Why A.A.P. Guidelines Are Pushing for Schools to Reopen This Fall

The American Academy of Pediatrics has a reputation as conservative and cautious, which is what you would expect from an organization devoted to protecting children’s health. But this week, the academy made a splash with advice about reopening schools that appears to be somewhat at odds with what administrators are hearing from some federal and state health officials.

The Centers for Disease Control and Prevention, for example, has advised that remote learning is the safest option. But the academy’s guidelines strongly recommend that students be “physically present in school” as much as possible, and emphasize that there are major health, social and educational risks to keeping children at home.

Dr. Sean O’Leary, a pediatrics infectious disease specialist at the University of Colorado Anschutz Medical Campus, helped write the academy’s guidelines. He is a father of two children, 12 and 16, and a survivor of Covid-19 who is still experiencing some symptoms after he and his wife contracted the coronavirus in March.

“I absolutely take this seriously,” Dr. O’Leary said. “I’m still sick.” But he explained why the academy was emphasizing the need to get students back in classrooms.

As I talk to school administrators, most are planning temperature checks. The academy guidelines warn this could be impractical and take away instructional time. Can you say more about why you’re skeptical that this is the right strategy?

Do the harms outweigh the benefits? In this case, if it means students are congregating, it could increase the risk of spread. And we don’t have great evidence that temperature screening is helpful. That’s for a couple reasons. One, a lot of kids who have Covid-19, perhaps the majority, never get a fever. To use fever as a screen and assume that’s going to be good enough? You will miss a kid. And many fevers are not going to be Covid-19. Kids should not go to a school with a fever, period.

As you were preparing these guidelines, did the emergence of the potentially deadly pediatric inflammatory syndrome linked to Covid-19 sway you at all?

We talked about it. It is by any measure a rare condition. And so it’s something we have to pay attention to and figure out what causes it and the best treatment. We should also point out that even those kids who have gotten very sick, the vast majority of them have recovered and done well.

The guidelines emphasize that teachers and school staff members should stay physically distanced to the greatest extent possible and conduct meetings remotely. But I am hearing from a lot of teachers. Many are, frankly, scared to go back to school before a vaccine is available. A few have told me that they feel that their health is treated as expendable. What’s your message to them?

We’re pediatricians. We’re not educators. We don’t want to tread in space where we don’t belong. But what I would say is it depends on the level of risk for the individual person. Every district I have talked to here in Colorado? They are making major considerations for their teachers, trying to figure out how to keep them safe.

There are a couple of things we know now that we didn’t know when we closed schools down in March. One is that masks really do seem to work. They are very effective. Two, physical distancing works as well. If they are taking as many precautions as they can, I think the risk is pretty low.

Some of these are very personal decisions. But schools can do a lot of things to really make the environment as safe as possible.

What do you hope is next in terms of local schools making specific plans to reopen?

How this gets rolled out in August or September when schools reopen is really dependent on what is going on at that time with the virus. If you’re in a state that is doing well with very few cases, all of the measures in the guidance are far less important. But if you’re in a place where the virus is raging, all of those things become much more important.

As a country, we have to get on the same page. It’s a tragedy to me that the virus has become a political issue. It’s costing tens of thousands, potentially hundreds of thousands, of lives.

Reopening schools is so important for the kids, but really for the entire community. So much of our world relies on kids being in school and parents being able to work. Trying to work from home with the kids home is disproportionately impacting women. So it goes beyond just the health of the child, which is, of course, very important. As a country, we should be doing everything we can right now, for lots of reasons, to make sure we can safely reopen schools in the fall.

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