Wading into the contentious debate over reopening schools, an influential committee of scientists and educators on Wednesday recommended that, wherever possible, younger children and those with special needs should attend school in person.
Their report — issued by the prestigious National Academies of Science, Engineering and Medicine, which advises the nation on issues related to science — is less prescriptive for middle and high schools, but offered a framework for school districts to decide whether and how to open, with help from public health experts, families and teachers.
The committee emphasized common-sense precautions, such as hand-washing, physical distancing and minimizing group activities, including lunch and recess.
But the experts went further than guidelines issued by the Centers for Disease Control and Prevention and other groups, also calling for surgical masks to be worn by all teachers and staff members during school hours, and for cloth face coverings to be worn by all students, including those in elementary school.
Regular symptom checks should be conducted, the committee said, and not just temperature checks. In the long term, schools will need upgrades to ventilation and air-filtration systems, and federal and state governments must fund these efforts, the report said.
Online learning is ineffective for most elementary-school children and special-needs children, the panel of scientists and educators concluded.
To the extent possible, “it should be a priority for districts to reopen for in-person learning, especially for younger ages,” said Caitlin Rivers, an epidemiologist at Johns Hopkins and a member of the committee.
Mary Kathryn Malone, a mother of three children, has been eager for schools to reopen in Mount Vernon, Ohio, where she lives. Her 9-year-old daughter is pining for her friends, and her 3-year-old has only part-time day care — and not while Dr. Malone works.
But she was most worried about her 7-year-old son, who needs help for his attention deficit hyperactivity disorder and dyslexia.
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“At one point, we were three full weeks behind on schoolwork,” said Dr. Malone, who teaches French at Kenyon College. “I was working through my own job, and when I looked at this mountain accumulating, it was so stressful.”
The American Academy of Pediatrics last month also recommended that schools reopen, a position widely cited by the Trump administration, which has been pushing hard for a return to something resembling normal life despite soaring infection rates in many states.
Most studies suggest the virus poses minimal health risks to children under 18. And the report said that evidence for how easily children become infected or spread the virus to others, including teachers and parents, is “insufficient” to draw firm conclusions.
Outside experts said they appreciated the report’s distinction between younger and older children. “I think that’s really smart,” said Dr. Ashish Jha, director of the Harvard Global Health Institute.
“The risk is different for a third grader than for a 10th grader, and I say that as the dad of a third grader and a 10th grader.”
But Dr. Jha and other experts noted that the committee did not address the level of community transmission at which opening schools might become unsafe simply because too much virus may be circulating. “They punted the most critical question,” he said.
Committee members said the decision not to recommend a cutoff was deliberate. “There is no single prevalence or threshold that would be appropriate for all communities,” Dr. Rivers said.
Dr. Rivers said schools would need to decide how and when to open, close and reopen schools by taking into account many factors, including disease levels in the community — and should plan for what to do when students or teachers become infected.
“Even with extensive mitigation measures, it’s not possible to reduce the risk to zero, and that has to be part of the discussions,” Dr. Rivers said.
Reopening schools should be a priority because schools fulfill many roles beyond providing an education, the authors said. “It’s child care, it’s nutrition, it’s health services, it’s social and emotional support services,” said Dr. Enriqueta Bond, the committee’s chair.
“These functions are really undervalued, I think, in the conversation that’s been taking place.”
The report’s recommendations are largely consistent with those from the A.A.P., said Dr. Nathaniel Beers, who co-wrote the academy’s guidance. “The only nuanced difference is that they have acknowledged the disproportionate impact on younger kids of not being in school,” he said.
While teenagers may be better able to learn online, they suffer the social and emotional consequences of being separated from their peers, Dr. Beers said.
“Adolescence is a period of time in life when you are to be exploring your own sense of self and developing your identity,” he said. “It’s difficult to do that if you are at home with your parents all the time.”
Daniel A. Domenech, executive director of the American Association of School Administrators, said school superintendents were “already prioritizing in-person learning for the youngest learners.”
The new report is not “groundbreaking,” he said, “but it is helpful in affirming the touchy job ahead and the need for additional resources to do right by kids, educators and communities during this school year.”
Some 54 percent of public school districts need to update or replace facilities in their school buildings, and 41 percent should replace heating, ventilation and air-conditioning systems in at least half of their schools, according to an analysis by the Government Accountability Office.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated July 15, 2020
Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
What are the symptoms of coronavirus?
- Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
What’s the best material for a mask?
- Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
Is it harder to exercise while wearing a mask?
- A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
I’ve heard about a treatment called dexamethasone. Does it work?
- The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
What is pandemic paid leave?
- The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
Does asymptomatic transmission of Covid-19 happen?
- So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
What’s the risk of catching coronavirus from a surface?
- Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
How does blood type influence coronavirus?
- A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
How can I protect myself while flying?
- If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
What should I do if I feel sick?
- If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
“One of the shocks to me is that over 50 percent of the school buildings are awful,” Dr. Bond said.
New evidence suggests that the coronavirus may be airborne, and that many indoor spaces may need better air filtration to prevent infections. “Between now and September, you’re not going to be able to put in a new ventilation system,” she added.
In the meantime, schools may be able to opt for simpler solutions: Before the weather cools, they might emulate their counterparts in Europe and move classes outdoors, set up tents or build outdoor classrooms, said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security.
Schools may also need to hire additional staff to replace educators or other staff members who may not wish to return, the report noted, and to implement some of the recommendations, such as enforcing social distancing in the classroom or ensuring that groups of children remain with a particular teacher.
Some 28 percent of the more than 3.8 million full-time teachers in the country are older than 50, and about a third of school principals are over 55, age groups at high risk of severe illness from the coronavirus.
In one survey, 62 percent of educators and administrators reported that they were somewhat or very concerned about returning to school while the coronavirus continues to be a threat, according to the report. “The school work force issue is really not discussed that much,” Dr. Bond said.
Racial and socio-economic inequities are another prominent concern. The communities where children struggle to learn in dilapidated, understaffed schools are also those hit hardest by the pandemic, said Keisha Scarlett, a committee member and chief of equity, partnerships and engagement at the Seattle Public Schools.
Remote learning is often difficult for children in low-income families. Nationwide, about 30 percent of Indigenous families and about 20 percent of Black and Latino families do not have access to the internet or have it only through a smartphone, compared with 7 percent of white families and 4 percent of Asian families.
Adults in these communities are also more likely to be essential workers who cannot stay home with their children, Dr. Scarlett said. Rates of hospitalization for Covid-19 are four to five times higher in Black, Latino and Indigenous populations than among whites.
“Covid-19 exacerbates those disparities,” Dr. Scarlett said.
The report also noted significant differences between rural and urban schools. Some 26 percent of people in rural districts and 32 percent of those living on tribal lands do not have reliable internet access.
Samuel Berry-Foster Sr., a sixth-grade science teacher, lives just outside Asheville, N.C., in a pocket of the Appalachian Mountains, with his wife and two school-age children.
For his family and for those of many of his students, Mr. Berry-Foster said, even a simple phone call can be plagued with delays and hangups. For more than one family member to be online at the same time is “impossible.”
“What we end up doing is driving about eight miles to a little bitty library for broadband,” he said. “We sit in the parking lot and do our meetings and such.”
The C.D.C. has provided limited guidance on reopening schools and largely puts the onus on district leaders to make judgments they may be unequipped to make.
The new report offers more detailed guidance for how to reopen, including a list of the kinds of experts to consult — such as epidemiologists who can interpret disease transmission rates. Local task forces should take into account the number of coronavirus infections, hospitalizations and deaths, and the percentage of diagnostic tests that are positive.
President Trump has said that even the C.D.C.’s less detailed recommendations were “very tough and expensive.” But the new report’s recommended retrofits are likely to be out of reach for most school districts, costing roughly $1.8 million for a school district with eight school buildings and about 3,200 students.
“In my view, this has to be a top priority,” Dr. Nuzzo said. “The economy depends on this, the future of our country depends on this.”