Should kids return to school? 20 medical experts weigh in

Parents everywhere are grappling with the question whether it’s safe to send their children back to school.

The Centers for Disease Control and Prevention recently released guidelines emphasizing that students get back to the classroom for the sake of their own emotional well-being. But not every student, parent, or teacher is comfortable with that. Some school districts will likely continue with remote learning or some hybrid blend of in-person and remote.

The situation is highly confusing and the guidelines seem to be shifting. So we asked twenty doctors, public health experts and epidemiologists with school-age children if they’re sending them to school this fall.

We got a wide range of responses, which were highly dependent on their location, personal risk tolerance, degree of support at home, the measures taken at the individual school, and the age of their children.

Six of the medical experts felt confident about sending their kids back. Eight were in “wait and see” mode. And a final six were leaning strongly towards remote learning and were not comfortable with the prospect of having kids in school — at least for the beginning of the year.

Things could certainly change as the start of school approaches. As Boston-based emergency medicine physician Dr. Jeremy Faust put it, “the answers will entirely depend on how well Covid-19 is being controlled” as we move into the fall. 

Here’s a summary of what each group had to say.

Dr. Ashish Jha, director of the Harvard Global Health Institute, is feeling confident that his three kids will return to their schools in Massachusetts this fall. But it’s likely that their school will embrace more of a hybrid model, meaning some combination of remote and in-person learning.

Jha isn’t wholly convinced the hybrid approach is necessary. “Our infection numbers are relatively low,” he said. “And there’s enough capacity to create safe spaces.”

Jha says there’s some evidence that kids are less likely to catch the virus and less likely to spread it. But he acknowledges that the data is still limited, particularly given that countries like Sweden that kept schools open for young kids throughout the pandemic didn’t do a thorough job collecting the data. So while he thinks it’s possible for many schools to safely open up, but believes that much more should have been done on a federal level to help them prepare.

“If you open up without a good plan in a place that isn’t safe, you’ll get outbreaks and you’ll shut down,” he explained. 

While Jha is leaning to sending his own kids back, he wouldn’t recommend that every parent return children to school. He would look at the community spread in the region first before making a decision. “If I were in Dallas, for instance, which is experiencing an active outbreak, I’d strongly recommend against it.”

Likewise, John Brownstein, an infectious disease epidemiologist and the chief innovation officer of Boston Children’s Hospital, is helping his kids’ school come up with a plan for how to re-open. A lot of the parents are doctors and infectious disease experts, he notes, given the sheer number of universities and academic medical centers in the area. So many are recommending social distancing, masks and other protocols. His kids, who are aged 9 and 10, will go back to school unless community transmissions spike in the area. 

Physicians in states that are seeing lower rates of infections tended to be more in favor of sending their kids to school. Dr. Mary Beth Miotto, a pediatrician and public health advocate based in Massachusetts, has thought a great deal about whether she’s comfortable sending her youngest child to Williams College as a freshman. She ultimately decided in favor of in-person learning because the college, which is in a relatively remote area, had systems and processes in place to keep the kids safe. But she didn’t take the decision lightly.

“After carefully examining the systems to control and respond rapidly to change, yes, I’m sending him because it’s a developmentally appropriate step and important socially-emotionally,” said Dr. Miotto. 

Others were deferring their decision to the school. Dr. Dan Buckland, an emergency medicine doctor at Duke, feels relatively confident about sending his kids back to school if the right steps are taken to keep them safe.

“For a lot of people, especially with kids under the age of 10, It’s not sustainable to continue to work and take care of them at home,” he shared. That said, Dr. Buckland would keep his kids home if there were a significant danger to the staff, teachers and support personnel. “I don’t think we should obligate them to put themselves at risk,” he said. 

For single parents, the equation might be different.

“I am a single mom of a child adopted from foster care. I would accept the risks of infection to send her back to school,” said Carolyn Cardamone, a Physician Assistant with One Medical. Cardomone noted that her child needs help with social and development skills, which she can gain by learning alongside her peers. “She is entering fifth grade this year and the idea she will miss this year of in-person instruction, then go straight to middle school, is terrifying.”

Many of parents were still on the fence.

Dr. Esther Choo, an emergency medicine physician at Oregon Health & Science University, has four school-age kids. She’s leaning towards distance learning because her school is asking parents to decide within a few weeks if they plan to return their kids by September. For Choo, that’s a big challenge as there’s no way to know yet whether Covid-19 cases will spike by then. 

“What I struggle with is schools needing us to commit now,” she said. 

Likewise, Aaron Miri, a chief information officer for UT Health Austin in Texax, said it would all depend on the plan in place. He’s hoping there will be adequate personal protective equipment available and whether there’s testing and/or contact tracing to track potential exposures to the virus. Right now, he’s not feeling confident. And his wife is a fifth-grade teacher, which makes the issue more complex for him. “If they can’t give assurances soon, I think lots of folks will say ‘no thanks’ to in-person,” said Aaron Miri. 

Texas, where Miri lives, is still struggling to get Covid-19 under control. The situation starting to level off in Austin, he notes, although it’s unclear how things will be in the fall.  

For many of the doctors, it’s a challenge to look at the public health data objectively because they’re also parents. And as parents, they feel their kids would be best served by being back in school.

Dr. Megan Ranney, an emergency medicine physician at Rhode Island Hospital, recognizes the challenges for so many of her peers trying to juggle work with kids at home. She feels fortunate to have some child care support, but recognizes that it isn’t easy to recreate the stimulation that her two kids — ages 8 and 11 — are getting at school.

“I believe so strongly in getting kids back, but it has to be done in a way that is safe for the kids and the teachers,” she said by phone, while her son reminded her that it’s time to play Roblox. 

Ranney said she plans to send her kids back if there are protocols in place, like proper ventilation, masks and smaller class-sizes. But she has warned her kids that she anticipates a scenario where the situation doesn’t last because of an outbreak. She personally doesn’t expect life to return to normalcy until next spring. “I want them back but with the state of public school funding and the state of Covid-19, I don’t know how it’s going to be possible,” she said. “But in Rhode Island, I think we at least have a chance.”

For Katie McMillan, a public health expert with a digital health consultancy firm, it doesn’t feel like the right time to send her three-year-old back to pre-school. Cases in North Carolina, where she lives, are continuing to rise. McMillan said she initially pulled her daughter out in March and then fully un-enrolled her in June. McMillan’s husband works at a hospital in the area, so they were also concerned about putting others at risk if he got sick — although he’s taking steps to mitigate that possibility by using proper protective gear and leaving his scrubs in the garage. 

For the fall, she may enroll her daughter in a school that offers smaller classes fully outdoors “from a sanity standpoint,” but says it’s unlikely. McMillan, with the help of her childrens’ grandparents, keeps up with her own work as best she can. It’s a struggle because her youngest is only eight months old.

Many parents face a similarly tough road because their shifts are long and it’s a challenge to find childcare.

 “I need them back in school yesterday,” said Dr. Jon Steuernagle, who’s currently separated from his partner and is looking after the kids most of the time on his own. But he probably won’t return them to school anytime soon. He fears for the teaching staff who might be highly vulnerable to getting sick from Covid-19. And he recognizes the challenges with maintaining social distancing when it comes to young kids.

Some of the doctors say they don’t have much of a choice.

Dr. Jane Van Dis, an obstetrician-gynecologist, was planning to send her kids back but in California it’s unlikely to happen because most schools have been ordered to start with remote-learning only.

“Even though I feel like in my area and school district, people are following the guidelines,” she said. “But I live in Los Angeles County, which is so big, and I wonder if there’s a chance that we can bring the numbers down to allow for in-person school.” 

Many agreed that they are privileged as doctors and academics to be able to afford help when it’s needed. Dr. Jonathan Slotkin, vice chair of neurosurgery at Geisinger based in Pennsylvania, is keeping his five-year-old at home. But he recognizes that he’s in a fairly unique position to be able to do so. Still, with Covid-19 still spreading in the United States, it’s a firm “no” for him. 

Even the parents who are planning to send their kids back to school in the fall are expecting that there could be a bump in transmissions. So families should be aware of the risks, they say, while weighing them against the benefits of socialization.

Moreover, school districts might react differently if there is an outbreak. Some might shut down, while others attempt to continue if they have the resources to do so. 

“I’m concerned our numbers in the community will dramatically change — and that could change my comfort levels with my own kids,” said Dr. Wendy Sue Swanson, a pediatrician based in Madison, Wisconsin. She feels confident about the plans underway at her own school, but it’s hard to know what the future will hold. 

“No place can guarantee zero transmission,” she said. “And there’s no guarantee that going back to school is as safe as not going back, but there’s always that difficult balance of risks and benefits.”