A coalition of doctors at UCSF are calling for California schools to reopen by February 1, saying mounting evidence shows that schools are not a primary driver of outbreaks or COVID-19 transmission.
"In the Bay Area, we actually have the lowest mortality rate from COVID of anywhere in the country. So we’ve done very well in our COVID response, but our schools remain closed,” said Dr. Jeanne Noble, the Director of COVID response and Professor of Emergency Medicine at UCSF and the lead author of the open letter, first published by the SF Examiner.
"We have now the longest school closures of anywhere in the world."
A recent study published in the journal Pediatrics followed 90,000 K-12 students and 10,000 teachers for nine weeks and found only 32 cases of campus-based transmission, during a period where community spread was well above the level California’s purple tier.
"These are just tiny numbers, and it’s a testimony to the power of masks and social distancing," said Dr. Noble.
Locally, data from Marin County’s school reopening documented only seven cases of campus-based transmission. The county has had 40,000 students and 5,000 teachers back in school since September during the region’s worst ever surge.
Meanwhile, keeping classrooms closed had led to lower attendance, worsening grades, increased stress on parents and significant mental health impacts.
Benioff Children’s Hospital-Oakland conducts suicide screenings for every children age 10-17 that is admitted into the emergency room. In March, 6% of children screened positive for suicidal ideation. That number increased to 16% by September, with school closures often cited as a reason for despair.
"That’s really the tip of the iceberg. When a child becomes suicidal that’s quite severe," said Dr. Noble, citing "off the charts" increases in diagnoses of eating disorders, social anxiety and social phobias.
"Our kids are suffering and since we now know that schools can be operated safely, there’s no longer the justification to continue this ongoing harm."
There has been significant pushback against reopening schools in some areas from teachers and teachers’ unions who have expressed concern over the winter surge and safety measures.
Dr. Noble added that transparency from school and public health officials is crucial to dispelling that fear.
She worried that the discussion around ventilation and aerosol transmission has eclipsed the importance and effectiveness of simple masking and social distancing, as droplets are still the dominant form of transmission.
"You don’t have to be terrified as a teacher that when there are COVID cases in your school that you are going to bring it home and infect a family member. Masks and social distancing work."
She said that while new HVAC systems and HEPA filters are beneficial, even keeping hallway doors open can improve ventilation.
"Because we now have the data that schools can operate safely - we know that based on studies, based on observation - and we have real measurable data of detrimental impact to kids from school closures, it really feels like from a public health point of view, from a mental health point of view, from a societal health point of view, it is time to get kids back in school. We know we can do it safely."