'Welcome to Typhoid Mary Middle School': Why an Educator and Dad Thinks Reopening Our Schools Is a Non-Starter

Faced with the looming start of the fall semester amid an epidemic that seems, daily, to grow ever more unmanageable, decision makers in school districts across the country are facing an almost impossible choice. We are tasked with deciding when and how to go about opening our schools for face-to-face instruction.

Most of us who are making these decisions are not medical professionals, and so we are desirous of advice from those who are. Sadly, everything about this disease has become politicized, and local, state, and national public health departments are not beyond the reach of political pressure. Even professionals at hospitals have often been intimidated by their employers into maintaining silence.

So we often find that the kind of unbiased advice that we need to make these kinds of momentous decisions are unavailable precisely when we need it the most. For that reason, I would like to thank Dr. Linas for speaking on these issues and providing desperately needed data to help inform our decisions ("I'm an epidemiologist and a dad. Here's why I think schools should reopen." Vox 07/09/2020).

"Rather than pressuring our underfunded school system to recklessly open our doors, concerned citizens would be better off asking the federal government to initiate a coordinated national plan to defeat this disease."Of course, Dr. Linas is correct that "a decision has to be made." But that phrase is in the passive voice. It is not just that the decision has to be made, it is that some of us have to be the ones to make that decision. And it is an almost impossible choice: the data is uncertain, we have little access to medical professionals (my district has not consulted with a single physician), and we face competing interests and incredible pressure from all quarters to ensure that their interests are the ones that prevail.

I should know. I am one of those who is tasked with making that decision in my local district. I serve on the school board of a medium-sized high school district in Southern California. And, while I am not a medical professional, I do have quite a bit of training in how to make decisions with incomplete information. I teach philosophy at my local community college, and my courses in both logic and critical thinking contain a module on reasoning under conditions of uncertainty. And, while I value Dr. Linas's input and certainly want to address the inadequacies of remote education that he mentions in his article, I also want to explain why I continue to believe that opening our schools to face-to-face instruction is not the best decision at this time.

First, I want to reiterate what Dr. Linas explicated in his article: part of opening safely involves access to extensive testing, contact tracing, and isolation procedures that schools currently do not have, and are not likely to have in the near future. While I may agree with the consensus medical opinion that schools need such resources to open safely, these are not the idyllic conditions under which we are being asked to open our schools. If we are to open our schools in the next three weeks, it will certainly involve opening without these needed resources. Moreover, many schools also have antiquated ventilation systems, and even many ventilation systems that are up to the latest standards still use 50% recirculated air and lack adequate filtration or sterilization.

I will grant that the best available evidence seems to indicate that children do not contract the disease at the same rates as adults, nor do they seem to transmit it as readily. Furthermore, it also seems that when children do contract the disease, it tends to be more mild than in adults. Of course, this comes with the caveat that, as Dr. Linas mentions, our best available evidence has been wrong before. Moreover, even these smaller figures are alarming. Dr. Linas claims that only 5% of children who contract the disease require hospitalization. But that is an alarming percentage that could easily overwhelm our already fragile healthcare system. In my county, the hospitals are nearly full, and poor areas like ours have even fewer hospital beds even in the best of times. While children are unlikely to be denied care at a hospital, even a small percentage of children requiring hospitalization could overwhelm the hospitals, forcing them to ration care, possibly denying it altogether to the most vulnerable who need hospital resources the most.

Additionally, to base our decision solely on the fatality and hospitalization rates of our children seems to overlook important questions about the long-term health effects of contracting Covid-19. It does not seem to be the case that people either recover fully or die. There are many reports that even asymptomatic individuals who recover are left with organ damage, especially to the lungs and heart, but also to the brain and kidneys. At this time, we do not know whether this damage is temporary or permanent, nor do we have reliable data about just how extensive these potentially long-term effects may be.

I often advocate for taking a stance that philosophers call 'the precautionary principle.' That is to say, that we should be especially wary of introducing novel products (or diseases!) to the general population when the long-term effects are unknown. Like so much in life, there is nuance to be had here. We certainly need to consider the opportunity costs of making alternative decisions. And, lest we inhibit progress, we need to ensure that there is a non-trivial risk that the anticipated harmful effects will come to pass. But still, the precautionary principle is a useful, ethical heuristic that can guide our decision making. As Dr. Linas is aware, the risks to keeping our schools closed are relatively well-known. The risks to opening our schools are, by comparison, relatively unknown. But I do not think that any medical professional - certainly not the ones with whom I have conversed - would consider the risks associated with opening to be negligible.

And what are those risks? They go beyond just health risks to our children. Our district is one of the largest employers in our area. If we open, we would potentially be exposing, not only teachers, but also support staff to a deadly disease. Furthermore, teaching professionals tend to be older and more vulnerable than the population at large. Teachers are in short supply, and the decision to reopen at this time would only exacerbate that shortage. Many teachers who are close to retirement will simply retire immediately rather than take on a substantial health risk. This will be a massive blow to the system. Moreover, have we considered the effect of absences and sickness on the system? Last semester, before we closed on-campus instruction, I called out because I had a runny nose. I never call out for a runny nose. But I did not think that I could risk exposing my class to the disease if it did turn out to be Covid-19. Are we to ask our teachers to call out every time they exhibit cold-like symptoms? Our school districts already have a critical shortage of substitute teachers, and many of our existing substitute teachers are retired teachers who will not likely be available due to the risk.

Beyond that, we need to be aware of the mental health and pedagogical risks. Tremendous numbers of teachers and students have significant trauma from this disease, and have overwhelming anxiety about their health prospects. In such an environment, every sniffle, every cough, and every sneeze is likely to produce anxiety in those in the room. Neither is it reasonable to expect that face-to-face instruction will return to normal. Teachers do not just teach behind a lectern. A physically-distanced environment is not conducive to modern pedagogical techniques that involve group work and hands-on instruction. Face-to-face instruction that is constrained by physical distance is not likely to be anywhere near as effective as it was before the pandemic. And consider that in many poorer communities, multi-generational families are the norm. Can you imagine the psychological harm that would befall a child who gets sick and brings this disease home to a grandparent, who then dies? Survivor guilt is very much a thing.

I am not insensitive to the risks associated with keeping our schools closed. For many students, there is a risk of falling behind in their education. And these risks are distributed, as Dr. Linas notes, disproportionately: much of the burden will be borne by the children who are most socially vulnerable. As a licensed foster parent, I am not insensitive to the problems of child abuse and domestic violence. All school employees are mandated reporters, and many of these problems are discovered by school personnel. Our schools are not just places where students go to learn and to socialize. They are safe spaces where children have access to personnel who are trained to help. I agree that this is a tragic loss. In addition, although this is not their primary purpose, our schools also provide free childcare for individuals who have to work. So there could be huge economic risks to keeping our schools closed.

Do these known risks skew the calculation in favor of opening our schools? I think not. But neither should these risks be ignored. I believe that we can mitigate some of these risks - "hedging our bets," in Linas's words - without opening our schools.

First, it is critical that our residents understand that remote instruction in the Fall will not look at all like remote instruction in the Spring. Remote instruction in the Spring was not really remote instruction; it was crisis instruction. Our teachers were asked to come up with a plan to transition seemingly overnight. We did not have resources in place at that time to adequately help the children. But since then, we have had a lot of time to prepare. Accountability standards are going to be re-instituted. In most areas, children who lack internet connectivity or a computer have been supplied with wifi hotspots and Chromebooks. School lunches continue to be provided for those who need them. That is not to say that challenges do not still exist. But we are developing plans to address those hurdles. Teachers will need to quickly identify children who are falling behind and add additional resources. It is possible that individualized or small group tutoring can be provided, face-to-face if necessary, for those students who are most at risk. We can bring in students who are in need of specialized instruction without bringing in everyone and increasing everyone's exposure. Expanding our summer school offerings will likely be a huge part of all of our post-pandemic plans.

"Many schools in Europe and Asia are opening their doors, but that was after containing the disease, or at least controlling it far better than we have done in this country."

Second, what about the need to help those children who are victims of child abuse or domestic violence? This certainly needs to be accounted for. But schools do not have to solve all of our social problems. Other government agencies can be part of the solution as well. We have to realize that children will still have engagement with their teachers. So, while school personnel may identify a smaller percentage of such cases, presumably they will still identify some of these issues. Moreover, county social workers can pick up much of this slack. As their cases have decreased, there is presumably more time for social workers to be proactive. Many of these cases are already known to the county. Often, there is a history of complaints against parents who need such help. Social workers can be proactive by contacting these families and offering services. Such intervention before there is a crisis could prevent many cases of abuse and neglect. Schools can help by hiring social workers. I, for one, would welcome an emergency response team that is proactive in trying to forestall the escalation of problems like these.

And what of the childcare situation? Certainly, schools cannot be the only solution here, and we would require additional funding to help solve these problems. But, given sufficient funding, we could do a lot to help. One idea that has received a lot of support is the idea of bringing in children who need childcare and setting them up in small pods of about eight to twelve students; such children could then complete their remote instruction at computer stations in the schools while being supervised by a proctor. Although this option would carry a higher risk than completely remote instruction, in the event that districts do decide to permit students to return to campus, it would be preferable to have students supervised by a twenty-four year old proctor than to have them supervised by a sixty-four year old teacher. And we would not have to bring in all the students to accomplish this, only students whose parents require child supervision and cannot afford or otherwise arrange childcare.

What about a hybrid model? Could that solve some of our problems? Although many districts are considering a hybrid model, I believe that a hybrid model is, in fact, the worst of both worlds. First, while it may reduce (though not eliminate) student exposure, it exposes our personnel - who are already more vulnerable than the student population - to daily risk of exposure in an indoor environment. Second, the instruction under such conditions would be, I believe, worse than remote instruction. Teachers will still have a full day of teaching on campus. When they are teaching students face-to-face, how will they engage with the other half or three quarters of their class that is supposed to be at home learning remotely? That seems like a recipe for limiting teacher engagement with the students far beyond anything proposed by a remote model. And finally, how does a hybrid model meet the needs of parents who require childcare? Are parents really helped by being told that we can have their student on campus once or twice a week, but that they will need to fend for themselves the other three or four days?

There are no good options here, only relatively better and worse options. I would suggest that we need a coordinated national plan for defeating this disease rather than surrendering to it. Many schools in Europe and Asia are opening their doors, but that was after containing the disease, or at least controlling it far better than we have done in this country. Experience from around the world has shown that the disease can be controlled in two or three months by sheltering in place until the case counts are at a manageable level, then reopening with aggressive testing, contact tracing, and isolation procedures.

With a good strategy, there is no need to close down the entire school year. If we begin today, we can be ready to open our doors in September or October. But we do need this coordinated national plan. I would suggest that, rather than pressuring our underfunded school system to recklessly open our doors, concerned citizens would be better off asking the federal government to initiate a coordinated national plan to defeat this disease and provide for the economic well-being of all residents in the interim. That is the best way to open our schools safely.

Trust me when I say that all of us in education desperately want to get back in our classrooms, but we also want assurances that we are not taking on catastrophic health risks by doing so.