UVM Expert On Kids And Disease Argues For A Careful Return To In-Person Learning
As schools around the country struggle with whether and how to open for in-person learning in the fall, two pediatric infectious disease specialists at the UVM Medical Center have written a commentary on the issue in the medical journal Pediatrics.
In the piece, Dr. Benjamin Lee and Dr. William Razska describe some of the recent research on the transmission of COVID-19, by children. They write that the transmission of the disease by kids seems relatively low, and therefore they're recommending that many schools open for in-person learning in the fall, providing they use appropriate mitigating measures such as masks.
Dr. Lee spoke with VPR's Mitch Wertlieb about the research and commentary. Their interview is below; it has been edited and condensed for clarity.
Mitch Wertlieb: Can you briefly describe the research that you looked at and what you think about whether schools should open for in-person learning in the fall?
Dr. Benjamin Lee: The data that we presented in the commentary was looking at the spread of COVID-19 within household clusters. A recent study performed in Geneva, Switzerland, looked at all children under the age of 16 that they were able to identify as having COVID-19, over a one-month period of time. And in over 90% of the cases, there was an infected adult in the household that was the most likely source of the illness in the child. And what this strongly suggested, was that children who present with COVID-19 are probably catching it from adults, not the other way around.
One thing I wonder then, is: If even if these younger people are catching it more from adults than they are from other people of their same age group, they're going to be taught by adults. They're going to be taught by teachers. So isn't there the risk then that those kids get infected by teachers in the classroom?
That is a risk. And for this reason, we have been cautioning all along that we should be taking appropriate safety and mitigation strategies in the classroom setting. This becomes more challenging in areas that have a lot more community transmission.
It sounds to me like you're saying that you have some confidence in reopening for in-person learning in Vermont, because this is a state, as we know, that has done better with infection rates than other states. Would you feel less confident about reopening schools for in- person learning if we were living in a place like Arizona, Florida or Texas where the COVID numbers are much, much higher?
Absolutely. Here in Vermont, I think we're extremely well poised to be able to do this safely. In areas where we're seeing lots and lots of viral transmission, it does become a very challenging question, because
"I think what this means is that we should probably be approaching elementary schools and middle schools and high schools differently." - Dr. Benjamin Lee, University of Vermont Medical Center
so much of this depends on what the local circumstances are.
There is a new study out of South Korea now suggesting that while kids under the age of 10 do not transmit COVID-19 as much as adults, kids between the ages of 10 and 19 appear to transmit it just as much as adults. What's your reaction to that study?
I think it's always worth paying close attention to data that come out of South Korea. They have one of the best mechanisms in the world, I would argue, for doing good testing and contact tracing. I think what this means is that we should probably be approaching elementary schools and middle schools and high schools differently. Now, that doesn't mean that the schools can't reopen. It just means that we really need to place a lot of priority and emphasis on developing ways to make sure we're keeping specifically the high school setting as safe as possible.
The actual school settings are one thing. And then, of course, there's the problem with getting kids to those schools. What about kids being on busses together in close proximity? How should that problem be dealt with?
Yeah, it is a challenge, to be sure. One strategy that we have recommended here in Vermont is that while the school bus is a very convenient way of getting kids to school, and particularly for working parents, we would strongly suggest that families that have the means to transport their children to school independently really should do so. That would reduce the number of kids who rely on the buses. We probably just have to accept the reality that, on buses, kids are going to be in slightly closer contact and very mundane things as simple as cracking the windows probably will make a big difference in making that school bus as safe as possible for everybody.
What would you say to parents or people who work at schools who say that any risk of transmission, infection or possibly death is too high, and it's too much of a risk to send these kids back to school in the fall?
Yeah, I think at the end of the day, this is really at the crux of the matter. And once again, I would like to point to the scientific data that overwhelmingly indicate that children are at very, very low risk of having any form of serious health outcome or complication, even if they were to catch COVID-19. That's not to say that we shouldn't be concerned, but we have to weigh the risk of a child getting COVID-19, and suffering what would more likely than not be a relatively mild illness, against the harm that we know is going to come about if children are out of the school environment over the coming school year.
In addition, when we keep kids out of the school environment, there are so many other ripple effects that causes beyond just education. So much of childhood has to do with social and emotional development, learning how to interact with others, learning how to be good citizens even. And I would argue that the best place for that to happen, the natural place for that to happen, is within the school setting. The best way to keep our classrooms safe is to make our communities safe.
I think that there's been this idea that we can separate what's happening within the schools or daycare centers and view that as distinct from what's happening in the community. Part of this is that we all need to do our part outside of the school setting to make sure that the classroom itself is as safe as possible. That takes everybody, and that's part of the challenge as well.
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