Virus Outbreak schools

Des Moines Public Schools custodian Tracy Harris cleans chairs in a classroom at Brubaker Elementary School, Wednesday, July 8, 2020, in Des Moines, Iowa. Getting children back to school safely could mean keeping high-risk spots like bars and gyms closed. That's the latest thinking from some public health experts. (AP Photo/Charlie Neibergall)

An alternative collective to the state's Reopening Schools Working Group has submitted a plan of their own as public comment to be a part of the process for getting children back into Delaware's classrooms.

Stand Up Delaware, a Facebook group whose members have claimed the state's coronavirus restrictions violate their constitutional rights, called Delaware's schools reopening fully this fall "a crucial step." 

"There are lot of political aspects of this. We don't believe [reopening schools] should be one. We want our kids to be socially healthy, we want them to be educated, and we want them to be physically healthy," said Dr. Bryan McCarthy, who authored the white paper on behalf of the group.

Governor John Carney doesn't disagree, but said during his weekly coronavirus news conference, it has to be done safely.

"Our goal is to get as much in-person instruction as possible, but to do it in a way that's safe...and it can't be one or the other, it has to be both," said the governor.

While the Centers for Disease Control has called remote learning the "safest," the American Academy of Pediatrics issued a different position, stressing the importance of students being "physically present in school as much as possible," noting health, social, and educational risks of keeping children at home. The CDC's guidelines for reopening schools have also been deemed by experts, across the nation, as arduous, costly, and in some cases, simply not possible as everyone looks to balance education with health. Despite the criticism, the CDC has said it has no plans to rewrite its guidance for reopening schools.

McCarthy, a physician anesthesiologist, now part-time at Bayhealth Hospital, prepared the paper as part of a "collaborative effort" with the group's members. The paper includes statements from doctors, nurses, teachers, administrators, and parents who are part of the Stand Up Delaware Facebook group. 

The group calls for full-time, in-person instruction and no combination of distance learning, except in cases of high-risk students and educators.

To accomplish that, the paper calls for any plan to reopen to be "practical" with emphasis placed on "minimal but vital evidence-based practices that can and will be earnestly enforced."

He called for students, parents, and teachers not to be over-burdened by the return to the classroom.

"Any disruptions to a normal school routine, normal being pre-COVID-19 should be effective. If it's minimally effective or just sort of theoretically effective, it's going to add to the impracticality of the plan," said McCarthy.

But Dr. Meghan Walls, a pediatric psychologist with Nemours/A.I. DuPont Hospital for Children who co-chaired the Reopening Schools Health and Wellness sub-group, noted kids are resilient.

"If the risk is kids might be a little uncomfortable and that some kiddos, perhaps, can't wear a mask--and we'll have to figure out what to do in those cases--but the reward is kids get to be back in school and see their friends and engage in learning in person. That reward, I think, for a lot of families and a lot of kiddos would out-weigh the risks," she said. "And then being empathetic, and saying, 'Look, we know this is not perfect. We know it's hard to wear a mask or to stay six feet away, we really want to get you back in school, so this is what we need to do, so let's work really hard together.'

"I've heard a lot of comments of like 'Oh my gosh, our kids are going to be miserable.' And I'm not sure that's true, and I think we really need to give our kids the benefit of the doubt and help to prepare them for that," she said.

When it comes to effective measures, neither McCarthy nor the Facebook group's members believe masks or facial coverings should be a part of returning to the classroom, claiming there's a lack of evidence in the coverings' efficacy. Currently, Delaware has a mask mandate that requires face coverings for indoor public settings--with the exception of sitting at a table in a restaurant--and outdoor settings where one cannot safely social distance. Sunbathing on beach does not require a facial covering, with the exception for a strict face covering ordinance in Rehoboth that was quickly repealed after the 4th of July holiday.

"Facing desks forward is not disruptive, and is not likely to result in push-back and truancy, whereas...universal masking of healthy people is likely to be highly divisive," he said. "The people on our committee, the parents we talked to, feel the same way. They're not sending their kids back into an environment like that...they think the kids would be better at home rather than be subjected to that." 

Masks was also heavily debated among the state's working group.

"There was some back-and-forth on that because not everyone is convinced that both masks, which is part of the scenario we did not get to [last week] and that guard are necessary," Walls said. "Some folks feel like that's, perhaps, an overreaction to have both," said Walls.

Dr. Kevin Fitzgerald, superintendent of Caesar Rodney Schools, talked about the difficulties of enforcing mask-wearing during one of the virtual meetings.

"I don’t believe this should ever become a disciplinary issue, where we would exclude a student because they don’t have a facial covering,” he said. “I’m always reluctant to put something in that is almost impossible to enforce."

Stand Up Delaware's white paper includes temperature-taking before entering schools as a part of the process of reopening schools safely. McCarthy noted the importance of identifying people at risk and balancing that with an "as close to normal education" as possible.

"If somebody becomes symptomatic with COVID-19--that's a whole different ballgame, now they are potentially shedding larger amounts of virus...when you have a cough and you have a fever...you're sick. So yeah, we think that that's a reasonable thing to do."

The group identifies a temperature of 100.4 degrees as warranting sending a student, educator, or staffer home for the day. The Reopening Schools group also used that same temperature as a guideline, but noted temperature-taking should occur prior to the start of school, at home.

McCarthy added any routine temperature-taking at school would require additional personnel.

"The teachers, the school buses, the administrators, are going to be working harder this year than they ever have before; it's not reasonable to expect them to be standing there at ingress points...taking kids' temperatures everyday, in addition to their other jobs."

Colleges and universities are implementing widespread testing, in some cases weekly, as a part of campus life. While the paper doesn't discuss testing, McCarthy doesn't see it being a part of K-12 education, citing the possibility of false negatives with testing.

The group's plan also called for "whole child support"-- a specific area that the Reopening Schools Working Group is addressing.

"As students return, schools must have counseling support to address the numerous causes of trauma that result from the deaths of friends and family members, economic hardship from a parent losing his or her job, or abuse, violence, or neglect of the student. The isolation brought about by social distancing can also exasperate a child’s depression and anxiety," the white paper said.

Kristin Dwyer, Director of Legislation for the Delaware State Education Association, said she heard from school psychologists and other professionals that there needs to be time spent on the students, before hitting the books again.

"There's a concern among specialists that districts will not give them the time to really focus on the mental health on the children. Rather, there will be such pressure on curriculum, getting students learning again. But our specialists think they might not be in a place to learn."

Dwyer added those changes could be tough for some trying to adjust.

"They need time to address the mental health of their students, to address the PTSD they may have, from anxiety to thoughts of suicide they may have experienced during this time. From going from learning digitally to having a schedule..." 

While the younger population has seen less COVID-19 infection, and fewer complications tied to infection in particular, teachers and multi-generational households could be at risk by returning to the classroom. 

"They can certainly catch it like we all can, but whether they become symptomatic and suffer serious consequences, it appears very much not likely that they would," said McCarthy. 

Asymptomatic spread of the virus continues to be an area under study. The World Health Organization last month was forced to walk-back comments that asymptomatic spread of the virus was "very rare." They later clarified that asymptomatic transmission rates aren't yet known.

Stand Up Delaware's plan calls for remote learning only for at-risk families and educators.

"The distance learning that was taking place in the spring...it really has sort of exacerbated learning inequality," McCarthy noted, an issue heavily discussed by the state's appointed working group.  

"If a child really has a high-risk individual in the home, there's a situation where, perhaps, distance learning or some change in the domestic arrangement might serve the whole family better, and similarly, teachers that are at-risk...older teachers or administrators, or anybody in the school system that is highly at-risk, has reason to believe they might be at risk, certainly they should have the option to be reassigned to tasks that don't involve a lot of contact with students or even other staff members," said McCarthy.

The Reopening Delaware Schools recommendations, under scenario three, where significant community spread is occurring, calls for teaching to be moved online for medically vulnerable students and educators.

He noted any kind of outbreak of symptomatic spread of COVID-19 in a school which leads to children hospitalized in large numbers--"everything would have to be re-thought," though he notes evidence doesn't suggest that likelihood.

"There's predictably going to be a spike--as people get back to their normal lives--in cases, especially if you're defining that by positive tests, and it's going to happen really sort of no matter when," said McCarthy. "We can delay it; we can delay it in hopes of a vaccine that has a 40-percent effective rate, but even if we delay it, we're going to see it."

In a recent non-scientific survey of more than 1,000 parents and caregivers by the Rodel Foundation of Delaware, parents expressed concerns that remote learning was "stressful" yet they worry about returning to school. Many said they would feel more comfortable sending children to camps, childcare centers, or back to school if the following measures were in place: 

  • Alerts for positive COVID-19 cases (85%)
  • Daily cleaning routines (84%)
  • Limiting group/classroom size (71%)
  • Temperature checks and screenings (67%)
  • Publicly available plans for instruction and services (54%)
  • Educator training and supports (52%)
  • Changes in transportation (20%)

The Reopening Schools Working Group completed its recommendations after weeks of virtual meetings, and submitted them to Delaware Education Secretary Susan Bunting. The group's recommendations are now under review by Delaware Division of Public Health. Their work encompassed three sectors: health and wellness, academics and equity, and operations and services, each discussing three scenarios: minimal, moderate, and substantial community spread of the virus.

"How can we bring school children back to schools to protect them, make sure that they're not going to get sick, and that they're well--from lots of different perspectives, not just protected by COVID-19 virus, but also mental health and stress concerns that we're all experiencing as a result of the shutdown, and the changes in lifestyle that students feel pretty dramatically," said Carney.

The health and wellness subcommittee's draft recommendations can be read here.  

The academics and equity input sought to ensure students get the instruction that they need, including those who aren't as well-connected via remote learning devices. That subgroup's recommendations can be read here.

"How do we move into an in-person arrangement? Because that's the most important and most effective," said the governor.

The operations/services piece includes meal programs and transportation. Their draft recommendations can be reviewed here.

"You pile all the children into buses, it's hard to distance them, and putting them into classes and serving them lunch as they move through their school buildings," said the governor.

McCarthy doesn't want to see a staggered school day as part of any plan to resolve transportation issues.

"I think parents should be encouraged, when possible, to provide alternate transportation for their kids, if they're able, perhaps in their little social bubble, car-pooling," he said. "I think that the school buses need to run; they need supervisory personnel on the buses...a kid's temperature should probably be taken," said McCarthy. 

Delaware Department of Education spokeswoman Alison May confirmed the group's report was received and is being reviewed. Delaware's reopening school guidance is expected next week.