This Doctor Makes The Case For Looking At School Closures In Terms Of Lives Saved

As a huge baseball family, there’s been a hole in our lives since spring. Every March and April we all anxiously anticipate watching those first few pitches. As we see our favorite players run out onto the field on the big screen in our living room, my husband and I crack a beer, put out some snacks for us and the kids, and make it official. It’s baseball season.

But this year COVID-19 took professional sports away, like it took everything else away, and we’ve spent the last few months watching Netflix and Friends reruns and movies we love instead.

Until recently, when MLB announced they’re going to try and make it work, somehow, in 2020. But, as many expected, COVID-19 began to spread throughout the clubhouses, throughout the teams, infecting player after player. And now it’s looking grim and likely that this modified, shortened season will, for some teams, not happen at all.

Because newsflash! that’s what happens when groups of people congregate during a pandemic. That’s how family gatherings become super-spreaders and how Aunt Carol and your cousin Jim end up picking up the virus and taking it to their work, to rest of their family, to their neighbors, and to their friends. And that’s what happens when groups of athletes join together to play a sport. Because even if they wear masks in the dugout, some will not be wearing them correctly at all times. And while running, or actively playing, they take their masks down. In the clubhouse or training facilities, who knows who is wearing masks, social distancing, sanitizing surfaces, etc. and how often. We’d like to believe every single person is taking every single necessary measure to protect themselves and others, but somehow the virus continues to spread. Somehow, despite throwing millions of dollars at this problem and having top-of-the line equipment and protective gear and regular tests and the best medical care, somehow, not even the multi-billion-dollar industry of major league baseball can contain the spread.

Now imagine the group of people in this scenario isn’t grown adults who understand the severity of COVID-19. Imagine they are children, forgetting to keep their masks on, forgetting to social distance, forgetting to wash their hands properly, forgetting that they can’t share school supplies anymore, and feeling hyper and excited to see their friends again for the first time since March.

What do you truly think is going to happen when all those kids enter school buildings? Be realistic, please.

One of the primary arguments many “leaders” have given for reopening schools is that kids don’t seem to fall victim to this virus nearly as much as adults. Besides the fact that this argument doesn’t address the need for a whole swath of adults to be in a school building to make it function, and the fact that high schools are chock-full of near-adult students, there’s another key point to be made here.

What if the reason the statistics tell us that children likely won’t get terribly sick from COVID-19 and die is because we shut down schools and limited their exposure early on?

Theresa Chapple-McGruder, PhD, MPH, who has worked extensively in the areas of maternal and child health, chronic disease, and infectious disease, and who did her doctoral work in maternal and child health and epidemiology, started a Twitter thread recently that addressed this exact issue.

Her tweet includes a link to an article from JAMA Network (Journal of American Medical Association) reminding us of some big numbers we probably haven’t considered. Not the number of deaths, but the number of potential lives saved by school closures. “By mid-April, 192 countries had closed schools, affecting more than 90% (nearly 1.6 billion) of the world’s students.”

How then, can we assess the way this virus affects kids, especially kids in school? How can we possibly know the true mortality rate when the world’s children have been largely isolated for the past months? Are we so willing to experiment with their lives and long-term health that we’ll throw them into the COVID-19 germ-pit that their schools will inevitably become within the first few days and weeks?

Dr. Chapple says no, this is not okay. And that children will die as a result.

As the article states, and as she re-emphasizes in her tweet, medical researchers have found that closing schools prevented millions of cases and saved thousands of children’s lives. Medical research that set out to answer that very question—how was the COVID-19 mortality rate in children affected by school closures?

And the answer is astronomically.

Specifically, school closure was associated with a −62% relative change in COVID-19 incidence per week. The authors also reported that school closure was associated with a −58% relative change in mortality per week. Extrapolating these results to the U.S. population, the authors were able to estimate that school closures may have been associated with 1.37 million fewer cases of COVID-19 over a 26-day period and 40,600 fewer deaths over a 16-day period during the spring of 2020, as Dr. Chapple tweeted.

The JAMA Network article addresses that yes, the evidence we have points to children who have been infected being more likely than adults to show mild or no symptoms. However, due to this virus being new and because children worldwide were pulled out of school, there remains an overall lack of evidence and research with regards to “how easily they contract the virus, and how contagious they are once they do.”

Doctors worldwide are recognizing that we don’t truly know what will happen when swarms of kids return to school. “Kids don’t seem to be super spreaders,” Dr. Aaron Carroll, a pediatrician at Indiana University School of Medicine, tells NPR. But, the article goes on to add, “since most schools around the country closed in March as the virus began to circulate more widely, it’s really an unanswered question.”

“Schools will now be the experiment,” Dr. Carroll says. “We’re going to see a bunch of schools open with varying levels of control, and then we will see what happens.”

An experiment that could result in the deaths of children.

The JAMA article also addresses the other side—the myriad of reasons so many parents and politicians are pushing for in-person school. Obviously face-to-face instruction is ideal, and the authors address the need for parents to return to work and children to have access to all the resources schools offer, well beyond reading and writing and math. And, they recognize that online learning isn’t near equitable across the nation and widens the achievement gap that already plagues our nation’s children.

Teachers know this. Administrators know this. Counselors know this. School boards know this.

“It is better to have kids back in school every day,” Paul Imhoff, the superintendent of Upper Arlington Schools, near Columbus, Ohio, tells NPR. “All of us want that. All of us are anxious for that.”

But then Imhoff pauses.

“As soon as it’s safe.”

The only feasible way to even approach reopening schools, is, according to JAMA Network, a “precision public health approach” that includes the willingness to listen to advice from medical professionals and data, adaptability based on a changing environment, and modifying their school’s schedule and daily instruction practices as needed, among other requirements.

And, schools need money. “Schools also need federal financial support to meet the dual threats posed by COVID-19. There are increased costs associated with adhering to public health guidance and plummeting state and local tax revenues to finance education, especially in school districts that are overburdened and underresourced,” the article explains. “Giving schools the support they need to confront COVID-19 could result in safe, healthy, and thriving environments for children and youth and ultimately recognize education as a critical determinant of health.”

Like any other reputable doctor, Dr. Chapple (whose Twitter handle reads: “In God we trust, everyone else must show data”) says we must base our decisions—decisions that could mean life or death for our kids and their teachers and school staff—on scientific research. This virus is new, which means there’s not a whole of concrete data yet, so we might all need to press pause on starting the world up again until we know more.

And what we do know, we must use to help guide us as we decide whether to put our kids back into large groups—when large group gatherings have been nothing but disastrous these past few months—because their lives could be at stake.