With schools across the country now fully reopened our public education system has become a powder box, ready to explode. After declining in early summer, Covid cases among children are skyrocketing. More than 243,000 new cases among children were logged last week alone, the second highest in a week since the pandemic began, and around 2,000 children were hospitalized.
Last year around this time, I released a book called A Covid-19 Back To School Guide in which I described countless conversations with family and friends who were struggling over whether to send their kids back to school. Now here I find myself, one year later, once again lamenting the life and death decision parents and students are facing, except this year with fewer options: all of the 100 largest districts in the country, including the biggest urban districts in every state, have chosen to eliminate online learning options in favor of full reopenings.
Schools started reopening in late July and almost immediately Covid-19 cases among children in those states started rising. The predominant variant circulating in communities this year, Delta, is significantly more transmissible than the versions of the virus we were facing in the 2020/2021 academic year. Mississippi, for example, reported more positive Covid cases among K-12 students in the first month of school this year compared to the entirety of the previous school year. In Georgia, about 60% of outbreaks in the state over the last two months are happening in K-12 schools, a sevenfold increase from July.
A CDC study released in August confirmed how quickly the Delta variant can spread in schools. The study found that one infected teacher, who removed her mask as she read a book to students, directly infected half of the children in the class. The CDC has said they would not be revising their school reopening guidelines, which they claim to be effective when applied fully. The guidelines include recommendations — but not requirements —- to maintain a 3 foot distance between students, to screen and test students and staff regularly and ensure universal indoor masking, while encouraging vaccinations for all eligible students and staff.
The lack of enforcement is a critical issue. According to a recently released Washington Post survey, one quarter of the nation’s 200 largest school districts are ignoring the primary CDC recommendation to mandate masks. Even those schools trying to follow recommendations are confused by the CDC’s screening and quarantine recommendations when a student is exposed. Current CDC guidelines give schools the option of 14, 10, or 7 day quarantines. Some school districts are abandoning them altogether.
So where does that leave our youngest students and their families? The good news is that top of the line mRNA vaccines for children under 12 may soon be available. Pfizer has said they would apply for approval for their vaccine for kids 5-12 by early October and for younger children by November. Currently, the drugmaker is experimenting with three different dosages in its Phase 3 of its clinical trial for kids 5-12: two low-level doses of 10mcg delivered 21 days apart, two mid-level doses of 20mcg delivered on the same time frame, and two high-level doses of 30mcg. Moderna is running a similar trial with their version of the mRNA vaccine though no word yet on when it might be approved.
But even when vaccines are approved for younger children, they alone will not be enough. First, while vaccines may help prevent children from becoming seriously ill, they are unlikely to prevent infection entirely. This means that the virus could continue to spread, especially if other measures, like masking, are not in place. And if the virus continues to spread, it means that it will continue to mutate and adapt, potentially emerging as a new variant that is more adept at evading our immune response and making us, and our children, ill.
The Biden administration recently had the courage to enforce vaccine mandates for all federal employees, most healthcare workers, and employees of larger businesses. Though already they are under pressure to renege. But if anything, they should go a step further now to protect the youngest and most precious among us. The federal government has said they would use every means available to enforce mask mandates across all public schools, which they should continue. When approved for all students, they should do the same for vaccines.
Beyond these efforts, they should ramp up enforcement of other life-saving measures, clarifying testing and quarantine requirements and ensuring that masking, distancing, testing and quarantine strategies stay in place, even after vaccines are approved. Our most recent wave of infections was a result of lifting restrictions too soon. Many are talking today about “pandemic equilibrium”, learning to live with the virus as we do with influenza. But with this virus, which mutates and adapts with alarming regularity, equilibrium is no certainty.
For parents today who have no choice but to send their children into schools, I have little advice other than to remain vigilant. Eligible students and parents should be vaccinated, with a third dose or booster shot if they received their first set of vaccines more than five months ago. Unvaccinated students should stay masked at all times, and maintain their distance as much as possible from other students and teachers, especially if those students and teachers aren’t wearing their masks. Many parents have appealed to their pediatricians, asking them to provide vaccines for their kids, based on the doses used in the clinical study. Most pediatricians will likely decline these requests, as such off-label use is unauthorized and leaves providers open to liability claims. Still, some doctors are likely offering the option, though not advertising it.
Until all Covid-19 protection measures, including masks, testing, quarantine and vaccines, are enforced equally across all schools, the safety of our children is a fallacy, a fairy tale we tell ourselves to lull ourselves into a sense of security.