I honestly can’t believe I have to write about this, but, the barrage of messages, social media posts, and news segments debating if and when schools should open has me slightly irritated and more so concerned. I am a family certified nurse practitioner and trained in pediatrics, so I do have some credibility on this topic, or at least I like to think so. I obviously don’t have all the answers and I am not an expert but I can professionally and rationally interpret the data and give my clinical opinion. It seems that the well-being of children is a priority to our federal administration however their actions and statements say otherwise. Yes, the American Academy of Pediatrics has released a statement and guidance on reopening schools but this does not explicitly state that they should be put in unsafe conditions. There are some factors that need to be considered before rushing to open schools in August/September. Despite what our clueless president and sad excuse of a secretary of education say, the issue of reopening schools is quite complex. We don’t want to use our children as guinea pigs in a dangerous experiment because, as the laughable Dr. Oz put it, the mortality rate for children is so low, it seems like an “appetizing option” (his words, not mine…gross).

Of course, with schools being closed, kids are lacking meals that normally would be their main source of food during the week, social interaction has been lost, academic support and mental development has lagged, and abuse reports have drastically fallen. There is no question that school is critical for the health, well-being, and development of every child, of every race, intellectual status, or socioeconomic status. I would never say otherwise. However, the real question being posed is what schools can open when, how, and where; not if. We know that children younger than 18 are less likely to have severe COVID-19 infections and transmission is lower than their older counterparts. This doesn’t mean that they are invincible and deaths or illness will not occur as a result of reopening. There are many things we still don’t know about COVID-19 and its effects on children. Also, I worry that even if the fatality rate in children is thousandths of a percent, that would still equate to thousands of children dying from this disease, and potentially more falling ill with unknown consequences. There is also the risk of a multi-system inflammatory syndrome which we still don’t understand as a result of COVID-19 infections in young children. We need more information before we can accurately assess the risk of this disease in kids.

Many schools in rural areas where infection rates are low may be able to reopen on time with appropriate infection control measures. Places such as Florida, where they are seeing more than 15,000 new cases per day, may want to delay school openings until the infection rate falls dramatically and better measures are implemented. You would think this would sound the alarm for all public officials, however the ignorant and poorly informed, governor DeSantis, is still pushing for schools to reopen in a few weeks despite the rising cases and death rate. So location plays a large factor as infection rates can vary from state to state and even, county to county. Also, different age groups have different risks. Kids in elementary school are a far less risk to themselves and others than those in high school or college (as we currently understand it).

Now is reopening possible with just 4-6 weeks of summer left? I’m not quite sure. Young children will have to wear masks and wash hands. With limited sinks in a single school with hundreds of children, how will this be done. If a child has to use the restroom, how will physical distancing and proper hand hygiene be performed and monitored. Kids are already little germ factories and unfortunately don’t know how to keep their slimy secretions to themselves. For those old enough to semi-understand the pandemic occurring around them, might have anxiety surrounding being in groups or fear other kids who aren’t as aware or don’t follow the recommendations their parents have instilled in themselves. Limited square footage within classrooms will make physical distancing difficult. If teachers fail self screens or have had a high risk exposure and feel symptomatic, they will have to call out of teaching. If they are unable to contact trace, does that mean the children now all have to self quarantine for 14 days and then place their own families at risk? If a substitute teacher comes in from another school, will contact tracing be possible? These are just a few of the questions that need to be asked and addressed by public health officials in all the school districts across the country. Places with poor funding may find it difficult to implement some of these safety measures while those schools that are private or have robust funding may be able to afford layered safety precautions which excel at protecting their children. This will cause a further divide within our country and further deepen disparities.

We should first talk about the true risks of sending our kids back to school without fully developed public health plans in place and adequate preparation. First the obvious risk is putting our children in clinical harms way. There is about a 1.7% infection rate among children out of 150,000 people infected in the U.S. which is comparable to other countries per a CDC study tracking infections from February 24th through April 2nd. So in just a week, 2,572 children were confirmed to be infected under the age of 18, and of those, the average age was 11 years old. It is common for children to be asymptomatic carriers of the infection but they are not immune to this disease and can still develop symptoms and complex clinical syndromes. Those with respiratory diseases, congenital heart defects, or other disorders are at high risk of severe disease and death. Part of the severe complications that arise in adults is related to a release of inflammatory molecules in the body which are the result of an overreaction of the immune system. Because younger children have developing immune systems, it is theorized that this is the reason why kids don’t get as severely ill as adults, their immature immune system does not create such a hyper-response. Another idea is that children are often getting sick with colds and other viral illnesses which are often the result of other types of coronaviruses providing them with semi-protective antibodies. When children are sick with COVID-19, their symptoms are very cryptic as they resemble many childhood illnesses. These symptoms include: diarrhea, fever, runny nose, cough, fatigue, muscle aches, and vomiting. So if a child is suffering from allergies or catches a stomach bug (viral gastroenteritis), their symptoms alone would prevent them from attending school and causing a false panic. Allergies and stomach bugs are VERY common in young children, so false alarms may be frequent. Another concern is many children have missed their well-visits with their pediatricians due to the pandemic and may have missed vital vaccines which are protective against other serious infectious illnesses. Clinically, we cannot risk the health and wellness of our children by rushing them into school without devising a comprehensive public health program for reopening schools which is well thought out and planned appropriately. By Trump stating that the CDC’s guidelines for reopening schools are too strict, that is showing a disregard for the expert opinion being put forth to the public in protecting our children.

What is the risk to those interacting with the students? Administrators, teachers, custodians, bus drivers, and the children’s family/caregivers are all at risk of becoming infected if children go back to school prematurely without proper safety measures. There was recently a report of a teacher in Arizona who died of COVID-19 in June and two of her colleagues who were teaching summer classes with her became infected as well. Is it fair to tell people who have dedicated their lives to helping children such as bus drivers whose only income is that job, custodians who have spent decades in the same school, or teachers who taken pride in their lifelong career to stay home because they are at risk and allow others who are less risk to take their jobs? How is one able to plan for this and mitigate the risk for those adults in the room? Especially when kids have little regard for sneezing, coughing, touching, and interacting with their environment.

If kids do return to school, will they reap the same rewards as pre-pandemic schooling? While school lunches provide essential food for millions of children who wouldn’t otherwise have something to eat, a safe space where abuse can be recognized and reported, and cognitive development is fostered, many other benefits may not be present in the new post-COVID world. Kids won’t be able to hug or play with one another which is essential for social and emotional development. They may see that their friends who they normally hold hands with, hug, or play with are avoiding them and not understand why. This can be damaging to their mental health. Tactile touch with various objects and textures will be limited because of surface contamination. Sharing toys, books, snacks, and writing utensils is part of the school experience that kids enjoy. Fear and anxiety about catching the virus or giving it to their friends may grow within each child. It is hard to predict these things but schools need to consider them as part of the reopening process. What needs to happen is teachers need to convene with school officials, pediatricians, behavioral health specialists, and public health experts to create a comprehensive plan which will address all of these factors while mitigating any risk of COVID-19. I honestly don’t think this is feasible at this time when only a month or two remain before schools are slated to reopen again.

The sadly, idiotic federal government is threatening to defund educational systems if schools don’t reopen for the regular school year and Mr. Trump’s cronies such as the governor of Florida are staying on track to open schools despite the record high cases of COVID-19. The Secretary of Education uses the argument that other countries have let their children go back to school without seeing any rise in cases or deaths. What they don’t understand for some reason is that many of the countries combined, still don’t have the amount of cases that a single U.S. state has had in just one day. For instance, the new cases in many Scandinavian countries remains in the double digits. The state of Florida, passed 15,000 in a single day. If ten people are on a bus and only one of them is sick my chances of getting sick are low as opposed to if all ten of them are sick. The same applies to rising cases of COVID-19 and the risk of reopening schools. The conspiracy-esque musings of an unintelligent president state that this is all a political ploy against him. The mysterious “they” he refers to his conspirators as, are out to get him, in his mind, but, definitely not concerned parents, citizens, or health experts scared for the wellbeing of children and school staff alike (I hope my sarcasm screams from the page). Trump’s press secretary or hired spin machine continues to state that thousands of pediatricians support children returning to school however what they fail to leave out is that pediatricians support children returning to a safe environment that strictly follows the CDC guidelines for reopening schools, not rushing into schools during record cases. Trump, his press secretary, and DeSantis say that it is safe to go back to schools because while cases are rising “because of testing” (wrong, wrong, WRONG), the death rate is at its lowest since the pandemic started. What these people fail to recognize is that the death rate frightfully lags weeks behind case increases. In just one week, Florida’s new daily death rate has nearly doubled from 45 to 73 between 7/5 to 7/12, totaling 4,242 deaths since the pandemic started. If this doesn’t concern you, then I don’t know what else I can say to convince you that opening school suddenly without an in-depth plan with appropriate preparations and measures taken is a horrible idea.

Our children need to return to school, but let the expert opinions of those who use science, fact, and rational thought, plan this safely so that the kids can actually get the benefits it purports. Once again, our federal government is failing us by ignoring science and evidence. Let the appropriate stakeholders such as the teachers, epidemiologists, behavioral health specialists, and pediatricians guide this process, not political minds with ulterior motives and personal agendas. Use honest judgement and read the data; it’s as simple as that.

Be safe, stay well!