Educators and child health experts agree broadly that it is hard to match virtually the value of in-person learning. But the goal of bringing students back to school buildings must be balanced with the imperative that we limit the spread of COVID-19. It is tempting to assign school leaders primary responsibility for achieving this balance. However, we need to consider our own role. How we handle ourselves as adults in the community will be the biggest predictor of success in the endeavor to safely open schools.
Here in Maine, the epidemiological picture is very good: as of this writing, no state has fewer new COVID-19 cases per capita than we do. In the overwhelming majority of Maine counties, we are seeing no evidence of significant community transmission. Maine has been a national leader in expanding access to COVID-19 testing. Current data includes a large volume of testing in asymptomatic people, the best way to learn in real time what is — or in this case is not — going on. Numbers have remained stable despite more than a month of increased tourist and seasonal resident presence. Yes, some visitors from out of state have received positive COVID-19 test results after their arrival, but this does not appear to be driving community spread here. It appears our visitors are generally doing what they’re supposed to do.
In this context, we are uniquely privileged to be able to develop responsible school reopening plans that include in-person instruction while much of the country is not in a position to do so. Educators and health professionals all over Maine have been collaborating to create these plans based on the best available scientific evidence, lessons learned from schools in other countries and input from families, teachers, school nurses and others.
These plans are complex. Many include a combination of remote and in-person teaching. They require multiple contingencies to accommodate possible changes in local epidemiology. They all incorporate many interlocking interventions to maximize safety. This is a monumental effort.
It is an understatement to say that we are asking a great deal of our school leaders and of all who are working to make it possible to safely operate schools during the COVID-19 pandemic. All of us want to know, what is the school district doing to ensure the safety of my child, me, my family members, my community? These crucial questions deserve well-considered answers.
Perhaps the most important question of all, however, is this: What will I do to make school as safe as possible? This question matters not only for the sake of our children, but for those who work in our schools as well as our friends and family at increased risk for serious COVID-19 illness. The simple truth is, if we can effectively prevent community spread in other settings, we are unlikely to see it emerge in schools.
So what should you do to keep our kids in class and protect yourself and others? Here are some guidelines:
At the top of the list is avoiding non-essential travel to any area with more COVID-19 transmission than ours. Given our current situation, the value of this cannot be overstated. Conversely, think carefully before welcoming visits to a home or workplace from individuals who live in communities with higher levels of COVID-19 activity.
Wear a mask, especially in indoor settings and especially when physical distancing is not possible. Hell, I’ve been wearing a mask every workday at the hospital since April 6. Do I love it? No. Is it doable? Yes. Is it worth it? Absolutely.
Continue to implement the physical distancing guidance with which we are already familiar. This will get harder as the weather cools and we spend more time indoors. Children need to be able to attend school, have some play dates, maybe even engage in some team sports activities. For that, we need to be smart about our own play dates.
Keep up the good hand hygiene.
Model the masking, social distancing and hand hygiene behavior for the children in our lives; teach by example. Prepare kids for what will be expected of them at school — before school starts. Many children in our community have already got this down, meeting these expectations in stores, at day camps, at medical visits and in various other settings.
For those who are low risk for serious COVID-19 illness: be especially cautious in all interactions with anyone you know is higher risk.
For those at higher risk for serious COVID-19 illness: in addition to everything else on this list, meet with your medical provider to review this risk and how to minimize it.
Stay home if you become ill; seek medical evaluation and get tested if indicated. Access to testing for symptoms is excellent locally, with rapid turnaround times.
Never knowingly send a sick child to in-person school. Adhere to all daily symptom screening guidance from your child’s school. If a school nurse calls you to report illness in your child, promptly pick that student up and contact a medical provider for advice on next steps.
Most of us have by now established various social or family “bubbles,” within which we may relax some of these measures. Currently, that is okay. But we need to continue to be very careful about all of this if we want to be able to safely maintain these oases of relative freedom.
Can we do all of the things above all of the time? No, but be mindful of what matters most for us here in Maine: travel avoidance, masking and extra caution around those at higher risk. We cannot realistically always be physically distanced from each other, but consider those of us in health care. Across MaineHealth, our care team of 22,000 people has avoided significant outbreaks, thanks in large part to the effectiveness of masking.
The work being undertaken by our local school districts is vital, and we all should engage in this community planning, asking questions and providing feedback. But even the best-laid plans risk failure unless we as a community, led by the adults among us, do what we can on a day-to day basis to maximize our safety. We are starting from an ideal epidemiological position. We are the envy of our country. Let’s keep it that way. For kids, for teachers, for all of us.
Cheryl A. Liechty, MD, MPH, is an infectious disease specialist and hospital epidemiologist with MaineHealth. Prior to joining the medical staff at Pen Bay Medical Center in 2005, she worked for the U.S. Centers for Disease Control in Uganda and the University of California, San Francisco. She lives in Rockport with her husband and two sons.
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