By NIRAN AL-AGBA, MD (3)
Two weeks ago, Gov. Jay Inslee announced that Washington will likely reopen in stages. Halfway across the globe, Denmark has already begun a gradual process lifting its nation’s coronavirus lockdown by reopening schools for children in kindergarten up through the age of 11, in an effort to prioritize the education of its youngest students.
Kåre Mølbak, from Denmark’s infectious diseases agency SSI, commented that the decision to gradually reopen was based on the confidence that citizens would continue upholding social distancing and hygiene recommendations. Denmark also plans to reopen in phases, though it will focus next on the return of middle- and high-school students to school by May 10. Restaurants, bars and other businesses will remain closed until “the next phase.” The ban on large festivals and other events, thought to contribute significantly to the spread of disease, will remain in place until much later, reportedly through the summer.
Washington will likely resume activity in the reverse order in which it shut down, however, Denmark might be on to something. Children not only get milder disease, but they also seem far less likely to contract COVID-19. A study published in the journal Nature Medicine screened 745 children who had close contact with patients or family members with confirmed COVID-19 disease and found only 10 children in the entire group tested positive. Of the 10,000 confirmed cases in Washington state, just 3% have occurred in children under the age of 19. Children’s Hospital in Seattle reported in March that out of 660 children tested, only 4 children tested positive. In my office, though I have only sent about a dozen nasal swab tests, not a single child has tested positive either.
On April 6, Gov. Inslee announced schools will remain closed, and distance learning will continue through June. While I supported school closure this past March to slow the spread of COVID-19 disease, my feelings are mixed about the notion of not re-opening our schools this year. Extended school closure has far-reaching economic and societal consequences and will exacerbate disparities in the educational, socioeconomic and health needs of children.
We need to ask ourselves how this decision to extend school closure will impact our vulnerable children in the long-run.
While research demonstrates short-term closures — due to inclement weather — have minimal effects on learning, the impact of more prolonged closures on student progress is largely unknown. The best comparative research shows test scores of Canadian and Belgian schoolchildren decline significantly following school closure associated with lengthy teacher strikes. In the U.S., student test scores almost always decline in the fall because of a phenomenon known as the “summer slide.” How much farther will students’ scores tumble after missing five months of school?
The role schools play as a provider of social services is indispensable. Right now, parents are forced into an impossible situation. They are arranging childcare to be able to work while struggling to facilitate learning at home. Schools are an economic safety net for many disadvantaged families. The school lunch program is the second only to the food stamp program as a critical anti-hunger initiative in the United States. Almost 45% of Washington state’s 1.1 million students enrolled in traditional public and charter schools qualify for subsidized school meals.
As a pediatrician, I am even more concerned about those students who are homeless, food insecure or being exposed to violence more regularly at home as a result of school closure. School is the one place where children can feel safe, fed and supported. Children with disabilities — who receive speech, language and other therapies — have been unable to continue their specialized services at school, which are essential to fostering learning and development.
Our local school districts have been tremendously innovative during this time to support students who would not otherwise have access to critical resources. They should be commended for their work to adapt to this unprecedented situation. But there is little a school district can do about a widening achievement gap between children from poorer and richer homes as school closure drags on.
While Gov. Inslee has announced a gradual re-opening of society, he has not shared the finer details yet. In my opinion, we should watch Denmark closely and consider prioritizing the education of our youngest citizens. We are already educationally behind developed countries like Denmark. Inequality, already a huge problem before the pandemic began, is likely to grow worse after the shutdown ends. What if the COVID-19 school closure permanently divides our school children into a group that pulls ahead and a group that lags behind? And if those differences have a life-long impact, that is bad news for our future generations.
Dr. Niran Al-Agba is a pediatrician in Silverdale
Related to this:
I’ve been tracking @aliostad on Twitter on the situation in Iran for months …
There are reports of kids getting sick and dying at a children’s hospital in Tehran, which is counter to what we “know” about the virus. The conventional wisdom is that kids are essentially immune to the virus for reasons that we don’t yet fully understand.
If the reports from Tehran are accurate, they may be a warning of what could happen in places where lockdowns are relaxed too early
Authorities allowed the epidemic to spread unchecked and denied that was anything was wrong
It is has now advanced
(Fundamentalists in general have a real problem wrapping their minds around the virus, it seems)
As a result Iran’s outbreak is believed to be much worse than officially acknowledged.
One epidemiologist puts the number of infected at 1.6 million
And things are happening there first. Things we haven’t seen yet …
Doctors are dying. Younger people are dying. Healthy people are collapsing in the street with mysterious neurological symptoms. And now kids may be dying.
This tells me we should be paying very, very close attention to what happens in Iran
I did a little digging and found one preprint on Iranian COVID cases by local researchers that dates to early March.
It’s possible we may even be seeing the early stages of a second wave in Iran
That’s something we should be watching closely. Because thanks to the political chaos that has allowed the virus to spread unchecked, the country which looks most like Iran right now is us.
Agree, we should look to the experience of other countries of the world (both good and bad) for direction. The disparities amongst nations is an interesting discussion alone. Some are seeing considerable numbers of children with Atypical Kawasaki disease and some are not. We have never known the causative agent of Kawasaki to begin with which creates more questions than answers.
I think the point here is that we’re dealing with a huge amount of uncertainty.
We keep telling people what the Virus is and what it isn’t.
The fact is that we don’t know.
We’re seeing kids getting sick in places where outbreaks have reached advanced (Italy, Iran and the UK) and in places like Long Island and Michigan in this country. This contradicts the conventional wisdom.
We’ve gone from “no kids are at risk” to “kids can develop life-threatening heart problems” in record time.
https://www.nbcnewyork.com/news/local/more-local-hospitals-report-children-with-possible-covid-19-health-consequences/2399514/
https://www.cbsnews.com/news/coronavirus-kawasaki-disease-rare-children/
https://www.ctvnews.ca/health/coronavirus/canadian-doctors-investigate-possible-link-between-covid-19-and-rare-children-s-disease-1.4922856
https://www.ctvnews.ca/health/coronavirus/canadian-doctors-investigate-possible-link-between-covid-19-and-rare-children-s-disease-1.4922856
https://www.voanews.com/covid-19-pandemic/covid-link-suspected-childrens-inflammatory-disease
Does this mean that we should keep the lockdowns going and schools closed? Maybe. Maybe not. The economic damage we’re seeing may be the greater evil.
As we debate the wisdom of reopening the economy and sending kids back to school, we need to understand what’s going