Why We Are Closing our Schools and Others Should Too, Even Though It Will Be Hard

Many children rely on school for food, many parents struggle with child care and need to go to work, and our kids need to be in school and learning.  All that said, we still should be closing schools.  And for the thousands of children that I am responsible for at Education for Change, we are closing our school buildings starting Monday, and moving to a remote instruction model.

This is public health versus public education, and in this case public health should win.  The COVID virus is here, it probably is already in the schools.  However, young people are less likely to present severe symptoms or symptoms at all. 

And have you ever been to a school.  I say this lovingly, but kids are pretty, ahem, lax on the hygiene front.  A school is the perfect place for the virus to spread and the issue is not so much with those young healthy kids.  It is who they will transmit the virus to.

COVID is a very deadly virus, especially when the infected person is elderly, health compromised, or the health system is overwhelmed, and people who otherwise would get care,  cannot.  These are the numbers from China Mortality Rate in China as of Feb. 4 (2.1% nationwide, 4.9% Wuhan, 3.1% Hubei, and 0.16% other provinces) reported by the NHC of ChinaWhere there is a widespread outbreaks the numbers are much higher.  Further, nearly 15% of people over 80 who contract the virus die.   So, 15 out of every 100 elderly people who contract the virus will die.  The seasonal flu rate is less than 1 in 1000 by contrast.

So the issue is not with the child it is with children infecting grandpa, or the auntie with compromised health.  Closing schools in reaction to a confirmed case reduces transmission by 25% and closing schools proactively (before the active spread) can reduce deaths by 2/3rds.  Given the severity of this virus, we need to close schools.

Here are the mortality stats from Worldometer

COVID-19 Fatality Rate by AGE:

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).

confirmed cases
all cases
80+ years old 21.9% 14.8%
70-79 years old 8.0%
60-69 years old 3.6%
50-59 years old 1.3%
40-49 years old 0.4%
30-39 years old 0.2%
20-29 years old 0.2%
10-19 years old 0.2%
0-9 years old no fatalities

*Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%).

We also know that we can slow the spread of viruses by shutting schools, especially doing so proactively.   Closing school’s reactively (after a confirmed case), as a recent Science article stated, reduces transmission by 25% which is significant, and proactive measures are even more robust, reducing deaths by 2/3rds,

The data on reactive closures

There have been a number of studies that have looked at reactive closures. These analyses, including a paper in Nature in 2006 using math models [of an influenza pandemic], typically find that such reactive school closures for a moderately transmissible pathogen reduces the cumulative infection rate by about 25% and delay the peak of the epidemic [in that region] by about 2 weeks. When you postpone the peak, you also typically flatten the epidemic and space out your cases. This has value. It means that the incidence on any given day is lower, so we don’t overburden our health care system.

The evidence on proactive measures again from Science

Proactive school closures—closing schools before there’s a case there—have been shown to be one of the most powerful nonpharmaceutical interventions that we can deploy. Proactive school closures work like reactive school closures not just because they get the children, the little vectors, removed from circulation. It’s not just about keeping the kids safe. It’s keeping the whole community safe. When you close the schools, you reduce the mixing of the adults—parents dropping off at the school, the teachers being present. When you close the schools, you effectively require the parents to stay home.

There was a wonderful paper published that analyzed data regarding the Spanish flu in 1918, examining proactive versus reactive school closures. When did [regional] authorities close the schools relative to when the epidemic was spiking? What they found was that proactive school closing saved substantial numbers of lives. St. Louis closed the schools about a day in advance of the epidemic spiking, for 143 days. Pittsburgh closed 7 days after the peak and only for 53 days. And the death rate for the epidemic in St. Louis was roughly one-third as high as in Pittsburgh. These things work.

Closing schools now, will save lives, it will also cost families.

The Costs to Grapple with

There are at least 5 big issues we need to address, to make this actually work for families

  1. Instruction- we need to figure out remote, socially distanced, and online instruction, including support for students who may not have wireless access or computers to access wireless.
  2. Food- many youth rely on school for food, we need to have continuity for youth in need
  3. Child care- many families do not have day time child care and can’t take time off, school closings will be counterproductive if children still congregate outside of school, either in large group child care or, for older children by mixing socially
  4. Health and mental health support- many students rely on schools, school based clinics or staff members for basic health and mental health care
  5. Economic and job market effects- related to the child care issue, many workers will stay home, including health care workers, to care for children, draining the public health system of key resources.  We should provide basic income payments as other countries have where there is a state of emergency.

Every day we wait increases the likelihood of spread.  And the nature of a spreading virus is exponential.  It’s hard for me to say this, but we really need to put public health ahead of public education right now, close our schools, support our families, and stop the spread of this virus before it is too late.

What do you think?

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