Reopening Schools: Three COVID-19 Risk Mitigation Strategies for Students, Teachers and Families

Perhaps nothing in the current pandemic defines the complexity of both the virus and our times as that of returning children to schools.

The jury is still out on the risk the coronavirus presents to children, and their role in the transmission of COVID-19. However, with certain exceptions, the Centers for Disease Control and Prevention (CDC) urges parents, guardians, and caregivers to weigh the relative health risks of COVID-19 transmission from in-person instruction against the risks—educational, social and emotional—of in-person schooling. They conclude, ultimately, that other than a child’s home, there is no other setting that has more influence on a child’s health and well-being than their school.

In a timely editorial in the September 4th edition of Science, Penn clinician researcher Garret A. FitzGerald, MD, FRS, and colleagues Ronan Lordan, PhD, and Tilo Grosser, MD, propose a practical approach to reopening schools during the COVID-19 pandemic.

Highly regarded in his field, Dr. FitzGerald is the founding director of the Center for Experimental Therapeutics at Penn Medicine -- now the Institute of Translational Medicine and Therapeutics (ITMAT), and the McNeil Professor in Translational Medicine and Therapeutics at the Perelman School of Medicine at the University of Pennsylvania.

Additionally, Dr. FitzGerald is Chair of the Department of Systems Pharmacology and Translational Therapeutics at the Perelman School of Medicine, which specializes in the discovery of new drugs and their investigation. His colleagues Drs. Lordan and Grosser are currently conducting research at ITMAT.

Science Editorial: Reopening Schools During COVID-19

In their report, FitzGerald, et al. suggest that schools considering reopening follow an array of commonsense risk mitigation strategies, specific to school operation, personal protection, teaching, student and teacher health and family life. When combined with increasing stringency in a layered approach, these measures may reduce the probability of infection risk in children, teachers, staff and family members.

Three COVID-19 Risk Mitigation Strategies for Students, Teachers and Families

The following offers a general overview of the the authors' proposed risk reduction strategies:

Minimize the import of infections into schools to contain outbreaks.

• This may be achieved by restricting in-person learning to local communities in which infection is controlled. Schools may regulate hallway traffic and student-to-student and student-teacher interactions.
• For students, protocols for quarantine and immediate isolation, if necessary, should be in place.

Reduce the likelihood of further viral transmission within schools.

• Transmission within schools is rare when rigorous measures are in place to reduce person-to-person spread.
• For students, this may involve distancing, face masks in hallways, hand hygiene, avoidance of activities in which excessive exhalation is intrinsic, and stay-at-home schooling if minimal symptoms are noted.
• To reduce transmission, schools may establish daily symptom screening, frequent cleaning procedures, provide sufficient ventilation, and limit room occupancy.

Minimize large outbreaks by limiting secondary transmission to the smallest possible number of persons.

• Large outbreaks in school can be minimized by limiting secondary transmission to the smallest possible number of persons. Should outbreaks occur, contact tracing may be established.
• For schools, early detection of infected individuals through symptom screening and diagnostic testing, the authors note, can limit quarantine to affected student cohorts, rather than having to close entire grades or schools.
• For students, reducing the risk of transmission means improving health behaviors at home, better nutrition, sleep-stress reduction and limiting exposure to non-family members. Schools can institute the same measures applied to the containment of outbreaks to limit seed infections.
• Finally, the authors reflect on community responsibility, observing that children can go to school if communities prioritize suppressing viral spread in other social gatherings.