After recently moving, my 80-year-old new neighbor introduced himself with an announcement (“I am fully vaccinated”) and a handshake.
We both knew the risk of COVID-19 transmission was not zero, even though we were both outdoors and fully vaccinated, but we assumed the very insignificant risk of asymptomatic transmission because it was worth the human connection.
This thoughtful balance between public health and individual choice has not been what has led decisions regarding school openings this year.
As the school year ends, states like Maryland, with COVID-19 new cases and deaths precipitously falling, adult vaccination rates among the highest in the world, and evidence of lower COVID-19 transmission in schools as compared to community transmission, our public schools are still providing limited in-person instruction.
Many children are on waitlists to re-enter school and many more only have two days of in-person instruction a week or four days every other week. Existing data show concerning attendance rates (as low as 56% in disadvantaged students), plummeting grades, and decreased hours of instruction among students.
As of now, all but one Maryland county meet CDC guidelines for full school reopening for all grades.
One reason given by boards of education to continue to preclude students from attending school full time is that it is too late in the year to make changes.
Mental health providers working with children know too well that school attendance provides structure, purpose, and socialization opportunities for children.
We always recommend a quick return to the classroom, especially for those suffering from depression, anxiety, and/or school absenteeism. Every day of school counts.
This last month could be an opportunity to transition back to regular school. We should not waste it.
Public school closures during the pandemic have been the consequence of three main failures.
The first one is a failure to assess risk stratified by age.
The risk of death from COVID-19 in an adult older than 85 years is 8,700 times higher than that of a child or adolescent 17 years or younger. Yet, we have treated everyone equally regardless of the person’s risk for severe symptoms related to infection.
The second one is a failure to balance risk.
Lowering risks in some areas inevitably increases risks in others. For example, while school-related injuries decreased during the pandemic, we saw a 93% increase in injuries related to swallowing or inserting button batteries in the nose among 5- to 9-year-olds.
Additionally, the mental health effects of isolation in children and adolescents have been many and largely ignored. An adolescent’s risk of dying from suicide is about 10 times as high as their risk of dying from COVID-19, but we have insisted on depriving students of their social home and connections as public schools virtually disappeared from our neighborhoods.
Finally, there has been a failure to recognize that children have their own rights as human beings and to balance human rights with public health. It’s a concept pioneered decades ago by Dr. Johnathan Mann who, in the context of HIV prevention, understood that human rights violations result in adverse health effects.
The intervention of closing schools for over a year to protect adults has neglected children’s rights and stems from discrimination on the grounds of age, which continues to be an ignored form of prejudice in modern society.
COVID-19-focused decisions that have ignored the devastating effects of academic loss and other health problems in children, coupled with the lack of rush to reopen, have frustrated many parents and scientists who have nationally banded together as an army of soldiers for American children in public schools. This is a positive.
The other positive is that the lockdowns this year have sparked a new debate about the balance between public health, human rights, and specifically, children’s rights.
Once schools closed, the political risk to reopen in a COVID-19-focused society was too much for our local and state officials to overcome. Shortsighted decisions ignored the complexity of the effects of school closures on children.
Nevertheless, there is an implicit agreement among members of society to cooperate for everyone’s benefit. Our schools are supposed to provide quality education so that our children become informed citizens who will sustain our future democracy.
We need all schools to fully open tomorrow. At the very least, fully opening schools now, as we finally take control of the pandemic, will help start the rebuilding of the social contract between school systems expected to follow data and families expected to trust those systems with our children’s education.
Dr. Carol Vidal, who lives in Baltimore County, is a child and adolescent psychiatrist at Johns Hopkins University with two children in public school. She is a member of the Together Again MCPS health professionals and scientists task force, which advocates for school reopening. This opinion is her own and is not intended to represent her employer’s position on the topic.
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