Closing schools was the right call but here’s what must come next
Closing schools was the right call but here’s what must come next
In a recent briefing, Dr Michael J. Ryan, the grizzled executive director of the World Health Organization, laid out the lessons he learned about coronavirus from years of beating back Ebola in West Africa. “Be fast, have no regrets. You must be the first mover. The virus will always get you if you don’t move quickly,” Ryan said, “If you need to be right before you move, you will never win.”
New York City Mayor Bill de Blasio announced Sunday that public schools would be closed at least until April 20 to slow the spread of coronavirus. The mayor looked stricken as he explained that he’d spent the day with his health advisers who told him the virus is spreading so fast that what seemed unthinkable last week is now unavoidable. Last week, as a growing chorus of epidemiologists, parents, and labor leaders urged de Blasio to close the schools to slow pandemic’s spread and other localities such as Virginia, Ohio, Maryland, and Los Angeles County closed their schools, de Blasio resisted because he argued closing the schools would hamper the public health response, by forcing essential workers to stay home with their kids and deprive poor children of much-needed food, supervision, and medical care from school nurses.
Now, confirmed cases of coronavirus are surging in New York and the virus is now spreading so rapidly that city health officials told the public that we should all assume we’ve been exposed. “It is going to be a wave. And it is going to be a wave that at any of these projections will overwhelm the healthcare system,” Gov. Andrew Cuomo said on Sunday. On Monday, the governor announced that all 700 school districts in New York would be shut down for two weeks.
So New York’s challenge is to free up parents with essential jobs and to feed and provide medical care for the system’s neediest kids. Schools statewide should implement plans to meet these nutrition and health needs that typically are met by schools.
The epidemiological case for closing schools everywhere in the state is overwhelming. The average New York City public school has 562 students, and the largest over 5,000. While suburban and upstate schools are often smaller, many are larger than 500 people – the threshold Cuomo invoked on March 12 for closing entertainment venues. The CDC recently advised Americans to hold off on gatherings of more than 50 people for the next eight weeks. The guidance doesn’t officially apply to schools, but it’s hard to see why schools should be exempted. The virus doesn’t ask why we’re getting together. All that matters is whether we’re close enough to inhale each other’s virus-laden vapor droplets or rub them on our faces.
Some early rationales for keeping kids in school were based on bad science. Cuomo claimed as recently as last Thursday that kids may not be suscpetible to coronavirus, but that’s a dangerous misconception. Infected children are less likely to show severe symptoms of coronavirus, but they can still infect others.
With nearly 450,000 members, 1199 SEIU is the nation’s largest healthcare union, representing nurses, home care workers, nursing home attendants, and pharmacists. These workers are on the front lines of the battle against coronavirus. Until Sunday, 1199 had opposed closing the public schools out of concern that many of its members would be sidelined from the fight against the virus. On Sunday, 1199, the New York City teachers’ union and the city reportedly agreed to close the public schools and use them to provide child care for essential workers. The governor gave the city 24 hours to flesh out a plan to provide breakfast, lunch, and childcare for families who relied on the public schools.
The deal cleared a major barrier to closing the schools. The city is also acting to help students whose parents aren’t part of the essential workforce. A few school campuses will re-open on March 23 as “enrichment centers” to serve homeless kids and kids with special needs.
The New York City school system serves 1.1 million kids, including 750,000 students at or below the poverty line and 114,000 homeless students. About 70% percent of New York City public school pupils receive free or subsidized lunch, as do about 40% of kids statewide. Food is one of the most pressing issues, but also one of the easiest to address. New York City already provides free “grab and go” meals to kids during the summer months and that program will continue during the coronavirus response. Kids across New York state depend on their schools for food, so all districts need to implement “grab and go” programs if they don’t already have them.
It will be much more complicated to arrange for childcare for all the low-income families scrambling to cope with the school closures. Any proposed solution must take care not to replicate the crowding problem that the school closures are meant to address.
The logic of school closings is the same as the rationale behind all of our responses to coronavirus: Social distancing.
Social distancing is the only weapon we have against the virus, which has no specific treatment and no vaccine. The virus spreads through the tiny water droplets that we constantly expel when we breathe, talk, and cough. The best way to slow transmission is to literally distance ourselves from other humans by staying home.
Isolating people with symptoms isn’t good enough. “Approximately one to two days prior to the first indication that you're sick, you already have enough virus to transmit to other people,” explained Dr. Theodora Hatziioannou, associate professor and virologist at The Rockefeller University and one of the organizers behind an open letter to the government of New York signed by 36 leading experts on infectious disease, urging authorities to close the schools,
The so far coronavirus is spreading faster than the flu, but contagiousness is largely a function of human behavior. “If you get sick, go to your apartment and don't come out for a month, you're not going to transmit it to everybody,” said Dr. Paul Bieniasz, a professor of virology at Rockefeller University, an organizer of the open letter and the husband of Dr. Hatziioannou, “If on the other hand, you go to a basketball game, you could transmit it to hundreds and hundreds of people.”
The fact that so many infected kids feel just fine makes them especially powerful conduits for infection once the virus starts spreading freely in the community, which coronavirus is now doing in New York City. Forty percent of the nation’s grandparents provide childcare for their grandchildren, according to the federal Centers for Disease Control and Prevention. So, if kids are getting infected at school they are a direct line to some of the most vulnerable people in society.
By the time the mayor made his announcement, at least three New York City schools had already closed temporarily for deep cleaning after a student, a teacher, or someone in the school community came up positive for coronavirus. A school that closed for deep cleaning on Friday could just as easily be infected again on Monday.
Another way to help families who are struggling would be to increase federal food stamp benefits so that parents can buy more food. This would also be a form of stimulus for New York’s economy because food stamps go right back into local businesses.
The closing of the schools raises urgent questions about how to manage a large population of bored teenagers. Our overriding imperative during the corona pandemic is to stop people from congregating and mixing. But our usual approach to channeling teenage energy is to offer safe spaces for them to congregate, like playgrounds, skateparks and community centers, which is the opposite of what epidemiologists advise to slow the spread of the virus. Sports are also a no-no. Now, even the public libraries have closed due to coronavirus.
This is likely to be a long hiatus, and if the experience of locked-down Wuhan, China is any guide, boredom is the enemy of good decision-making. The CDC’s models suggest there’s no point in closing the schools for less than 8 weeks. The mayor hinted that city schools could be closed through the end of the school year, or beyond, so we’re going to have a lot of hours to fill.
Right now, it’s more important to entertain kids than it is to educate them. The more fun stuff kids have to do at home, the less likely they are to roam the streets, endangering themselves and others.
Free books, DVDs, board games, and video games should be available for pickup alongside the Grab & Go meals, so that kids without internet access can entertain themselves. Kids should also be able to go online and order free books, movies, and games by mail – to keep, not on loan, we don’t want to spread germs with returns. If that sounds expensive, consider the cost of even one extra case of coronavirus. Now is not the time to cheap out. Get the kids the good stuff.
The most powerful strategy for keeping kids at home is to make the outside world as boring as possible--as the mayor and the governor have already started doing by closing restaurants, gyms, and entertainment venues.
Ultimately, the best we can hope for is to make it feasible for parents to stay home to supervise their kids. That’s why we need New York State to pass paid leave for all residents, so that parents, kids, and everyone else can stay home before we get sick. The overarching public health goal is to keep a safe distance between people. So, we need everyone to stay home as much as possible.
Congress passed a sweeping aid package last week to support American workers grappling with coronavirus, but the bill leaves 20 million workers uncovered. Corporations with more than 500 employees are exempted outright and businesses with fewer than 50 workers can apply for exemptions. Needless to say, a lot of New Yorkers work in very large and very small businesses. What is necessary is for the federal government to push cash in the hands of ordinary people, regardless of their employment status. It’s not just compassionate, it’s economically necessary.
There was no good choice on closing the schools, only a range of bad options. But as Dr. Ryan said, it’s more important in an infectious disease crisis to be fast than to wait to be exactly right. The challenge now is to be just as fast in delivering aid to the people who need it.