Seven months later, some schools and colleges are back in the classroom, while others are still distance learning at home and still others are participating in hybrid models. There is no one-size-fits-all strategy, but there is more knowledge for educators to glean and develop plans that fit their jurisdiction’s needs.
Two specialists in the areas of education and infectious disease joined a briefing hosted by the Infectious Diseases Society of America and shared some of the lessons learned so far that can help schools and colleges when they develop their strategies for returning to the classroom.
Among the lessons of the last few months are the strong rate of asymptomatic transmission; that face coverings can limit the spread; that social gatherings are a major source of the spread; and that younger children can be carriers of the virus, although those under five are less likely to spread it than older children.
“March feels like a lifetime ago and a lot has changed since then,” said Preeti Malani, chief health officer and professor of medicine in the Division of Infectious Diseases at the University of Michigan. “Even at that moment, everyone knew that getting back to face-to-face learning was going to be difficult even in the best circumstances, and several colleges and universities that had originally planned on being in residence had to rescind those decisions late in the summer because it’s so complicated."
The nature of college campuses as being built around togetherness, whether it’s in the residence hall or the classroom or the student section at a football game, has made mitigating the virus a major challenge. “And trying to retrofit the opposite means trying to make a boat out of a car,” Malani said. “It’s messy, it’s imperfect, it looks weird, but the University of Michigan, we’re almost seven weeks into the semester and our boat is floating.”
The university has taken a “public health-informed approach,” which doesn’t preclude it from having cases of the coronavirus, but means that the infrastructure is in place to contain and prevent large outbreaks.
That infrastructure includes relying on public health strategies like social distancing, face coverings, hand washing, symptom screening, testing, isolation and quarantine, contact tracing, and minimizing travel in and out of the area, as well as limiting large gatherings.
It is working well enough with buy-in from the students and faculty. “Returning to face-to-face learning is not a zero-risk proposition, but the value of in-person instruction assumes some level of risk,” Malani said.
She said not everyone is able to learn remotely for various reasons, so it’s vital to get students back into the classroom. Other considerations, such as mental health, economics and academic performance are reasons for getting back to face-to-face learning.
The university has partnered with the local county health department for contact tracing and case investigation, and has built the capacity for quarantining and isolation housing. It also limits gatherings to fewer than 25.
Most of the outbreaks have occurred during social gatherings and not in classrooms or residence halls. “I worry about residence halls and large houses where transmission could really take off, but what we’re seeing with each passing week is social gatherings are the risk, not simply living in these settings,” Malani said.
The challenges are even greater at the K-12 level because of the uneven application of various protocols and the lack of data available. Though there are gaps in the data, a recent CDC report showed that two-thirds of cases of the coronavirus in school-aged kids occur among 12- to 17-year-olds, and one-third of the cases are among kids ages 5 to 11.
But since there’s no national approach to mitigation within schools, there are limits to the guidance for schools developing plans. “There is not a perfect plan and they vary by community,” said Wendy Armstrong, professor of medicine at Emory University School of Medicine. “It is the absence of a considered plan that is where the problem lies.”
Armstrong said early in the pandemic it was thought that young, school-age children wouldn’t be able to comply with wearing a mask. “We were wrong,” she said. “Young children are willingly wearing masks and do it proudly.”
They do it with a sense of community, and it is the community that is so important to mitigating the virus on K-12 campuses. “Schools exist as a microcosm of their communities,” Armstrong said. Areas with high community spread, certainly with rates greater than 10 per 100,000, probably should think carefully about reopening schools.”
Those that open need to develop clear, structured, well-written and transparent plans with input from teachers and parents and that are constructed in an environment of trust. Plans should incorporate universal masking, address decreased crowding, ventilation, safe meal times, include screening and testing polices, and have plans for taking care of symptomatic students and teachers.
Plans should also address disparities in resources, as some students don’t have the capacity for distance learning. “Schools with resources are not only more likely to have extensive mitigation strategies for return to school, but also to have resources at home that make virtual schooling more successful,” Armstrong said.
