Scientific Findings May Support School Reopening

by Doug McClure

MONTPELIER – At its July 28 press conference, Governor Phil Scott’s administration provided more science-based evidence supporting his plans to re-open schools.

Governor Scott began his words at the press conference by describing the seven-week-long process to come up with the school re-opening plan, and said: “We recognized how unpredictable this pandemic is, and the anxiety it can and has caused.”

The plan divides children into two age groups, younger children and high schoolers, based on the response to remote learning and the effects of COVID-19, according to Dr. Rebecca Bell. Dr. Bell is a pediatrician and president of the Vermont Chapter of the American Academy of Pediatrics (AAP) and stressed she does not work for the State of Vermont.

Dr. Bell cited an AAP statement that reads in part “SARS-CoV-2 [the virus that causes COVID-19] appears to behave differently in children and adolescents than other common respiratory viruses, such as influenza, on which much of the current guidance regarding school closures is based. Although children and adolescents play a major role in amplifying influenza outbreaks, to date, this does not appear to be the case with SARS-CoV-2. Although many questions remain, the preponderance of evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection. In addition, children may be less likely to become infected and to spread infection.”

The statement also described documented evidence that students learn better in-person, but more importantly, receive significant social and emotional support from in-person school. “Children and adolescents,” said Dr. Bell, “especially those who are most vulnerable, are really untethered right now, they’re not doing okay. The loss of structure and routine, and consistent adult presence, and social and emotional connection has been really upending.”

Other experts agree, with the Royal College of Pediatrics and Child Health in London stating in an open letter that the closure of schools “risks scarring the life chances of a generation of young people. Clinically, most young people have been spared the worst effects of COVID-19 but the health and social impact will be severe … School is about much more than learning … For many children and their families, these interventions are the difference between surviving and thriving. In their absence our already frayed safety net cannot function, and we risk failing a generation.”

Dr. Bell said that younger children are “less likely to contract the virus, less likely to become seriously ill, and less likely to transmit the virus than adults or older adolescents.” She said, “The data we have now says that schools will most likely not be a main driver of transmission in this pandemic, they will instead mirror what’s happening in the community.” To that end, Dr. Bell said communities play a critical role in keeping schools safe through physical distancing, wearing masks, washing hands, and avoiding being in public if ill.

The state’s goal of as much in-person learning as possible is driven by science, according to Gov. Scott, Health Commissioner Dr. Mark Levine, and Dr. Bell. The state uses the metric of “positivity rate,” which is the percent of new COVID-19 tests that come back positive. By that standard, Vermont is the lowest of any U.S. state at 0.4%, less than half the next-lowest state, which is Maine. Neighboring New York is the third lowest and New Hampshire the sixth lowest. Vermont’s latest report found that since March 5, children aged 10-19 represent the second-lowest number of cases, and children under 10, the lowest, with no deaths or hospitalizations in anyone under 19.

A caveat which the governor and Dr. Levine both frequently acknowledge is that SARS-CoV-2 is just nine months old in humans. Much is not yet understood. Its role in children is less understood because scientific studies show thus far children seem to not display symptoms as frequently. A study just published in the Journal of the American Medical Association, Pediatrics, discovered that one assumption about young children and COVID-19 might be misunderstood, largely because so many children were kept home from the outset. “A study from Ann & Robert H. Lurie Children’s Hospital of Chicago discovered that children younger than five years with mild to moderate COVID-19 have much higher levels of genetic material for the virus in the nose compared to older children and adults.” The study said these findings “point to the possibility that the youngest children transmit the virus as much as other age groups.” Other studies have found this age group to have little to no transmission in school environments where schools have re-opened, leading some to question the scientific justification for closing primary schools in the first place. For teenagers, the science is less clear, with some studies suggesting older children can transmit the virus almost as efficiently as adults. Science has no explanation yet as to why the children’s age appears to be a factor in transmission and symptoms.

Dr. Levine stated that in regards to COVID-19, “Vermont essentially looks more like Europe than the rest of the United States.” Vermont did not get the explosion of cases most other states did at the outset and, like many European countries, flattened the curve quickly.

Other countries have adopted reopening policies for schools similar to the Vermont Agency of Education’s proposals. Science Magazine looked at re-opening strategies in multiple countries and “they suggest a combination of keeping student groups small and requiring masks and some social distancing helps keep schools and communities safe, and that younger children rarely spread the virus to one another or bring it home.”

With much about COVID-19 still unknown and its effects on children still not clarified, others advise caution until a vaccine is available.