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As officials weigh closing schools, experts see little evidence they are 'hot spots'

FILE- In this Oct. 29, 2020, file photo, students at West Brooklyn Community High School listen to questions posed by their principal during a current events-trivia quiz and pizza party in the school's cafeteria in New York. (AP Photo/Kathy Willen, File)
FILE- In this Oct. 29, 2020, file photo, students at West Brooklyn Community High School listen to questions posed by their principal during a current events-trivia quiz and pizza party in the school's cafeteria in New York. (AP Photo/Kathy Willen, File)
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The nation’s largest school system became the latest to halt in-person classes Wednesday amid a surge in coronavirus cases in New York City, but some infectious disease experts questioned the rush to shutter classrooms in some communities while higher-risk activities continue.

“I think it’s misguided to shut down education as the first resort and other sort of adult activities as the last resort,” said Dr. Joshua Barocas, an infectious disease physician and a professor at Boston University School of Medicine.

Schools in New York City had only been open for in-person instruction for about eight weeks, but the change will force hundreds of thousands of students who were in classrooms part-time back into remote learning. Only about 300,000 of the district’s 1.1 million students had opted into a hybrid learning schedule since September, while the rest were still learning from home full-time.

“The schools have been shut temporarily, but only temporarily. They will be back and there'll be safer than ever. The city is going to go through some tough times in the coming weeks, but we'll fight back,” Mayor Bill de Blasio said Thursday, though he acknowledged officials were still developing a plan for reopening.

New York City Schools Chancellor Richard Carranza said Wednesday the city’s schools had been “remarkably safe” since reopening, but he backed de Blasio’s decision and vowed to get students back in classrooms as soon as possible.

“New Yorkers have proven they are ready and willing to do the work to fight against this virus,” Carranza said in a statement. “And we need to ask that of you again, because that’s how we get schools back open: with the support of each and every one of you. We will get through this, together.”

De Blasio had long warned the city would close down schools if the local test positivity rate hit 3%, though the infection rate within the school system was much lower. Coronavirus cases are rising rapidly elsewhere in the country, as well, but officials in other cities and states have not been as quick to cancel in-person education.

As New York City officials faced blowback Wednesday, Gov. Ned Lamont in neighboring Connecticut said keeping schools open would remain one of his top priorities, even if other restrictions become necessary. He said school buildings had become one of the safest places to be during the pandemic.

Minnesota Gov. Tim Walz has announced new restrictions beginning Friday that will shut down indoor dining, gyms and fitness studios, indoor entertainment venues, and youth sports for four weeks. However, schools and child care will remain open with safety protocols in place.

In Michigan, where school-related infections rose 49% last week, high schools and colleges have been ordered to shift to online classes for at least three weeks, along with strict limits on businesses and entertainment. Elementary schools are not being forced to close.

“We know that in-person instruction is really important for younger students,” Michigan Gov. Gretchen Whitmer said earlier this week. “We know that the way that we have seen COVID-19 spread happening in schools, that is more often in those high school grades."

New York City had set the lowest threshold for shutting down of any major school district in the country. De Blasio announced the 3% threshold over the summer when the city’s average positivity rate was around 1%, and city officials told The New York Times the mayor’s public health advisers agreed it was appropriate.

Michael Mulgrew, president of the city’s teachers’ union, said the intent of the 3% threshold was to keep schools from becoming vectors for community spread of the virus. He placed responsibility for getting schools open again on the city’s residents.

“Now it’s the job of all New Yorkers to maintain social distance, wear masks, and take all other steps to substantially lower the infection rate so school buildings can re-open for in-person instruction,” Mulgrew said.

New York Gov. Andrew Cuomo declined to intervene in the city’s school closure decision, but he stressed the spread of the virus appears to be driven by other sources like bars, restaurants, and indoor gatherings. The state only plans to require school districts to shut down classrooms if the community positivity rate hits 9%.

As of Wednesday, New Yorkers were still able to dine indoors and work out in gyms, but officials indicated further restrictions were expected. De Blasio said Thursday it would be “just a matter of time” until the governor ordered those activities shut down.

Other large school districts have faced similar struggles, and some have been even more cautious than New York. Schools in Los Angeles, Chicago, and Philadelphia have not yet resumed in-person education at all, and Detroit recently suspended in-person classes. Washington, D.C. opened up schools Wednesday for about 400 of its 50,000 students.

Many European countries have opted to keep schools open this fall despite surges in infections, even as they close restaurants and bars or impose widespread evening lockdowns. Those countries have also provided financial assistance to cover the wages of workers in business that have been forced to close their doors.

Most countries that have reopened schools with social distancing and other precautions have avoided major outbreaks as a result. In Sweden and Israel, though, high schools do appear to have driven a rise in infections.

According to Dr. Stephen Thomas, chief of infectious disease at SUNY Upstate Medical University, communities weighing new school closures at this point may have to consider which they value more: in-person education or keeping restaurants, bars, and gyms open. Given the economic ramifications of lockdowns, that is not necessarily a simple choice.

“Obviously, educating our children is a priority and it’s very important... On the other hand, keeping small businesses afloat and keeping people solvent and keeping people employed, all of that is incredibly important, as well,” Thomas said.

If the primary concern is slowing the spread of the outbreak, Dr. Lisa Lee, an epidemiologist at Virginia Tech and former public health official, said the available data supports closing bars, restaurants, and other places before schools. Schools have been more successful than other environments in implementing and enforcing mitigation strategies.

“No gathering is zero-risk, but classrooms where students are wearing masks and keeping a ‘two-arms-lengths’ distance are much safer than indoor restaurants and bars where adults crowd in and do not consistently wear masks,” Lee said.

Opening schools has been a politically sensitive subject since the summer, when President Donald Trump aggressively pushed for schools to resume in-person classes despite public health concerns. The Centers for Disease Control and Prevention published guidance minimizing the risk of transmission at the time, but those documents were quietly removed from the agency’s website last month because the content was deemed “outdated.”

More than a dozen national education organizations issued a joint statement Monday begging Congress to appropriate additional federal funds to help schools operate safely before the end of the year. Stimulus talks have been stalled for months, and Republicans and Democrats have been unable to agree on how much to spend on education funding.

“We can make our schools safer,” Barocas said. “It just seems like there’s a lack of political will to put that effort into it.”

One of President-elect Joe Biden’s coronavirus advisers, infectious disease specialist Dr. Céline Gounder, emphasized the importance of getting schools open and keeping them open in an interview with The New York Times earlier this week. She described schools as an “essential service” and argued more high-risk activities like indoor dining should be targeted first.

“If you have widespread community transmission, there may come a tipping point where you do need to go back to virtual schooling. But I think the priority is to try to keep schools open as much as possible, and to provide the resources for that to happen,” Gounder said.

Teachers and school administrators have broadly acknowledged remote education is far from ideal. Many students lack sufficient internet access and technology to participate effectively, and some efforts to provide additional resources have stumbled.

Experts fear school closures will exacerbate existing disparities in education and place lower-income students at deeper disadvantages. The months of lost in-person instruction students are facing will be difficult to make up, and it is not clear the public health benefits of closing schools are worth the cost.

Data collected by economist Emily Oster at Brown University from more than 20,000 schools around the country with nearly 4 million in-person students suggests infection rates among students are slightly below case rates in surrounding communities, while infections among staff are about even with or slightly higher than in the community. Larger outbreaks of ten cases or more at a school have been very rare.

“We have not seen major community spread from schools,” Lee said. “It is more likely that community spread is getting to schools.”

That data has significant limitations. It is not geographically representative—about half of the schools providing information are in New York, and only a handful of schools in some other states have responded—and mitigation strategies employed by districts vary widely. Most of the schools involved are operating with reduced capacity or hybrid schedules.

“What we can deduce from data from a number of states is that schools are not the hot spot that they were sort of made out to be early on in the school year,” Barocas said.

The trends largely track with other research, particularly with regard to an apparent low risk of transmission among younger children. A study published in Pediatrics last month surveyed more than 57,000 child care providers and found no elevated risk of infection with mitigation measures in place. Another recent report in Nature Immunology showed young children infected with the virus had a reduced antibody response, suggesting they were less likely to transmit it.

That said, experts believe concerns about children spreading the coronavirus are still valid. Severe symptoms have been seen in children with existing medical conditions, more than 100 children in the U.S. have died, and a dangerous multi-symptom inflammatory syndrome that seems to be linked to the virus has also emerged.

“I don’t think we’re being overly cautious,” Thomas said. “There have been over a million children who have been diagnosed with COVID in the U.S.... A million kids getting sick is a lot.”

Even when children are asymptomatic, they could transmit the virus to more vulnerable school staffers or family members. In communities where test positivity rates are high, infections in schools might pose serious public health risks.

“Because healthy children are less likely to have symptoms and less likely to know that they are infected, the worry in high-spread communities is that students will serve as ‘silent spreaders,’ unknowingly infecting others and furthering the local epidemic,” Lee said.

Some outbreaks linked to schools have emerged. Officials in New Jersey announced Wednesday that 23 people at one Union County school had contracted the coronavirus in the classroom or during school-related activities. However, Gov. Phil Murphy told reporters he was confident in the state’s health protocols and did not anticipate ordering schools to switch to virtual learning, although some districts have already done so.

“Certainly, people come into school and there have been infections, but for the most part, school is not a breeding ground for widespread infections,” Thomas said.

While New York City schools are closing for the foreseeable future, Barocas said the fact that they were able to open for two months and keep positivity rates among students and staff low proves schools can be kept open safely during the pandemic. That is something other communities should keep in mind as they grapple with similar challenges.

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“Everyone is trying their best to balance education and health and safety and the economy,” he said. “It just seems like education and kids keep getting the short draw.”

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