Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, thinks it is a good idea for schools to reopen for in-person classes but with restrictions in place to protect teachers, staff and students against the coronavirus, including "wearing a mask, washing your hands, maintaining social distancing."
Reopening "has to be done safely, and it has to be done with the confidence of the teachers," Redfield said. "It has to be done with the confidence of parents. And so I think each of the school districts will begin to wrestle with this."
"It's not the risk of school openings versus public health. It's public health versus public health," he said during a recent webinar with the Buck Institute for Aging, an independent biomedical research institute based in Novato, California.
"I weigh that equation as an individual who has 11 grandchildren, that the greater risk to the nation is actually to keep these schools closed," said Redfield, who is a Catholic.
However, "local school districts are going to have to make these decisions," he added.
The threat of drug overdoses and suicide proves to be "far greater" concerns than the COVID-19 pandemic for many people, particularly in high schools, according to Redfield.
"You know, a lot of kids get their mental health services, over 7 million, in school. A lot of people get food and nutrition in schools. Schools are really important in terms of mandatory reporting sexual and child abuse," the physician explained. "Obviously, the socialization is important. And, obviously, for some kids, I think actually a majority of kids, their learning in a face-to-face school is the most effective method of teaching."
News reports Aug. 10 said that 17 out of the nation's 20 largest public school systems have decided to teach students only online, though in the state of New York, Gov. Andrew Cuomo has declared schools will open.
Other public and nonpublic schools are choosing a "hybrid" option with some in-person classes and some online classes. Some Catholic dioceses around the country have chosen to reopen their schools for in-person learning, following local health and safety protocols and CDC guidelines to protect students. teachers and staff from the coronavirus.
The CDC's guidance is aimed at K-12 schools as well as colleges and universities, but "our guidance is not in stone. Our guidance is not meant to be impractical," Redfield said, "and we have to work with each district as they try to translate that guidance into a functional plan."
Its lengthy detailed guidance -- which can be found online at https://bit.ly/2XODgHV -- includes about a dozen recommendations ranging from encouraging everyone in the school and community to practice preventive behaviors to educating and reinforcing "appropriate hygiene and social-distancing practices" to cleaning and disinfecting frequently touched surfaces.
"This guidance is meant to supplement -- not replace -- any state, local, territorial, or tribal health and safety laws, rules and regulations with which schools must comply," the CDC says.
Decisions must be made taking into account "the level of community transmission," it says.
"I don’t want people to overestimate the risk of serious illness to individuals that are school age," Redfield said during the webinar. "That said, there is a real risk to vulnerable individuals that are teachers, potentially, that may have comorbidities. And, obviously, there are some students that have a comorbidity." "Comorbidity" is the presence of two diseases or chronic conditions in a patient.
Schools cannot get ready "faster than you're ready to do it," he said.
"None of us is going to compromise safety," he added about himself and other doctors who support schools reopening.
"There is going to need to be accommodation for those teachers that have high risk. Some of our colleagues think it would be a great opportunity for younger teachers in the classroom to be mentored by older teachers by video that may have a risk and should be more separated," he said.
When it comes to testing, Redfield said the CDC has not recommended routine testing for K-12 students. "Different institutions, particularly in higher learning, are looking at some different strategies, particularly if they attract people from all over the country, which includes some areas that may be having significant transmission right now," he said.
He noted the U.S. has accelerated testing across the board and is at about 5 million tests a week, but about 3 million to 5 million tests a day is "where we need to be as a nation."
"The challenge this virus gives us (is it's) so unlike flu, which basically causes symptomatic illness and you can use that symptomatic illness to monitor flu. ... We actually do have a surveillance system which just monitors for flu-like illness," Redfield said. "We don't necessarily test everybody for flu. We just monitor influenza-like illness. This virus is problematic because a significant number of people don't have symptoms, and that's inversely related to age."
"So when you really are looking at a group of individuals under the age of 25, you know, it's probably going to be somewhere between 50%-80% of people that have this virus don't have any symptoms," he added.
"So the only way you begin to be able to detect that is if you set up broader surveillance programs," like contact tracing, he said, which is the process of identifying people who may have come into contact with an infected individual and collecting more information about such contacts.
Children appear to be at lower risk for contracting COVID-19 compared to adults. While some children have been sick with the disease, U.S. adults make up nearly 95% of reported COVID-19 cases. Children and adolescents under 18 account for just over 6% of all reported COVID-19 cases.
On its website, the American Academy of Pediatrics said that according to Aug. 6 data from U.S. states and the District of Columbia, Puerto Rico and Guam, over 380,000 children have tested positive for COVID-19 since the onset of the pandemic.
"At this time, it appears that severe illness due to COVID-19 is rare among children," the academy said. "However, states should continue to provide detailed reports on COVID-19 cases, testing, hospitalizations and mortality by age so that the effects of COVID-19 on children’s health can continue to be documented and monitored."
Redfield suggested people call the CDC's toll-free number for information on its guidance -- (800) CDC-INFO, or (800) 232-4636. He noted the agency has "over 2,000 guidelines, and "a lot of those were generated because someone took the time to call in and ask a question."