IDSA: Safe return to school is possible

One year ago, schools, colleges, and universities made the rapid shift to online learning to prevent the spread of coronavirus disease 2019 (COVID-19). The start of the 2020-2021 academic year initiated the debate over whether students could now safely return to classrooms, and what would be required to do so, which resulted in a massive patchwork of approaches across the United States. Now, with 3 available vaccines and a much greater understanding of COVID-19, the debate continues. A briefing from the Infectious Diseases Society of America offers some much needed information.

In her opening remarks, Tina Q. Tan, MD, FAAP, FIDSA, FPIDS, professor of pediatrics at Northwestern University, Feinberg School of Medicine in Chicago, Illinois, and editor-in-chief of Contemporary Pediatrics addressed the common questions that occur in the debate over school reopening: why is now the appropriate time; how will children be safe; and why is the return to school so important. Tan noted that research continues to indicate that schools are not a likely source of superspreader events, when proper infection control procedures, such as masking, creating small cohorts, and social distancing, are followed, and that community spread was a more likely source of infection. In-person education is critical for children, Tan said, not only for academic learning, but as a source of reliable nutrition, speech therapy, occupational therapy, and a safe place to address inequities. Over the past year with distance learning, a number of concerning educational outcomes have been noted including falling test scores, increased absences, and an increase in the number of drop-outs.

Tan also addressed how important vaccinations are in getting children back to school, with many states putting teachers and staff into priority groups. Only the Pfizer vaccine is authorized for use in any segment of the pediatric population and it can only be administered to children aged 16 years and older. Moderna is expected to report on their ongoing vaccine trial in children aged 12 to 16 years by early summer and if authorized, children in that age group could be receiving the vaccine in time for the start of the 2021-2022 academic year. Pfizer and Johnson & Johnson will likely report their results later in 2021. It’s expected that the companies will expand their vaccine trials to children aged younger than 12 years in the next few months, which could mean an authorized vaccine for all ages in early 2022.

Preeti Malani, MD, MS, MSJ, FIDSA, FSHEA, professor of medicine in the division of infectious diseases at the University of Michigan in Ann Arbor, noted that safe school openings will look different across all communities. It will require balancing the benefits gained from face-to-face learning with the risk of infection. In places where a full return to school may not be possible, she said that officials should prioritize elements of school that can’t be done remotely such as science labs, performance, and team sport physical education.

Tan addressed a couple of studies from Italy and Israel on schools and the new variants of COVID-19 that have popped up in those regions. She stressed that some of the schools included in the study did not utilize necessary infection control strategies, but that little information on this topic has been found in the United States so far. Malani felt that the variants allowed for very little room for error in managing the disease.

With the increasing roll-out of the vaccines and continued following of guidelines, both Tan and Malani agreed that returning to normalcy in schools will likely be possible in the near future, especially as vaccinations expand.