We are through with COVID-19 but COVID-19 is not through with us.
Nationwide, confirmed cases still range from about 88,000 to about 123,000 per day although they are probably much higher. US COVID-19 hospitalizations are now at a plateau of about 40,000 per day, nearly fourfold from April 1. Since then, 7-day averages for COVID-19 deaths have surpassed 480 per day, projecting to more than 175,000 Americans dying of COVID-19 in the next 12 months.
We are all personally impacted as many of us or our family members have been infected at least once in the past four months. We are concerned about long COVID or have faced interminably long periods of post-symptom isolation, anxiety, and disruption of our daily lives. This must give us pause as we approach another school year.
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Parents desperately want their children fully back in school. At the same time, how can pre-K through Grade 12 children best thrive, while staying in school throughout the year safely and healthily? Will the nation and the state’s plans of near-total nonchalance work or are we about to go forth with a grand and failed experiment on more than 900,000 Massachusetts schoolchildren and many thousands of their parents, guardians, school staff, and teachers?
Simply, here is what is being proposed for the upcoming school year across our state. No masks. No plans to ensure every classroom in our 1,820 public schools is well ventilated. No routine testing. No testing for children with COVID-19 before returning to school after a required 5-day absence. Although mandated to mask for 5 additional days, many will remain infectious. No plan to use school-specific COVID-19 infection data to alert districts and the state to spiking infection rates. And no organized statewide vaccination plan even though fewer than 50 percent of children ages 5 to 11 have received two shots in 185 of our 351 communities. The statewide vaccination rate for their younger siblings ages 6 months to 4 years stands at just 10 percent.
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Is Massachusetts prepared for a return to the classroom under these conditions or can we do better? Here’s what we can do:
Promote multilingual vaccine readiness and make schools vaccination sites for parents and children who have not had at least two shots and the recommended boosters. Such statewide efforts can build off the Massachusetts Department of Public Health’s Vaccine Equity Initiative that is working with 20 high-risk communities to host over 450 COVID-19 vaccination clinics in August and September.
Commit to using already existing funding mechanisms to perform ventilation audits in every classroom over the next few months. The DOE should provide portable air filters for all deficient rooms in the short term while supporting full HVAC systems in the longer term. Imagine a new publicly revealed metric reported weekly that shows the proportion of Massachusetts classrooms that are fully ventilated. Not only might this mitigate the burden of COVID-19, but also the chances of other airborne respiratory diseases.
Make available rapid antigen tests equitably and statewide to parents and districts, using money provided by ARPA and Elementary and Secondary School Emergency Relief funds. More testing, rather than no testing or little testing, is associated with approximately 50 percent less in-school transmission, which is the overall educational and public health goal. The more children whose COVID-19 status is known and who can can isolate for five days protects the larger community, particularly their relatives ages 65 and older who continue to comprise 75 percent of COVID-19 deaths.
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Track the real toll of COVID-19. Last spring, many districts tracked the results of rapid antigen tests and reported these numbers to their district dashboard. This should be expanded, not suspended. If this cannot be done efficiently or if it is too burdensome, parents, teachers, district administrators, and policy makers should figure out ways to make daily and weekly attendance records to be a surrogate at the school and district level. For example, in a district of 3,000 children accustomed to 90 percent attendance by students and teachers alike, a drop in attendance of 3 percent or 90 children could probably be attributed to new COVID-19 cases and should prompt a critical review and possibly improved public health measures.
And let’s be a beacon for community solidarity and kindness. In too many of our classrooms, there sits a child or teacher or paraprofessional who has returned from a bout with cancer, or a person with acute asthma who has had a tough summer with the heat and no air conditioning, or another who has faced a long-standing autoimmune disease and now deserves to worry less about being infected in the classroom or lunchroom.
We must do everything in our power to protect our children and teachers facing extraordinary circumstances. In these special but all too common cases, let us double down to ensure that we are all vaccinated, masked whenever possible, and air flow exceeds established guidelines.
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Alan Geller is a senior lecturer at the Harvard T.H. Chan School of Public Health.
