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Docs:Virus Spread Should Guide Schools 07/12 10:40

   As the Trump administration pushes full steam ahead to force schools to 
resume in-person education, public health experts warn that a one-size-fits-all 
reopening could drive infection and death rates even higher.

   (AP) -- As the Trump administration pushes full steam ahead to force schools 
to resume in-person education, public health experts warn that a 
one-size-fits-all reopening could drive infection and death rates even higher.

   They're urging a more cautious approach, which many local governments and 
school districts are already pursuing.

   There are too many uncertainties and variables, they say, for back-to-school 
to be back-to-normal.

   Where is the virus spreading rapidly? Do students live with aged 
grandparents? Do teachers have high-risk health conditions that would make 
online teaching safest? Do infected children easily spread COVID-19 to each 
other and to adults?

   Regarding the latter, some evidence suggests they don't, but a big 
government study aims to find better proof. Results won't be available before 
the fall, and some schools are slated to reopen in just a few weeks.

   "These are complicated issues. You can't just charge straight ahead," Dr. 
Tom Frieden, former director of the Centers for Disease Control and Prevention, 
said Wednesday during an online briefing.

   Children infected with coronavirus are more likely than adults to have mild 
illnesses, but their risk for severe disease and death isn't zero. While a 
virus-linked inflammatory condition is uncommon, most children who develop it 
require intensive care, and a few have died. Doctors don't know which children 
are at risk.

   "The single most important thing we can do to keep our schools safe has 
nothing to do with what happens in school. It's how well we control COVID-19 in 
the community," Frieden said. "Right now there are places around the country 
where the virus is spreading explosively and it would be difficult if not 
impossible to operate schools safely until the virus is under better control."

   Zahrah Wattier teaches high school in Galveston, Texas, where cases and 
deaths have been spiking. Until the state recently said schools must reopen to 
in-person classes, her district had been weighing options many others are 
considering, including full-time online teaching or a hybrid mix.

   Wattier's school has mostly Hispanic and Black students, many from 
low-income families; almost 70% qualify for free or reduced-cost lunches and 
many have parents who work in "essential" jobs that increase potential exposure 
to the virus. Online education was hard for many with limited internet access, 
and Wattier knows in-person classes can help even the playing field.

   But she's worried.

   "My school has over 2,000 students. That's over 2,000 exposures in a day," 
she said. "It's a lot to think about. It's my job. It's something I choose to 
do, it's something I love. Now it comes at a really high risk.''

   She also worries about her 2-year-old twins in day care and a 4-year-old who 
has asthma and is starting preschool. Her parents live with the family and 
they're both high-risk.

   The American Academy of Pediatrics, whose guidance the Trump administration 
has cited to support its demands, says the goal is for all students to be 
physically present in school. But it says school districts need to be flexible, 
consult with public health authorities and be ready to pivot as virus activity 
waxes and wanes.

   "It is not that the American Academy of Pediatrics thinks this is a done 
deal because we have put out guidance," said Dr. Nicholas Beers, a member of 
the academy's school health council. "But what we do know is that we need to 
have a more realistic dialogue about the implications of virtual learning on 
the future of children. We have left whole swaths of society behind, whether 
it's because they have limited access to a computer, or broadband internet," or 
because of other challenges that online education can't address.

   Following academy guidelines would mean big changes for most schools. 
Mask-wearing would be strongly encouraged for adult staff and students except 
the youngest. Desks would be distanced at least 3 feet apart; the CDC 
recommends 6 feet. Both the academy and the CDC suggest limiting adults allowed 
in schools, including parents, and canceling group activities like choir and 
assemblies. Staggered arrival and dismissal times, outdoor classes, and keeping 
kids in the same classroom all day are other options.

   President Donald Trump has threatened federal funding cuts for districts 
that don't fully reopen. While most funding typically comes from state and 
local sources, experts say schools will need more federal funding, not less, to 
reopen safely. Masks, extra cleaning supplies or janitors, additional classroom 
space, mental health support for students and staff traumatized by the pandemic 
are among potential costs. And with more parents out of work, more children 
will qualify for federally funded school lunches.

   Lynn Morales, 49, teaches 8th grade English at a high-poverty public school 
in Bloomington, Minnesota. Her district is considering several options 
including in-person classes; a final decision is expected Aug. 1.

   Some colleagues are considering not returning to the classroom because their 
children's day care centers aren't reopening. Some say they won't come back 
until there's a vaccine.

   "I am concerned and it's because of the age group," Morales said. ''Middle 
school students ... are lovely and I love them, but they touch, they get close, 
they roughhouse. It is their nature. They're 13 years old. They are defiant."

   "If masks are required and a kid isn't wearing a mask, is my job description 
going to be to chase down this kid and insist they wear a mask? And what if 
they don't?''

   She's heard outrage from parents angry at the prospect of some schools not 
reopening or incredulous about sending kids back into classrooms.

   ''There is no win-win,'' she said. ''Teachers are used to being scapegoats. 
This is just a whole new level of anger.''

   Dr. Emily Landon, a University of Chicago infectious disease specialist, is 
helping the university and a campus preK-12 school decide how to reopen safely.

   "Things are evolving from, 'We can't do it unless it's perfectly safe' to 
more of a harm reduction model, with the caveat that you can always step back" 
if virus activity flares, Landon said.

   Single-occupancy dorms, outdoor classes, socially distanced classrooms and 
mask-wearing by students and faculty are on tap for the university. Face 
coverings will be required at the school too. Policies may change depending on 
virus activity.

   She dismisses complaints from some parents who say masks are a loss of 
personal freedom.

   "It's not harmful for your child," she said. "If you see wearing masks as a 
loss of personal freedom, then you have to think the same of pants."

   Dr. Tina Hartert of Vanderbilt University is leading a National Institutes 
of Health-funded study aiming to determine what role children play in 
transmitting COVID-19. Almost 2,000 families are enrolled and self-test every 
two weeks. The idea is to find infected children without symptoms and see how 
easily disease spreads within families. Results may come by year's end.

   "If we don't see significant transmission within households, that would be 
very reassuring," Hartert said.

   She noted that in other countries where schools have reopened, evidence 
suggests no widespread transmission from children.

   In France, public schools reopened briefly before a summer break, with no 
sign of widespread virus transmission. Masks were only required for upper 
grades, but students stayed in the same classroom all day. Frequent 
hand-washing was mandatory. A better test will be when the new school year 
starts Sept. 1.

   In Norway, schools closed in March for several weeks. Nursery schools 
reopened first, then other grades. Children were put in smaller groups that 
stay together all day. Masks aren't required. There have been only a few virus 
cases, said Dr. Margrethe Greve-Isdahl of the Norwegian Institute of Public 
Health, but she noted virus activity is much lower than in the U.S.

   Kati Spaniak, a realtor in Northbrook, Illinois, says her five teenage 
daughters have struggled to cope with pandemic fears, school closures and 
deficits of online learning. She strongly supports getting kids back in the 
classroom, and all her girls will return to some form of that in the fall.

   It's been hard for her high school senior, Kylie Ciesla. Prom, graduation 
and other senior rituals were canceled, and there were no good-byes. "Just to 
get ripped away from everything I've worked for 12 years, it's really hard," 
Kylie said.

   At college, classes will be in person, masks mandated and a COVID-19 test 
required before she can move into her dorm. Kylie isn't sure all that is needed.

   "I hate that this thing has become so political. I just want the science. I 
want to know what we need to do to fix it," she said.

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