Infectious Disease

1 year after the pandemic began, experts are discussing the safety of opening schools

March 11, 2021

3 min read

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Press conference.

Disclosure:
Malani, Tan and Walensky do not report any relevant financial information.

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To mark the one year anniversary of WHO declaring a COVID-19 pandemic, the Infectious Diseases Society of America convened a press conference to discuss reopening schools.

Although the CDC has issued guidelines on how to safely return children to face-to-face learning, “there are some questions that always concern the reopening of schools”. Tina Q. Tan, MD, FIDSA, said during the discussion.

Tan, an attending physician in the infectious disease division at Lurie Children’s Hospital in Chicago, said they can help schools with their reopening plans as new data becomes available.

According to Education Week, at least six states require that K-12 in-person tuition be available in either part-time or full-time in all or some classes. In most states, however, decisions are made at the local level.

“Over the past year we have learned that the school environment, even when appropriate mitigation protocols are in place, does not seem to serve as an overarching environment and in-person learning in schools is not associated with significant community transmission,” Tan said.

Rochelle Walensky

CDC director Rochelle Walensky, MDalso stressed this when announcing the CDC guidelines last month, saying that the available data shows that “face-to-face learning in schools was not associated with substantial community transmission”. A recently published study showed that in-school SARS-CoV-2 transmission was “limited” during a 9-week period of face-to-face learning in 11 North Carolina school districts. Another study found that educators are “central” to the spread of SARS-CoV-2 in schools.

The CDC set out five mitigation strategies schools should follow in order to reopen safely, including two that Walensky highlighted: universal and correct use of masks, as well as keeping them at least 3 meters away.

Although teachers are a priority group for vaccinations, CDC guidelines do not require teachers, administrators and staff to be vaccinated to work in the building.

For college students, only one of the three vaccines available in the US – the one made by Pfizer-BioNTech – is approved for use in a pediatric population. Children aged 16 and over can receive it.

According to Tan, experts must estimate that at least 70% of the US population must be vaccinated to achieve herd immunity. She said the pediatric population is estimated to be around 25% of the total population.

“You can see that although the rate of vaccination is increasing in the adult population, a large portion of the pediatric population needs to be vaccinated in order for us to achieve herd immunity,” Tan said.

Pfizer recently completed registration for studies testing the vaccine in children ages 12-15, and Moderna has also started testing the vaccine in children ages 12 and up. Both are expected to release data in late spring or early summer, Tan said.

“Vaccinations for this age group may be available by the fall of the school year,” she said.

According to Tan, Johnson & Johnson, whose single-dose vaccine was recently approved, has just begun vaccine trials in the 12-16 age group and the results will not be available for a while. She said studies on vaccine use in infants and children up to the age of 12 should begin in early summer.

“The results of these studies are unlikely to be available until late fourth quarter or early 2022,” Tan said. “As the vaccine becomes available, it will be rolled out gradually according to age, with 6 to 12 year olds being vaccinated first … followed by 2 to 6 year olds and finally 6 month to 2 year olds. ”

Could COVID-19 vaccination be made mandatory for students as it is for other vaccines?

“It’s always a possibility as this is a virus that is very easily transmitted, especially some of the newer varieties,” Tan said. “We just have to see.”

Preeti N. Malani, MD, MS, MSJ, FIDSA, The chief health officer and professor of medicine in the Department of Infectious Diseases at the University of Michigan noted some differences between reopening K-12 public schools and reopening colleges and universities.

Testing among K-12 populations “isn’t quite as nimble,” Tan added.

Tan said that many American school districts do not have the financial means to test children in younger age groups, and that tests do not seem to work most of the time in younger children because they are often asymptomatic or have mild symptoms.

“The recommendation, at least in the pediatric population, is really not to do routine testing in the case of the K-12 room,” she said.

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