Why All Schools Should Remain Closed During the Pandemic

The following letter, written by a teacher and parent to the superintendent and school board members of his son's school district, clearly and articulately explains how dangerous it would be to reopen the schools in the fall and makes a compelling case both for keeping them closed during the pandemic and increasing funding.

Dear Superintendent and School Board Members,

I am a father of a middle school student and a teacher of high school Biology. Before I was a teacher, I was a scientist at the University of California San Francisco, in the Infectious Diseases Department. For more than a decade I have been teaching my students about Pandemic Preparedness as part of my unit on Human Body Systems and the Immune System. As a result of this curriculum, several of my students expressed to me that they felt less scared and anxious during the Shelter-in-Place (SIP) because they had a better scientific understanding of what was happening and how we could protect ourselves.

Please read carefully each of the arguments I lay out below. Any one of them, alone, should be sufficient justification to keep the schools physically closed and continue Distance Learning (DL) for the 2020-2021 school year. Contrary to the all the hype and propaganda we are hearing about “safety” and returning to normal, there is no truly safe way to return to school or work while a pandemic is happening.

1The most significant reason to continue DL is to help prevent this tragedy from becoming much worse. The pandemic is not going to end any time soon. The only way to slow it down or contain it is with continued SIP/DL, combined with universal weekly testing, PLUS contact tracing and quarantining. Anything short of this, we will see surges, like in NY, Italy and Spain, where people died because there weren’t enough ICU beds, ventilators or even sufficient doctors and nurses. Unfortunately, we are not seeing these requirements met anywhere in the U.S., including the Bay Area, and we are unlikely to by August.

·        A recent study by researchers at the University of Washington predicted there could be 1.2 million U.S. deaths by the end of the year, even if states continued to SIP.

·        Without mitigation, this could easily surpass the death and economic devastation of the Spanish Flu, or even the Black Death. Consider that without mitigation, the CDC and WHO predict 60-70% of all humans will catch this disease (that’s 196-230 million Americans). At a 3.8% mortality rate, that would be 7.6 million U.S. deaths, more than 10 times that of the Spanish flu, and more than 200 million deaths worldwide.

·        Even if only half that number got sick or died, this would still disrupt the production and distribution of food and other basic services because of the lack of sufficient healthy workers, and could result in famine, even here in the U.S. The UN has already warned of multiple famines of biblical proportion in the poorest war-torn nations. What we’re experiencing now would seem like a cakewalk in comparison.

·        There have already been surges in many of the states that have relaxed their SIP, including California. In contrast, studies indicate that starting SIP sooner could have reduced mortality by 55%.  A study of the Spanish flu pandemic showed that regions with the most aggressive social distancing policies had the fewest deaths and the quickest economic recoveries.

·        Therefore, keeping the schools closed not only protects students, staff and their families, it protects the entire community and helps prevent this pandemic from spiraling into a cataclysm.

2

•         One of the most effective ways to slow down a pandemic is by shutting schools.

·        Indoor environments are the riskiest places to be during a pandemic.

·        The infection rate indoors is 19 times higher than it is outdoors.

·        The longer you spend indoors with people outside your immediate family, the greater the exposure to their germs and the greater your chances of becoming infected. This is true for our students and even more so for our teachers, who will be expected to spend hours inside a potentially infectious room.

·        Studies show that Keeping Schools Closed Significantly Reduces Transmission rates.

·        This study shows a 40-60% reduction in infections when schools are closed.

·        And this one, by pandemic expert Dr. Howard Merkel, shows that closing schools early and keeping them closed is one of the best ways to curtail a pandemic.

·        In contrast, if we do reopen the schools in August, we will almost certainly have to close them again well before December, when the 2^nd wave hits concurrently with flu season. This would be far more disruptive than simply starting with DL and continuing with it for the duration of the year. As you may have read, they had to close down schools in France only one week after reopening them because of a surge of new infections.

3.      It is NOT true that kids don’t get this disease.

·        Studies show a similar infection rate among kids and adults.

·        Thus, even if the kids die at a lower rate, they can still spread it to their older teachers and family members who are at greater risk of severe complications and death.

·        Furthermore, young people are still getting acutely ill in significant numbers. 20% of U.S. hospitalizations for Covid-19 have been in people under the age of 44.

·        And what about the rare, but frightening Kawasaki-like syndrome? How many kids have to come down with that before a lawsuit bankrupts the school district?

4.      Clearly, in-person learning is better than DL. Children benefit from the social interactions with their peers and the one-on-one personal attention from their teachers. However, the way in-person learning will have to be implemented during the pandemic will undermine many of those benefits. Consider that the main route of transmission is droplets and aerosols that fly out of people’s mouths and noses when coughing, sneezing, talking, singing and breathing heavily. All of these activities increase the volume, velocity and distance infectious materials travel in the environment.

·        Therefore, we’d have to cancel band and orchestra (where students are blowing heavily into instruments); choir (where students are expelling virions with every syllable sung—remember the choir outbreak in Washington State?); athletics (where students are panting heavily with exertion and are in close contact with teammates and competitors)

·        However, even sitting still at a desk will be risky, (less so if it is done in silence), because speaking increases the release of potentially infectious droplets 10-fold. Only 5 minutes of face to face speaking would be enough to infect someone nearby.

·        Students will NOT be able to collaborate face to face at tables or lab benches without violating the 6-foot rule.

·        Likewise, teachers will not be able to kneel beside students’ desks to assist them. K-5 teachers will not be able to hug students who are distraught or hurt

·        Many of the social activities that create and sustain healthy school cultures and children’s relationships will not be possible with social distancing (e.g., most sports, band, choir, assemblies, dances, eating together at lunch, giving each other hugs and high-fives).

·        And where will the extra staff come from to police students to make sure these things aren’t happening outside the classroom, when we are faced with enormous budget cuts?

5.      Not all social interactions that happen at school are necessarily healthy and positive.

·        Here is an interesting editorial by a teen from NY who loved having her school close and doing DL at home because it allowed her to work at her own pace, at her own hours, and avoid some of the fraught and disruptive interactions that can happen at schools.

·        In my own experience this year, I had at least a half-dozen students who had D’s or F’s prior to March 16 because of absences and failure to make up the assignments. Yet during the SIP, they completed every single assignment and even went back and made up work from earlier in the semester and are now passing. Upon chatting with them, many had similar experiences to the NY teen who wrote the editorial.

6.      There are intractable logistical problems with Blended-Learning models where students attend class 2 days a week, with social distancing, and then continue doing DL at home the remaining 3 days a week

·        The CDC guidelines for reopening schools state that each cohort of students should remain in the same room with the same teacher all day to reduce social mixing, not switch rooms, like secondary schools traditionally do.

·        The CDC says no devices, tools or equipment should be shared, which means 1 chromebook per student (not class sets).

·        The CDC says students should eat in their classrooms and not congregate in hallways, cafeterias and yards. Will we hire more security to ensure students aren’t congregating?

·        Many districts’ proposals for blended learning suggest that custodians will disinfect rooms in between classes, but this is not feasible without hiring a lot more custodians. And with the severe budget cuts all districts face due to tax revenues lost because of the pandemic, this is highly unlikely, as they are doing much more firing than hiring

·        If student arrivals and departures are staggered to reduce social mixing, it could add significant time to the school day and seriously delay when classes can actually start.

·        48% of all teachers have their own children living at home with them. If all schools move to a blended learning model, what happens to those of us with younger children who have to stay home 2-3 days per week for their own schools’ DL? Will those teachers have to get substitutes and lose 60% of their income? Or will they have to hire babysitters? Clearly, the simplest solution is for all districts to continue with DL for the entire school year.

7.      Most back-to-work models include some form of screening at the beginning of the work day. While this was quite effective for SARS, where infectiousness coincided with the onset of symptoms, like fevers, it is virtually useless with Covid-19, where 44% of infections are caused by people who are asymptomatic. It also could give a false sense of security that could lead many people to engage in riskier behaviors and not respect the social distancing and hygiene rules. Also, the CDC recommends creating an isolation room for any suspected cases and a Covid-19 point person at each site who follows and reports on community trends to staff and the authorities. Where will the funding and humans come from for this, particularly if districts are cutting staff and struggling with budget shortfalls?

8.      According to Ed Week, one-third of all teachers are at elevated risk for severe covid-19 complications or death due to age and/or underlying health conditions.

·        Nearly 30% of all teachers are older than 50, which is a much higher risk group than those under the age of 50.

·        Because of the enclosed indoor work environment, and the significantly higher rate of social contacts compared with other adults, teachers are at much greater risk of contracting the disease.

·        The virus can remain viable in the air for up to 3 hours, which means that teachers, who must be in their classrooms all day, will have much greater exposure to any germs.

·        The CDC says that anyone with an underlying health condition should be allowed to self-identify and be allowed to telework (or continue teaching DL). It would be much easier to implement this if the entire district did DL from the start.

·        Will there be enough substitutes to cover this many sick teachers?

9.      The pandemic and the SIP are stressful to everyone, students, teachers, and their families. Right now, everyone needs more free time, not less, in order to manage the increased challenges, stress and time demands of the pandemic, like waiting in long lines to shop, sanitizing homes, spending extra time with children and family members to help calm and soothe them.

·        Reconfiguring in-person curriculum and classroom structure to accommodate social distancing could double teachers’ workload. However, teachers will be expected not only reconfigure what they do in the classroom, they will also have to create and assess DL lessons, potentially tripling their workload.

·        Considering that most teachers were already working far more than their contractual hours prior to the pandemic (most teachers come in early, stay late, and/or work weekends and holidays), where will all this extra time come from?

·        Rather than providing teachers with more time to take care of their families and their own mental health, the Blended Model could cause an epidemic of fatigue, stress, depression and even absenteeism among teaching staff.

10.   One final note: Continuing with DL for the entire 2020-2021 school year could save districts a lot of revenue when they are already facing severe budget shortfalls. By keeping schools closed, there would be much lower energy bills; less maintenance costs; and quite likely fewer teachers and staff on the payroll.

In a pandemic, no one is safe unless we are all safe.

Careful Which Health Experts You Follow—Many are Charlatans

America has a long history of misology (hatred of knowledge). Our anti-intellectual streak goes back to the colonial days, with the lynch mob murders of accused witches, and our forebears’ love of snake oil, and it continues to this day with climate-deniers, anti-vaxxers, and most of all with President Trump and his followers.

Perhaps at no time in our lives, though, as there been a greater urgency for reason, and evidence to support it. Yet quacks, fakes and posers are coming out of the woodwork to tell us that it’s safe to go back to school and work, that Covid-19 is just a “bad flu,” that maybe we can just inject bleach or irradiate ourselves to overcome this plague.

So How Do We Distinguish Real Experts From Fakes?

Sophisticated thinkers know to examine the credentials of so-called experts to determine whether they have standing or credibility on the subject. Obviously, if both a pharmacist and a basketball star are discussing the safety and effectiveness of a prescription medicine, the pharmacist has more  expertise on the subject. But we need more than credentials to really trust an expert. Scientists and doctors are humans. They are subject to the same biases, fears, and political, economic and religious influences that affect the rest of us. Consider the scientists who’ve shilled for Big Tobacco.

I have an acquaintance with a Ph.D. from Johns Hopkins School of Medicine, who has done years of biomedical research, who told me that “the stats” indicate Covid-19 is like a “new flu,” not a “virus of unparalleled danger.” Clearly, this is someone who should know better. The absurdity of his statement is obvious when one considers that in a bad flu season (Oct-April), 60,000 Americans die, but Covid-19 has already killed 80,000 Americans in just 3 months.

Is he stupid? No. Does he want his personal liberty restored? Yes. He told me as much.

What I think is happening is that he is cherry picking his evidence and experts to support his desires. This is known as the Fallacy of Incomplete Evidence, and it’s completely understandable, even sympathetic, at a time like this, as it gives one the perception of safety and security when surrounded by so much fear and uncertainty.

Much less sympathetic are all the charlatans and snake oil peddlers making it onto mainstream media, since they are potentially tricking millions of Americans into supporting or doing dangerous and stupid things.

Dr. David Katz is one of these quacks and he has found success on both right wing Fox and liberal Bill Maher’s Real Time show on HBO, precisely because his lies and distortions promote hope that the worst of our fears are unwarranted and that it is safe to return to our normal lives.

Katz sounds like he has valid credentials. The Bill Maher program starts by discussing his volunteer work at a front line Bronx Covid ward, and the fact he’s a Yale professor and physician. However, about 20% of the way into the broadcast, they flashed on the screen that he is founder and CEO of Diet ID Inc., which ought to draw everyone’s suspicions. When I looked deeper into who this Katz character was, I discovered that the overwhelming bulk of his professional career has been dedicated to nutrition and how lifestyle influences health, not the epidemiology of infectious diseases. Another red flag is that he promotes himself with 5 or more acronyms after his name. Nobody who is really good at what they do bothers to mention the lesser degrees and affiliations. At a certain point in one’s career, the high school diploma and bachelor’s degree gets dropped. More importantly, nobody who is really good at what they do has time for 5 fields of expertise.

This is an example of the False Authority Fallacy. David Katz is so desperate to get us to trust him that he tacks acronyms and degrees onto his name like medals on a general's breast. But he is NOT an authority on infectious diseases, nor pandemics.

But let’s look at the meat of what he has to say, since one doesn’t have to be an expert to have something valid to say.

Like Trump, Boris Johnson and many Wall Street leaders, he has suggested that the “cure is worse than the disease.”

Worse for whom?

The “Cure” of sheltering in place is bad for profits, but it will also save thousands, possibly millions of lives. How could staying home from work and surviving be worse than going to work and dying?

He argues that flattening the curve doesn’t reduce the number of deaths; it only delays when people die. This is a Straw Man Fallacy (defeating an argument that was never made; vanquishing a false enemy). The primary goal of flattening the curve is to reduce the burden on hospitals and the medical system so they aren’t overloaded and can continue treat patients, not to prevent deaths. So, to claim it doesn’t reduce deaths is blaming it for something it was never intended to do, at least not as its primary objective.

However, flattening the curve does save lives indirectly, because when the medical system is overloaded, people die from neglect and abandonment, as happened in NY, Italy, Spain, even Detroit, where patients were triaged and allowed to die because there weren’t enough hospital beds and ventilators. So, flattening the curve does save some lives, even if that isn’t the main goal.

He says that flattening the curve doesn’t allow people to gain immunity, but there’s no indication that people gain any lasting, robust immunity to this disease. It may turn out they do, but so far, the data does not show this to be the case. Low level, short-term immunity might be enough to slow down the pandemic, or it might not. We won’t know for a long time, probably years. Therefore, letting the disease run rampant could result in millions of deaths. That’s just plain cruel and, for young people like Dr. Katz, selfish, too, since he’s less likely to die from it. But it’s also stupid and short-sighted, because if millions of people get sick, even healthy young people with mild cases will still suffer from mass shortages and possibly famine.

Bill Maher, his interviewer, says that Sweden, which did not implement strong social distancing policies, had numbers that weren’t much different from countries that locked down, but this is not true. If you look at the data from Worldometer (as of 5/8/2020) Sweden had 314 deaths/million people and 2500 infections/million people, more than triple the mortality of Denmark, and nearly 8x the mortality of Norway. (Denmark had 90 deaths/million people and 1764 infections/million people. Norway had 40 deaths/million people and 1489 infections/million people. And Finland had 47 deaths/million people and 1036 infections/million people. Clearly, Sweden is being hit much harder than its neighbors who implemented social distancing policies.

In his attempt to get us all to relax and learn to love Covid-19, Katz says “There are risks we willing take on each day.” This is another fallacy. Sure, we take risks getting into car or planes, but it’s our own choice, not one forced upon us by the president, our employer, or our desperation to put food on the table. We could choose to take public transit, instead, which is much safer than driving ourselves, or choose not to vacation by plane. Also, a good driver has a lot more control over their own safety than they do in the workplace, where so much of their safety depends on the boss’ willingness to provide safety equipment, and on coworkers respecting safety and social distancing protocols.

Katz argues that people should be allowed back to work because “We don’t want to destroy people’s lives and livelihoods.”

Of course not, but it is not an either/or choice. We should be looking first at people’s survival needs. Contrary to common belief, work and income are not necessary for survival. Food, housing, and medicine are. These 3 necessities can be given to people, even in a system that lacks money or “work.” People’s jobs, businesses, lifestyles, can be rebuilt after the pandemic is over. Dead people cannot be brought back to life. More importantly, though, if too many people get sick or die, everyone’s survival is threatened anyway. This is why suppression of the pandemic is necessary.

Katz suggests that we should all want to get the disease and get over it so we’re immune and can go out, live our lives, without worry, but there is no evidence that people who’ve recovered from Covid-19 have robust, lasting immunity that protects them from catching it again. Worse, there IS evidence that the newer mutant strain that evolved in Europe and has become the dominant strain worldwide, is both more infectious AND makes people prone to 2^nd infections.

His “middle road” hypothesis of only protecting the most vulnerable, and forcing the rest of us back to school and work, is based on the premise that both extremes are wrong (i.e., letting the pandemic run its course, unmitigated, versus a complete lockdown). This notion is NOT supported by scientific data, which shows that 20% of hospitalizations in the U.S. are among people aged 20-44,  and that people from any age group can die. It is premised on the cynical and selfish idea that it’s okay to sacrifice people other than himself, since he presumably wouldn’t die due his youthfulness and good health.

The “middle road” hypothesis is based on another fallacy, that extremism is inherently bad and that moderation is inherently preferable. This is the same argument that gets millions of Americans to vote for the “lesser evil” every four years, instead of for what they really want.

So, are the extremes in this case inherently bad?

Well, locking things down has resulted 30 million unemployed Americans, and mass hunger, despair, fear and uncertainty. The quality of education online is most likely worse than if kids were able to learn in person. But the other extreme of sending them back into schools and workplaces while the pandemic is still running rampant, without PPE, mass testing, contact tracing and quarantines, is genocidal. It will cause infections and mortality rates to skyrocket. Hundreds of thousands, possibly millions will die.

Is Katz’ “middle road” the best alternative? NO! 

First, what does he even mean by protecting the most vulnerable? Will everyone over 70, or with an underlying health condition be allowed to continue sheltering in place? If so, that’s a lot of people. Obesity is a risk factor for dying from Covid-19. There are 70 million obese Americans, nearly a quarter of the population. There are 34 million Americans with diabetes and nearly half of all Americans have heart disease. If all of them continue to shelter in place, how much more productive would the economy become?

Katz argues that the middle way minimizes deaths and averts economic ruin. But it doesn’t. Any return to work without first having significant declines in infections, and ongoing testing, contact tracing, quarantines, risks causing new surges in infections and deaths, and potentially far worse economic outcomes than we’ve seen so far. We could easily get to a point where the economy collapses purely from too many people being sick to work and shop.

Extremism is not inherently a bad thing. We are in the worst crisis the world has experience in generations. When all is said and done, this pandemic could turn out to be far deadlier, and far more economically devastating than the Spanish flu. Under such conditions, extremism is exactly what’s needed. It’s the only possible way to slow this thing down and possibly stop it.  Furthermore, if we did ramp up testing to weekly universal tests, combined with contact tracing and quarantines, we could theoretically isolate the vast majority of infections and stop the pandemic that way, or at least slow it down long enough to allow us back to work and give scientists the time to find a vaccine to prevent future outbreaks.

Disease Far Worse Than Cure-Just Look At the Numbers

In their attempts to reopen economies and relax social distancing measures, many people (including Trump, Boris Johnson, Dr. Michael Katz, Thomas Friedman) make unfounded claims like Covid-19 is not that dangerous, it's like a bad flu, you can't hide from germs, you're going to catch it eventually, anyway, so why not just go out and get it over with.

Problem #1: We do not currently know if people gain any robust, long-term immunity that protects them from future infections

Problem #2: There is evidence that the newer mutant strain that evolved in Europe and has become the dominant strain worldwide, is both more infectious and makes people prone to 2^nd infections, 

Problem #3: It's already clear that this is much worse than a bad flu. In a bad flu season (Oct-April), we generally get around 50-60,000 deaths in the U.S., primarily among the very old, infants, and immune-compromised. Whereas with covid-19, we already have nearly 80,000 deaths, and that was primarily from Feb-April. Since we know this is going to continue for another 12-24 months, we can assume there will be at least tens of thousands (if not hundreds of thousands) of more deaths by the end of the pandemic, even if the nominal mitigation efforts currently in place continue. 

One of the big problems with people like Katz, Friedman, Trump and Johnson, and others who claim the "cure" is worse than the disease, and who are calling for us to just go out there and take our chances with this "bad flu," catch our immunity and move on, is that they don't bother to extrapolate the number of deaths that would occur, let alone put that into a context that is meaningful to the general public.

But here's an attempt:

• Because  Covid-19 a brand new zoonosis, humans have no natural immunity (unlike the flu, where we have been exposed to dozens of different flu strains over our lives and have developed immunity to many of them. And there are vaccines. This gives us the possibility of some protection against novel flu viruses). Consequently, in a typical flu season, 9-40 million Americans catch the disease, which translates to 2.5%-12% of the population.
• With Covid-19, we have no natural immunity, nor a vaccine, which means almost everyone is vulnerable. Consequently, the CDC and WHO predict that, without mitigation, 60-70% of all humans will catch the disease.
• In the U.S., that translates to 196-230 million people getting infected.
• Even if no one died, and if only 10% of these people got too sick to work, that's still 19-23 million people not working. When you consider that we currently have 30 million unemployed (official count), we are now looking at the disease doing as much damage to the economy as the "cure."
• But that's assuming it spreads in a random, heterogeneous manner. In reality, diseases don't spread heterogeneously. For example, Amazon warehouses, food warehouses, grocery stores, nursing homes, meat processing plants, are all places where we've already seen the disease spread rapidly among workers or patients who, by the nature of these facilities, are either crammed close together or have human vectors (eg nursing homes) passing the disease from person to person.
• So, if we let the disease run its course and see millions of people too sick to work, with concentrations in the food industry, we could see severe food shortages, even in a wealthy country like the U.S. In poor countries, particularly war-torn ones, it is nearly certain that we will see famines of biblical proportions.
• Now let's talk about deaths, since that's what really scares people. If we take the WHO-estimate of 3.8% mortality and multiply it times 200 million sick Americans, we're talking about 7,600,000 deaths, which would easily be the deadliest pandemic in history. The Spanish flu, which up until now was the deadliest pandemic in history (at least that we're aware of) killed 675,000 Americans and 50-100 million people worldwide.
• But the true mortality rate is, no doubt, lower than 3.8%. Let's be generous and give Covid-19 the same mortality rate as a bad flu (0.1%). That would still translate into 200,000 deaths, which is far worse than seasonal flu, and serious enough that to suggest we should just let it run its course, rather than doing everything in our power to mitigate it and reduce the deaths, is like proposing premeditated mass murder, just so the economy can reopen.
• The actual mortality rate, however, may actually fall somewhere between 3.8% and 0.1%. We just won't know for a while, probably not for a few years. But let's say it's actually 1%. That would translate into 2 million deaths.

To deliberately send us back into unsafe schools and workplaces knowing that it could result in 2 million deaths--That is Genocide!

Trump Quashes CDC Guidelines on Returning to Work & School

The Centers For Disease Control (CDC) recently came out with a set of guidelines for gradually phasing in a return to work and school. The Trump Administration quashed the document and said it would never see the light of day. Fortunately, it has been leaked, and you can read it here. Unfortunately, many of the guidelines will probably never be enacted, let alone enforced. This is partly because the document has been suppressed, and partly because many of the recommendations would be impossible for schools and workplaces to enact. Consequently, it must be concluded that it is not safe to reopen schools for in-person learning (and many other workplaces) and will not be safe to do so until the pandemic is over.

One of the recommendations is that when children return to school, social mixing should be reduced as much as possible. That means the same group of kids and adults remains together throughout the day. Rather than eating in the cafeteria, they remain in their classroom to eat. Rather than having several periods a day, as is the norm in most secondary classrooms, the same group of students should remain in the same classroom all day. Doing this reduces the number of different social contacts children and adults would have each day and, consequently, the potential for infection. It would also allow custodians to disinfect classrooms in between periods, which would not be possible under a typical bell schedule, with students changing classrooms every 45-55 minutes in dozens of rooms per school site.

However, none of the proposals for reopening the schools that I have seen suggest anything like this. They propose sending kids to school twice a week, and staying home the other 3 days. Secondary teachers typically teach 5 different classes per day. If the CDC recommendation was followed, that could have students attending school 5 days per week, each day attending a different period. For example, students who have English 1^st period would spend the entire day with their 1^st period teacher and do a week’s worth of lessons in that one day.

The problem is that this does not take into account social distancing, which is also recommended by the CDC. Students should not sit within six feet of anyone else. If only 10 students are possible per classroom to ensure six feet of space between them, that would mean that one-third, or fewer, of the students in a typical California classroom would be able to attend at any one time. This, in turn, would have students attending each class once every three weeks.

Another challenge for schools is arrival and departure. Typically, these times of the day create traffic and pedestrian bottlenecks, as hundreds of students attempt to get to class on time. The CDC’s recommendation is to stagger drop off and pick up times, which further complicates how to schedule classes. Although this could be achieved by scheduling student drop off and pick up by teacher (since they’d be staying with the same teacher all day) and staggering each teacher’s start time. Of course, this works much more easily in the K-5 grades, where students are already remaining with the same teacher all day.

Another recommendation is that students do not share anything, including electronic devices. That means every student would have to be provided their own laptop or chromebook. As it currently stands, schools that are fortunate enough to have a technology budget, are lucky if they have a class set for each classroom. Most do not. But even for those schools that do, that means potentially 5 or more students typically handling the same computer keyboard, spreading germs along the way. So, schools would have to come up with the funding to quintuple (or more than quintuple) their current computer stockpiles.

The CDC recommends daily health screenings for students and staff, including temperature checks. Doing this has clear and obvious benefits in reducing the risk of disease transmission. It could also add hours to everyone’s work/school day. While the screening might only take a few minutes per person, it could take an hour or more before all of a teacher’s students were screened and ready to enter their classroom.

Whenever a student or staff member displays signs of Covid-19 infection, they are to be isolated in a special area of the school that has been set aside for this purpose. Appropriate sites may not exist at all schools, particularly overcrowded ones. Further, any area used by the sick person (e.g., their classroom) should be closed off and not entered for another 24 hours, at which point it must be thoroughly disinfected. This would further reduce available classroom space and potentially the number of children who could attend school. It could even result in the entire school site shutting down for several days, or longer.

Each school site should have a Covid-19 point-person who monitors all absences, looks for trends that may indicate a local outbreak, reports these trends to authorities, ensures that adequate measure are taken when such trends are identified, and responds to staffs concerns about the pandemic. Schools do not have people who are trained to do this. Many schools do not even have a staff member who is free to do this, assuming they were provided training, as all staff members already have too many other responsibilities.

It is recommended that schools have a back-up roster of trained individuals, in case regular staff members get sick. This, of course, is a fantasy. Most school districts do not have a sufficient supply of substitute teachers under normal conditions. Quite often, school districts inform their employees not to take personal days on Mondays and Fridays because of this problem. Fairly often, when a teacher gets sick in the middle of the night, there are no substitutes available the next morning, and their classes must be covered by their colleagues during their prep periods. Furthermore, virtually no substitutes are actually trained as teachers or have credentials that qualify them to teach any subject. So, when too many teachers get sick, classes may end up just being canceled.

Vulnerable workers are supposed to be given duties that minimize their contact with the public. This includes anyone older than 65 (as is the case for many school staff members), and anyone with heart, liver, kidney or lung disease, diabetes, hypertension, obesity, or weakened immune systems. Such workers are to self-identify and employers are not to pry into their medical history. At schools, this could include significant portions of the staff, including teachers and administrators. Obviously, continuing to do Distance Learning at home solves this problem. Indeed, the CDC recommends that employers support their right to telework. But if schools are compelled to reopen for in-person learning, and all vulnerable staff members exercise their right to not be exposed to the public, they will likely have insufficient numbers of staff to actually reopen.

Lastly, and most significantly, the CDC document talks about phases, but does not define what these phases are. More alarmingly, epidemiologists and pandemic experts say that nothing should be reopened until new infection rates have dropped dramatically, which has not happened anywhere in the U.S. University of Washington scientist say the rate of new infections should drop to 1 new case per 1 million residents. They also say that there should be regular, repeated, universal testing, combined with contact tracing and mandatory quarantines before things reopen. Doing this makes it possible to isolate the majority of infectious individuals, significantly reducing the chances of further spread.

However, none of these recommendations are happening anywhere in the country, and they are unlikely to be in place by August-September, when schools typically reopen for their fall semesters. In most communities, neither the funding, nor their technical capacity are in place for this level of testing and tracing, let alone quarantine enforcement. Consequently, if will NOT be safe for children or staff to return to school sites in the fall, even if these other CDC recommendations were implemented.

Return to School Cost-Benefit Analysis Doesn't Add Up

We're hearing a lot about what school might look like when it resumes in the fall. The assumption always seems to be that children and teachers will return to their school sites for some form of live, in-person education.

Why? What are the benefits? And do they outweigh the costs?

The Benefits

As far as I see it, the most compelling reason the state has for resuming school is the free childcare service that schools provide. The  American Federation of Teachers (AFT) makes this argument in their plan to "safely" reopen the schools. When children are in school, their parents can go to work. If we continue sheltering in place (SIP) and doing distance learning from home, parents have to stay home with young children and, therefore, cannot work, undermining the profits of Wall Street and the big corporations. However, the AFT plan provides weak, toothless proposals, like relaxing social distancing  after 14 days of reduced infections in a community. So far, no state has met this prerequisite, including those that have ended social distancing. Secondly, even if they had, their infection rates would still surge again if no social distancing was practiced, at least until the pandemic ended.

Much of the discussions about reopening schools in the fall are in the context of how it could be done "safely," which it can't. A common proposal is for children to only attend live classes 2 days per week b/c of social distancing (keep class sizes down to 10 students per class). If this is how schools will operate in the fall, then reopening schools won't even solve the free day care problem. Not by a long shot. Are nurses, grocery store workers,Amazon drivers, cops and firefighters going to be allowed to work only 2 days per week, so they can care for their children the other 3 days when they aren't in school?

Pedagogically, in-person learning is better than Distance Learning. But the way in-person learning will have to be implemented during a pandemic won't come close to providing those benefits. K-5 teachers won't be able to hug young children. Secondary teachers won't be able to kneel at their students' desks to provide one on one help. Students won't be able to collaborate around tables or lab benches. All of these require social proximity. If our main goal is for students to be able to collaborate on projects, Google provides ample methods for remote collaboration. 

Psychologically, children need the social interactions. My child is going nuts not being able to hang out with friends. It's heartbreaking for me to have to repeatedly say no, and explain why. But does reopening the schools under these new conditions really provide healthy, robust social interactions if students aren't allowed within 6 feet of each other? If they can't hug, shake hands, high five, watch sports together, dance? How does a band practice or perform 6 feet apart? How does a basketball team practice 6 feet apart? How do kids eat lunch together and socialize 6 feet apart? How do schools even enforce social distancing during lunch and recess?

By the way, it should be pointed out that not all the social interactions that happen at school are positive. Here's an editorial by a middle school girl in NY who loves distance learning because she can work at her own pace, in a quieter, more relaxing environment than her traditional classroom. 

The Costs

The CDC now says there will be 3,000 Covid-19 deaths PER DAY, by June 1, just in the U.S., thanks to the premature relaxing of SIP and Social Distancing policies! That's just in June. By August-September, when schools usually reopen for their fall semesters, those numbers could be much higher. Remember, this disease doubles very quickly. It is very unlikely to be "safe" to send kids and staff back, even with smaller class sizes and increased hygiene.

Each time I see an article talking about the return to school, I wonder if I'm missing something. Is there some compelling reason to reopen the schools in August that makes the risk of killing thousands of people worth it, when education can be done remotely. Or is this just another cold calculation based on the assumption that Covid-19 primarily kills old people, that only a few kids and teachers will die? 

If so, our leaders are butchers and stupid. Children and young adults can still get very sick from Covid-19, and some of them are dying. 20% of Covid-19 hospitalizations are people aged 20-44. No child or teacher should have to die to get an education or a paycheck. School is not that important. 

Even if we knew that no child was going to die from this, we know that children can spread the disease to older family members, caregivers,teachers and community members, including those with underlying conditions. Their older relatives with underlying conditions should not have to die for their education, either. According to Ed Week, fully 1/3 of all teachers are at an elevated risk of severe illness from Covid-19 due to age and underlying health conditions. Nearly 30% of teachers are older than 50, and teachers have significantly more social contact than other adults.

Sending a bunch of kids back to an environment where they are swapping more germs than they were when they were when sheltering in place (e.g., schools, daycares, religious facilities), means a much quicker spread of the virus to grocery store workers, healthcare workers, emergency responders, the people we all rely on.

According to Dr. Howard Markel, who studies pandemics, closing schools early and keeping them closed is one of the best lines of defense against a pandemic. It's one of the best ways to slow the spread and reduce the casualties. And he has data from the 1918 Spanish flu pandemic to support this conclusion.

So, When Can We Reopen the Schools?

When infection rates are down to 1 in a million; AND we've implemented regular testing of everyone (ie weekly); AND we're doing contact tracing; AND we are enforcing mandatory quarantines of everyone infected and their contacts; AND providing financial relief & adequate medical care for those infected & quarantined; ONLY THEN can schools reopen. And even then, it's still not risk-free or truly safe. It's just less risky and social distancing, good hygiene, etc., still need to continue.,

Return to Work & Die: 3,000 Covid Deaths per Day by June 1, Thanks to Reopening States

The CDC now says there will be 3,000 Covid-19 deaths per day by June 1, thanks to the easing of social distancing restrictions. States that have ended their Shelter-in-Place (SIP) policies are already seeing surges in new cases. And this does not even take into account what will happen in fall, when flu season returns, and hospitals start filling with patients suffering from two severe respiratory diseases.

Remdesivir: Panacea for Wall Street or Sick Americans?

Remdesivir has been fast-tracked by the FDA to be used as a "frontline" treatment against Covid-19. In an emergency-use authorization, they claim the benefits of using the drug, without having complete data from the NIH clinical trial, far outweigh the risks. Keep in mind, the NIH study upon which their decision is based is only one of many Remdesivir studies currently going on, and they made their decision before all the data was even released. A recent study from China, published in The Lancet, showed no difference between Remdesivir and a placebo. Experts say the results from a single study, like the NIH study, are rarely game changers and safest approach is to pool data from several equally rigorous studies, which has not happened yet.

So, what are these benefits?

The only benefit that has been shared from the study, as of this posting, is that patients hospitalized with severe symptoms had a 31% faster recovery time than patients who received a placebo (11 days versus 15 days). There was a statistically negligible improvement in mortality.

Of course we'd all like to be sick for a shorter period of time when we are sick. But this drug does nothing to prevent us from catching Covid-19, and it does little to nothing to reduce our chances of dying from it. It does nothing to flatten the curve, reduce the infection rate or make the world a safer place. It does nothing to lower the risks associated with a premature return to work or relaxing social distancing policies.

And there are risks, though these get little mention in the press. For example, many patients dropped out of the Chinese study because of side effects and adverse reactions. The drug is toxic to both the liver and kidneys.

So, what's the real benefit? Why fast track its approval before all the data are in? Particularly when the drug is produced by a private company, Gilead, which expects to turn a handsome profit on the drug, meaning many people who need it won't even be able to get it?

1. Big profits for Gilead and their investors
2. A propaganda victory for Trump (See, we've got a drug to keep you safe. So, go to work. Go get your tattoos and massages.)
3. Shorter recovery possibly means less time away from work, assuming the sick person had a job in the first place and still has one now

Once all the data are in, Remdesivir may, in fact, become a "game-changer" for sick patients, but the real game-changers will be drugs that cure people quickly and reduce mortality. Even better, how about a vaccine that is effective against the entire coronavirus family? 

While we don't know if the latter is even possible, the need is urgent. Epidemiologists have known for a while now that Coronaviruses and Influenza viruses were the most likely culprits in causing the next deadly pandemic. And they believe another deadly pandemic, like the current one, is likely.

One reason is that both virus families are spread easily through the air and remain viable on surfaces, making them easy to spread from person to person, even by strangers in public places, in contrast to Ebola and HIV, which require fairly intimate contact with sick individuals. Another reason is that both virus families reproduce by RNA, rather than DNA, and the enzymes used to replicate RNA make far more mistakes than the DNA enzymes, resulting in highly mutable viruses. Consequently, even if you gain immunity to one strain, either through illness or vaccination, you could still be susceptible to next year's strain. This is why we need to get a new flu vaccine each year.

A third problem is that there are already 50 new coronaviruses discovered in bats that have the potential to cause deadly pandemics in humans. Due to climate change and habitat destruction, humans are coming into contact with wild animals far more now than in the past, causing a rapid increase in zoonoses.

While we don't know which, if any, of these new coronaviruses will jump species and cause a pandemic, we certainly should be prepared. If SARS and MERS weren't sufficient warning, Covid-19 certainly is. A corona-family vaccine, effective against all coronaviruses, might be the best hope against a repeat of what we're going through now.

Whatever the final results of the NIH study show us, and regardless of how the emergency use authorization plays out for sick individuals, we still need to continue with social distancing, drug and vaccine research and development, rebuilding the health infrastructure to prepare for the next wave, produce sufficient PPE for frontline workers, and provide a much more effective and generous safety next for the millions of Americans who are struggling to survive.

Stop Trump's Genocide Against America

As Trump, state governors, and other world leaders callously and selfishly send us back to school and work, experts are predicting that the Covid-19 pandemic will last another 18 months to 2 years, until 60-70% of the population has been infected and developed some degree of immunity. This prediction is similar to what we saw with the Spanish Flu pandemic of 1918.

In the United States, where there are 328.2 million people, that would translate into at least 197 million infections (at the 60% rate). At the currently accepted mortality rate of 3.2%, that would translate into 6.3 million deaths in the U.S., alone. But even if the mortality rate were an order of magnitude lower, let's say 0.3%, it could still result in 600,000 deaths.

Trump's argument that we've survived the worst of the pandemic and that it's safe to return to work and school are clearly not true. But is he simply ignorant or naive, as some have argued?

No!

The butcher knew full well that reopening the economy would result in a massive death toll. He ordered 100,000 body bags on April 21, in anticipation of the mass casualties that he knew would occur from "opening" the economy. Additionally, FEMA has order 200 refrigerated trailers to store the corpses because the morgues will be so backlogged. So, maybe he is a little naive, or simply can't do math, since this won't come close to covering 600,000 dead Americans, let alone 6.3 million.

At least the Veterans Administration, that bastion of corruption and incompetence, has done their math.  They've bought $12 million worth of body bags. If they paid a similar price to FEMA, that would get them around 250,000 body bags, plenty to cover their 9 million patients.

So, are we left with only these two miserable choices: (A) go back to work and school, get sick, and watch millions of our friends, relatives and neighbors die from Covid-19; or (B) continue sheltering in place and struggle not to starve to death?

Of Course Not! 

We could do what health experts, including Anthony Fauci, keep telling us to do, and what South Korea has effectively done: 

1. Universal repeated testing of Everyone
2. Contact tracing of all infected individuals
3. Mandatory quarantines of all infected individuals and their contacts

These 3 measures, according to Fauci, and anyone with an ounce of common sense, will help make the next wave LESS deadly and make it less dangerous to return to work and school. They will not prevent a 2nd wave. They will not eliminate the risk of infection and death. And they should be accompanied by the following:

1. Continued social distancing whenever and where ever possible (ie, no concerts and live sporting events; no tattoos and massages; continued restrictions on the number of people entering stores and classrooms)
2. Rebuild the medical infrastructure, purchase PPE for everyone who needs it, increase hospital capacity, continue developing and testing vaccines and anti-viral drugs, 
3. Give everyone what they need to survive, including sufficient cash and food