There may be certain teachers who should only be doing online things or a hybrid model, because it would be unsafe to have that teacher in the school.
Schools also have to plan what happens if teachers get sick and we have to start to quarantine people for a couple of weeks. There are all those logistical challenges we have to think through, and they should use scientific reasoning for that, and not just emotions.
Considering we're still learning things about this disease at a pretty rapid clip, how solid do you feel about the science on this right now?
The science is obviously evolving all the time. We don't know all the answers to everything, and I think that's one of the challenges. There has to be a willingness to listen to things as that information changes.
We are starting to get evidence pointing us in certain directions. There's a growing body of evidence that there's less transmission risk, less disease in the youngest kids. And I think that's been pretty consistent over the course of the epidemic. We have seen kids get sick, obviously with serious problems, but compared to adults, it's a very mild disease and it doesn't spread that easily from kid to kid.
