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.

Greatest Country in the World for Whom?

The United States is the richest country in the world. So what?

Under normal circumstances, one would expect repulsion at the fact that Jeff Bezos, head of Amazon, makes $150,000 per minute, more than triple the median ANNUAL income of U.S. workers. Or that 20% of Americans own 80% of the wealth. Or that 40 million Americans don't have enough to eat, even in "good" times.

But in a pandemic, with more than 500 people a day dying in New York from Covid-19; with Detroit making it official policy to DENY treatment to its sickest residents; with 6.6 million Americans filing for unemployment last week, and the St. Louis Fed predicting 50 million unemployed by July; the contradictions of capitalism, the greed and disregard for human life, should be obvious to everyone.

Take Amazon, which continues to force its employees to work with minimal or no PPE, the majority for $15/hour poverty wages, while at least 10 of their facilities have confirmed outbreaks of Covid-19. They also just fired an employee in Staten Island for leading a walk-out.

Trump has responded to the crisis by giving trillions of dollars to Wall Street and demanding we all go back to work, claiming the consequences of sheltering in place are far worse than the disease itself. Trillions for Wall Street and Corporate America, and pennies for working Americans and the rebuilding of our medical infrastructure. Not surprisingly, America's cities are desperately unprepared for the coming wave of infections and demand for ICU and ER beds.

A survey done by the U.S. Conference of Mayors on Friday (3/27/20), found that:

• 92% of U.S. cities lack sufficient Covid-19 test kits
• 91.5% have insufficient masks for 1st responders & medical staff
• 88% said they lacked enough other PPE for these workers (gloves, gowns, etc)
• 85% do not have enough ventilators
• 62.4% said they have NOT received any emergency medical supplies from their state governments

The U.S. has far more Nobel laureates in Physiology & Medicine than any other country (93, compared with the UK, #2, with only 29), by far the greatest share of Pharmaceutical R&D expenditures in the world (over 60% of all Pharma R&D is done by US companies, see graph above). One would think we'd be better prepared.

Not under the logic of capitalism, where hospitals maximize profits by ensuring that few, if any, beds are left open for emergencies like this one; where the number of U.S. companies producing flu vaccine (which kills 10-60,000 Americans per year, and continues to do so along side Covid-19), has gone down from 37, in 1976, to only 7, today because it is not profitable; where nearly 1 in 4 workers have no paid sick leave and have to continue working when sick so they don't get evicted or starve, potentially exposing and sickening their coworkers; where millions of Americans still lack health insurance, despite the Affordable Care Act; where we let 259,000 Americans die each year from preventable or treatable causes because it's more profitable for business to do so.