Experts recommend strict, costly approaches for reopening schools

Date:
August 11, 2020
Source:
Stanford Medicine
Summary:
The American Academy of Pediatrics recently highlighted the
importance of students' returning to the classroom in its COVID-19
return-to-school guidance. Jason Wang, MD, PhD, of Stanford Health
Policy also believes it's time for kids in the United States to
get back to school. But he believes school districts could better
protect their 55 million K-12 students by adhering to an additional
set of strict measures.



FULL STORY ========================================================================== Weary working parents aren't the only ones eager for their children to
return to school in a few weeks. Many teachers, staff and administrators
also want those classroom doors to reopen. Most importantly, kids are
craving the clamor of school hallways and interaction with their friends.


==========================================================================
The American Academy of Pediatrics recently highlighted the importance
of students' returning to the classroom in its COVID-19 return-to-school guidance.

Jason Wang, MD, PhD, of Stanford Health Policy also believes it's time
for kids in the United States to get back to school. But he believes
school districts could better protect their 55 million K-12 students by adhering to an additional set of strict measures.

"Prolonged school closures can exacerbate socioeconomic disparities,
causing negative education and health outcomes, and amplifying existing educational inequalities," said Wang, a pediatrician and director of
the Center for Policy, Outcomes and Prevention in the Stanford School of Medicine. "School closure may also aggravate food insecurity, domestic
violence and mental health disorders.

Many children from low-income households obtain food through the National School Lunch Program, and estimates suggest that 1 in 4 children may
face hunger this year due to COVID-19." But serious precautions must
first be put into place, Wang said, starting with each school district establishing a COVID-19 task force composed of the superintendent, members
of the school board, teachers, parents and health care professionals to
develop policies and procedures.

"To implement and evaluate specific measures, the task force should
create and oversee a command center for the school district, composed
of data analysts and health experts who can liaise with the local health department," Wang writes in a JAMA Pediatrics article with co-author Henry Bair, a medical student at the Stanford School of Medicine who is also
working on an MBA at the university's graduate school of business. The
article will be published Aug. 11.

Three-pronged testing approach The academy's guidance does not include
ways schools can test for the virus, so the authors recommend that school districts collaborate with local hospitals to:
* Test all students with symptoms.

* Devise a schedule to randomly select a proportion of students and
staffers for COVID-19 testing to identify asymptomatic
individuals. The researchers note that a pooled testing strategy
can significantly reduce costs.

* Offer more frequent testing to students from high-risk households
in ZIP
codes with socioeconomic challenges.



==========================================================================
In addition, the authors recommend that district task forces:
* Work with its local health department to provide educational
materials
and training for students, parents and school staff on the basics
of COVID-19 prevention.

* Provide school staff with thermometers and train them to screen for
COVID-19 symptoms.

* Build temporary modular buildings if schools cannot maintain 6
feet of
physical distance among students and teachers.

* Expand the district's fleet of school buses or develop different
pickup
schedules.

* Increase budgets to boost disinfection efforts of all teaching
spaces,
common areas and high-touch surfaces such as doorknobs, computers
and desks.

* Place transparent plastic shields in front of and along the sides of
student desks.

* Provide hand sanitizers and protective equipment, such as disposable
surgical masks, reusable cloth masks or reusable face shields.

Wang concedes these are expensive measures. But as the Centers for
Disease Control and Prevention noted in its July 24 telebriefing on new resources and tools to support opening schools: The 5.6 million parents
who haven't been able to work due to school closures have collectively
lost an estimated $232 billion in earnings.

Stricter measures mean bigger budgets Some low-resource communities
might find these guidelines difficult to adopt.

Those transparent desk barriers, for example, range from $100 to $200
per desk; COVID-19 tests run between $50 and $200 per individual.

Wang said that's why additional federal funding and state subsidies are
crucial for the low-income communities already hit by the double whammy
of having more parents as essential workers and some of the highest hospitalization and fatality rates from the pandemic.



========================================================================== "Low-income communities are suffering most from shelter-in-place policies because parents who are essential workers are out of the home and not
able to help with online learning," Wang said. "And many children in
these communities also live in crowded conditions that are not conducive
to learning at home." Wang and Bair note the academy's guidelines
emphasize the importance of identifying symptoms and signs of COVID-19,
but don't go far enough in recommending operational approaches.

"To address this, we recommend that schools implement multilevel
screening for students and staff," they write. Each morning parents
should report any fever or COVID-19 symptoms to an online or an automated telephone-based program maintained by the school or district. Any students
with symptoms should stay home.

Even with all the precautions in place, COVID-19 outbreaks within schools
are still likely, the authors said. Schools should prepare for temporary closures and be ready to transition back to full-time online education
by investing in remote education platforms and training.

"Schools will need to ensure equitable implementation of online education
among students, especially those with limited knowledge of or access to technological resources and consider subsidizing educational technologies
for these students," the authors write.


========================================================================== Story Source: Materials provided by Stanford_Medicine. Original written
by Beth Duff-Brown.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. C. Jason Wang, Henry Bair. Operational Considerations on the
American
Academy of Pediatrics Guidance for K-12 School Reentry. JAMA
Pediatrics, August 11, 2020; DOI: 10.1001/jamapediatrics.2020.3871 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200811120131.htm

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