The COVID-19 pandemic is among the worst public health crises of our lifetimes. Over the past 10 months, healthcare and public health professionals have worked tirelessly to overcome the unprecedented challenges COVID-19 has presented.
The magnitude of cases and deaths COVID-19 has been devastating, and we are still far from the finish line in ending this pandemic.
Another serious consequence of this pandemic is the effect it has had on school age children.
The educational, psychological and financial hardships of remote learning have had serious consequences for our children and their families, and those children with educational or behavioral challenges have been even more seriously affected. We cannot understate the serious psychological harm that prolonged virtual school has had on many children. We are seeing an epidemic of serious psychological illness that has reached a crisis point.
Furthermore, lack of daytime structure and lack of access to school amenities such as hot lunches, especially for younger students from disadvantaged communities, has had significant health consequences.
In March 2020, Chicago and Illinois at-large recognized the immediate threat that the community spread of COVID-19 posed. At that time, we were a facing a new virus with very little understanding of how it spread, how to prevent it and what risks the virus posed to children. This was compounded by limited access to personal protective equipment, diagnostic tests and medications to treat and prevent COVID-19.
For that reason, most schools went virtual. However, we have learned a lot over the last 10 months about children safely returning to the classroom. For example, we have discovered that in-school spread of COVID-19 is rare when proper precautions are taken. Furthermore, we know now that children and especially young children of elementary school age are much less likely to transmit infection to adults than the other way around.
The American Academy of Pediatrics and many of the world’s most prestigious children’s hospitals published guidelines over the summer in an attempt to keep schools open. Such rules have enabled many public, parochial and private schools in neighborhoods across Chicago and its suburbs to remain open for in-person learning over the last three months. In our collective experience, there have been few, if any, schools that have fully enforced public health mitigation guidelines that had to close because of secondary transmission. Simply put, layered mitigation strategies at schools have been proven effective.
The mitigation strategies are by now familiar to all. Masks are worn by all individuals at school.
Students and teachers are spaced three- to six-feet apart. Hand hygiene is consistently performed and environmental controls such as adequate ventilation is assured. Children are kept together as much as possible in small classes (pods), so that if there is an exposure, it is limited to a single class and not the entire grade or school. Transition of children between classrooms and crowding of hallways is limited. Lunch time is staggered, and lunches are often eaten in classrooms quickly and quietly. Recess has been modified. Parents are instructed not to send children with any COVID-19 compatible symptoms to school and are required to fill out a daily screener. Contact tracing and quarantining of exposed children and family members is strictly enforced, and proper behavior outside of school is reinforced. Access to testing for those who require it (such as symptomatic students or family members), either at school or locally, is also crucial.
The reality is that these strategies have been successfully implemented at many schools across Chicagoland. Understanding that our children’s education is of vital importance, with the support of administration, teachers, students and parents, these schools have safely been open for in-person learning all school year.
The past few weeks have brought a ray of hope. With vaccines being distributed to healthcare workers and high-risk adults, and soon to follow to the general public, we now have a tool that has high potential to lead us back to the lives we knew before COVID-19. As vaccines become more widely available over the coming weeks to months, vaccination campaigns will also help maintain a safe school environment.
It is widely agreed upon by the medical community that in-person classroom learning is both optimal and safe using the layered mitigation strategies described above. The healthcare professionals authoring this op-ed strongly advocate for schools to return to some form of in person learning as soon as possible. We would be happy to help schools implement this vital and time sensitive recommendation for the benefit of our children.
Michael Angarone, DO, Division of Infectious Disease, Northwestern Medicine
Allison H. Bartlett MD, Section of Pediatric infectious Diseases, University of Chicago Comer Children’s Hospital
Virginia DePaul MD, Pediatrician, North Suburban Pediatrics
Cathy DiVincenzo MD, Pediatrician, Kids First Pediatric Partners
Mary Dobbins MD, President, Illinois Chapter of the American Academy of Pediatrics (representing the chapter)
David Dobkin MD, Pediatrician, North Arlington Pediatrics
Daniel Evans MD, Internal Medicine, Northwestern Medicine
Shannon Galvin MD, Division of Infectious Disease, Northwestern Medicine
Mary C Hall MD, Pediatrician, Kids Health Partners
Daniel Johnson MD, Chief, Section of Pediatric infectious Diseases, University of Chicago Comer Children’s Hospital
Ben Katz MD, Pediatric Infectious Disease, Lurie Children’s Hospital
Valerie Kimball MD, Pediatrician, Chicago Area Pediatrics
Latania K. Logan MD, MSPH, Chief, Pediatric Infectious Diseases, Rush University Children’s Hospital
James Mitchell MD, Pediatrician, Section of Academic Pediatrics, University of Chicago Comer Children’s Hospital
James Olson MD, Pediatrician, Kids Health Partners
Bruce Rowell MD, Pediatrician, Lawndale Christian Health Center
Dov Shapiro MD, Pediatrician, Associated Pediatric Partners
Send letters to [email protected].