Doctors: COVID-19 Surge Demands Statewide Delay of In-Person Classes

Data should drive a safe reopening’: Doctors say starting in-person classes under current COVID-19 conditions endangers our children, teachers and their families. Doctors call for greater state leadership and interventions to get COVID-19 under control BEFORE rushing to reopen schools

Physicians are urging Gov. Bill Lee and local school officials to delay in-person classes at schools across the state until COVID-19 is brought under control in the community. 

There’s a clear danger to children, teachers and their families if districts rush to reopen schools while the COVID-19 health crisis is worsening across much of Tennessee, says Dr. Kathleen Hunt, a Chattanooga-area pediatrician. 

“Reopening schools while COVID-19 is spreading uncontrolled through our communities needlessly endangers our children, their families and our teachers. We’ve seen what happens when a state rushes to reopen: Tennessee is now experiencing a new peak of this pandemic with entirely avoidable increases in hospitalizations and deaths,” Dr. Hunt said. “This time data should drive a safe reopening and opening schools under these circumstances is contrary to the recommendations of the American Academy of Pediatrics, the Harvard Global Health Initiative and contrary to expert advice many of my Tennessee colleagues have been offering for months.” 

Dr. Kathleen Hunt, a Chattanooga-area pediatrician. 

This week, public health experts at Harvard’s Global Health Initiative released guidance for school officials to plan a safe reopening based on the size of the virus outbreak in their community. 

The American Academy of Pediatrics, which has previously stated the important role schools play in encouraging of social interaction, stated emphatically in July that science and community circumstances must guide school reopening, “not politics.” “Returning to school is important for the healthy development and well-being of children, but we must pursue re-opening in a way that is safe for all students, teachers and staff. Science should drive decision-making on safely reopening schools. Public health agencies must make recommendations based on evidence, not politics. We should leave it to health experts to tell us when the time is best to open up school buildings, and listen to educators and administrators to shape how we do it… For instance, schools in areas with high levels of COVID-19 community spread should not be compelled to reopen.”

Today, Tennessee physicians are calling for the start of all in-person classes to be delayed in counties that don’t currently meet health guidelines. Currently, 79 out of Tennessee’s 95 counties are seeing COVID-19 unacceptable case growth above an average of > 10 new cases per 100,000 residents over the last 14 days.  Any county seeing > 10 new cases per 100,000 people per day should delay that start of in-person classes.

U.S. Surgeon General Jerome Adams reinforced this metric Tuesday saying that community transmission rates are the most important factor in deciding whether to reopen schools. “The biggest determinant of whether or not we can go back to school actually has little to do with the actual schools—it is your background transmission rate,” Adams said on “CBS This Morning.”

Physicians say Gov. Lee and school officials must coordinate to implement several interventions that are needed to safely reopen schools. These health safeguards echo the interventions recommended by the medical community to safely reopen our economy.

1. Less than 10 new cases per 100,000 persons per day for at least 14 days in a row. Because the virus spreads before people show symptoms, a low, stable incidence rate is necessary to prevent new transmissions. The virus can be transmitted in the 2-3 days before symptoms begin (the presymptomatic window) and can be spread even by infected persons who never develop symptoms at all (asymptomatic people).
   
2. State must catch up on backlogged contact tracing and issue regular reports to inform school reopening. Parents and school staff need to know that people coming who are coming in contact with COVID-19 are isolating and not exposing students, teachers or their families to the virus. Because test results have been greatly delayed, doctors recommend no schools restart in-person classes until state contact tracers are caught up and notifying those who have been exposed to COVID closer to real time. Contact tracing must keep pace if schools are to have a safe reopening.
   
3. Ensure rapid and regular testing. A test today only shows whether you are infected today, and that does nothing to determine whether you get infected tomorrow. If testing is behind or slow, classrooms will experience significant disruptions when teachers or large groups of students are forced to quarantine.
   
4. Mask and distancing requirements. Masks are key to reducing the spread of the coronavirus. When people refuse to wear masks or stay apart it threatens everyone around them just as people who ignore speed limits endangering other drivers. Masks and social distancing requirements will reduce sharply the chance that students and teachers would carry the virus home to their family members.
   
5. Accountability for employers and people who endanger others: Just as the state should require employers to implement safeguards outlined in the Tennessee Pledge to protect workers and the public, the state should develop safeguards for school districts and require their implementation. If the decisions of managers endanger Tennesseans, the state should hold them accountable. A child’s learning environment is a teacher’s work environment and it must be safe for both to succeed. 

Rushing to reopen the schools without first Tennessee getting COVID-19 under control will bring the same result Tennessee has seen since the rush to reopen the state in May: avoidable increases in hospitalizations and deaths, but this time those increase will be concentrated among avoidable hospitalizations and deaths among children, teachers and their families.

BACKGROUND:

• Israeli data show school openings were a disaster that wiped out lockdown gains. Of 1,400 Israelis diagnosed with COVID-19 last month, 657 (47 percent) were infected in schools. Now 2,026 students, teachers, and staff have it, and 28,147 are quarantined. [The Daily Beast, 7/14/20]
• Yahoo News: By 3 to 1, Americans reject Trump’s push to reopen schools despite COVID-19 risk. “A full 63 percent of Americans say Trump should not be pressuring schools to reopen. Only 25 percent say he should continue his push… Instead, more than three-quarters (77 percent) insist that America’s priority should be to limit the spread of the virus, even if it means students can’t physically return to schools; just 23 percent think America’s priority should be to fully reopen schools this fall, even if it increases the risk to public health…. The survey, which was conducted between July 11 and 14, found a remarkable consensus on the issue of school reopenings that transcended party lines, geographic boundaries and demographic divisions. [Yahoo! News, 7/16/20]
• The Hill: Almost one-third of Florida children tested are positive for the coronavirus. “State data indicates that out of 54,022 Florida children tested, 31.1 percent have returned positive results on average. This is higher than the statewide positivity rate, which reads in at about 11 percent. Aside from the staggering figure indicating the transmission of the virus, health experts fear it can cause potential lifelong damage in children. Alina Alonso, the health department director of Palm Beach County, reportedly told county commissioners on Tuesday that the long-term consequences of coronavirus in children are unknown.” [The Hill,7/15/20]
• AZFamily.com: Doctors warn of rise in serious condition in Arizona kids from COVID-19 exposure. “Though it’s rare, some children are having severe reactions after COVID-19 exposure. It’s called “pediatric multisystem inflammatory syndrome,” known as MIS-C. Doctors in Phoenix said not only is MIS-C already here in Arizona, but they’re expecting the cases to rise. It can become very serious very quickly if not caught early, and sometimes that can be the hardest part.” [AZFamily.com, 7/14/20]

ICYMI: TN Doctors and Teachers on School Reopening