As a parent, and as a teacher, I look at all the information on rising case rates with the delta variant, and I worry – is going back to in-person school a reasonable choice at this time? I think the answer depends on a large number of factors. I’m going to walk you through questions to consider, using three examples: my current home of Kirkland Washington (in King County), and my home town of Cheyenne Wyoming (in Laramie County) and Dallas Texas. All numbers current from the week 8/16-20/21.
The questions to consider are:
- Chance of Exposure: how common is the virus in your area? How contagious is it?
- Reducing Community Spread: the more people in the community that have some immunity through vaccination and/or previous infection, the better, because that means fewer people in the community who will catch and transmit the virus.
- Risk Reduction: what is being done in the community / school to reduce children’s chance of catching coronavirus?
- Disease Severity: if a child does get coronavirus, how sick will they get?
- Your Goals for Your Child’s Learning this Year
It’s worth noting at the top that the American Academy of Pediatrics has urged a return to in-person schooling, saying “the benefits of in-person school outweigh the risks in almost all circumstances.”
What are the current infection rates?
So, first, let’s look at: how common is coronavirus in the community – this shows how likely it is that you could be exposed. In King County, over the past 7 days, there were 180 cases per 100,000 or ~1.8 per 1000 in 7 days. In Laramie County, they report 508 cases in the last 14 days in a county of ~90,000 people, so the equivalent of ~2.8 per 1000 people in 7 days. In Dallas, they’re currently reporting 1000+ cases a day, the equivalent of 2.7 per 1000.
How contagious is coronavirus?
The original COVID-19 strain had an R0 of around 2 – if there wasn’t any immunity in the people an infected person came in contact with, each sick person could get two other people sick (who then infect four people and so on).
The Delta variant is much more contagious. If there’s no immunity, one sick person can infect 5 or more other people, who then infect 25 or more people and so on.
With Delta, if there was no immunity and no attempts at prevention, the spread would be very rapid. Thankfully, we can gain some immunity through vaccination or some immunity through previous infection with COVID, and we can reduce risks with practices like masking, distancing, and ventilation.
What percent are vaccinated?
The best protection against COVID is the vaccine. In King County, WA, 71% of the total population has received at least one dose. (On the Eastside of Seattle, WA, vaccination rates are high: amongst people over 12 years old, 91.7% have received at least one shot. And amongst our elders – the most vulnerable to COVID – over 95% are fully vaccinated.) In Cheyenne, 35.4% of the total population is fully vaccinated. In Dallas, 54% one dose, 38% fully.
Vaccines do not completely prevent infection. But they significantly reduce the risk.
If someone does get a breakthrough infection, the illness will be much milder, and they’re much less likely to be hospitalized or die. (In the U.S., there have been ~8000 fully vaccinated people who have been hospitalized or died, but that is a small number amongst the 166 million people who have been fully vaccinated. With Delta, the numbers are increasing, but still the chance of severe illness or death is lower amongst the vaccinated.)
What percent have a previous COVID infection?
If someone has already had COVID, they may have immunity against it. (One study found that 92% had immunity 6 months after infection.) It’s recommended that those who have had it also add the layer of vaccination. Amongst people with previous infection, those with no vaccination were 2.5 times more likely to get re-infected than those who had also been vaccinated.
In King County, there have been ~127,000 confirmed cases. That’s about 4% of the population. In Laramie County, there have been 9832 confirmed cases. That’s about 10% of the population. In Dallas County, 287,000 or 11% of population.
Look at what is being done in your community and in the child’s school to reduce the risk of transmission. Think about layers of protection – covering coughs, masks, hand-washing, increased ventilation / outdoor activities, and social distancing. (Here are recommendations from the AAP – American Academy of Pediatrics.)
In the parent-child classes that I teach and at my son’s school, we are: requiring vaccines for all adults in the classroom, requiring masks indoors for everyone over the age of 5 and recommending for age 2 – 5, creating routines for frequent handwashing, increasing ventilation and the amount of time spent outdoors, splitting kids into cohorts or setting up rotation between activities to increase social distance. We also live in a community where a large percentage of people are masking everywhere they go, so I know our children have less community exposure in many places. I am feeling fairly confident about our protocols.
I would feel much less confident in Cheyenne. Their school district website does not mention COVID vaccines or describe any protocols other than saying they will decide on August 20 whether or not they’ll be requiring masking. I’ll also say that as we’ve been around Cheyenne this week, few people are wearing masks. And in Texas, there are battles between school districts, courts, and the governor about whether schools will be allowed to require masks and a lot of political and popular rhetoric about masks as an imposition on personal freedom.
What if a child gets COVID?
So, I can look at how likely it is my child might catch COVID and what all steps are being taken to reduce the risk, but I also have to ask what the impact would be if these steps did not prevent infection.
For most children, COVID is a mild infection with cough, fever, and body aches, or no symptoms at all. (More about symptoms.)
For some children, it can be severe, leading to severe illness (including MIS-C), hospitalization or death. Children who are obese, have diabetes or have chronic lung disease are at higher risk. Black and Latino children are also at higher risk.
Let’s take a moment to compare COVID risk to risks that we considered normal in past years. Let’s look at flu which has an R0 of 0.9 – 2. In 2019, when we weren’t doing much to prevent flu beyond typical school hygiene, there were an estimated 12 million cases of the flu in our 75 million children age 0 – 17. So, 16% of children had the flu. There 254 deaths, so a 5 in 100,000 chance of death after contracting flu.
Between February 2020 and May 2021 (source), when many schools across the country were shut down and we were taking many steps to prevent COVID transmission but there were no vaccines, there were an estimated 26 million COVID infections in children age 0 to 17. (There have been 3.7 million confirmed cases, but the CDC estimates that we’re missing lots of cases of kids who are asymptomatic or barely sick so don’t get tested.) There were 332 deaths. That’s a 1 in 100,000 chance of death after contracting COVID. The majority of those deaths were in children with other health conditions.
In academic year 20-21, when adults were at higher risk and couldn’t be vaccinated, many schools chose to stay closed. This year, when any adult who chooses to be vaccinated can be, it was looking like an easy decision to have schools be open. There was the risk that more children would catch COVID than caught it last year, and likely more than catch the flu in a typical year, but it also appeared that COVID was milder for many children than flu. If we were talking the original strain, then personally, as a teacher and as a parent, I would feel quite confident with school resuming in my community with our vaccination rates, masking habits and the protocols in place. (I would not feel nearly as confident in Cheyenne or Dallas.)
However, Delta variant complicates things. It is far more contagious than the original. It also appears that Delta may be riskier for kids than the original strain, leading to more cases of severe illness. So, there’s a lot of uncertainty right now. So, then I have to balance the coronavirus risk with all the other factors.
Benefits of In-Person Schooling
The American Academy of Pediatrics says: “Schools provide more than just academics to children and adolescents. In addition to reading, writing and math, students learn social and emotional skills, get exercise, and have access to mental health and other support services. For many families, schools are where kids get healthy meals, access to the internet, and other vital services… Families, schools, and communities can work together to help ensure students can safely return to and remain physically together in school this fall.”
The final factor for each parent to consider is what are the benefits of in-person schooling and whether they outweigh the possible COVID risks. What are your learning goals for your child. What does your child most need at this time to move forward in their learning and development?
Last year, my kid was quite successful at online schooling. As a child with ADHD and autism, he actually did better in many ways at home than he does in the classroom with his peers. Emotionally, he was more stable, and academically, he was solidly on track. But, I feel like he needs to get back in the classroom with peers. I have confidence about my child’s academic skills in any setting, but he needs to figure out social interaction, impulse control and emotional regulation in interaction with others. And he needs to do that this year – his last year in elementary school before hitting middle school.
Last year, I taught children ages 2 – 7 online. And they did far better than I could have imagined in engaging with the activities, learning the concepts, and even in connecting with the teachers and the other children. But I also feel like it’s time to get them back in the classroom with other children. In a typical year, my programs are play-based. The majority of class-time has children choosing their activities and having lots of one-on-one interactions with other kids and the teachers. We only spend a third of class time in a structured teacher-led format. We do some great stuff in that structured time, but it’s the play-based portions of the class where the most learning takes place. Our online classes were all structured teacher-led learning. (We, of course, encouraged parents to do lots of hands-on projects at home with their children. But that’s different than the free choice, child-led way we do it at class.)
I believe children are remarkably resilient. I believe adults are incredibly adaptable when pushed to be. I’m so proud of everything we did last year, and I think our kids are all pretty much on track despite all the learning disruption. And yet, I think the time has come to return to in-person learning. Yes, the COVID risks scare me. But for me personally – again, in my community with the vaccination rates, masking and protocols, I feel that returning to the class is the right answer.
Your choice for your family in your community with your local protocols may be different. I think, as always, every parent needs to decide what’s best for their child, taking into account the best information available.