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As Trump pushes to have schools open, CDCs cautious approach leaks

Enlarge / CDC Director Robert Redfield at an event focused on discussing how to safely reopen schools. Chip Somodevilla / Getty Images

The United States has seen a dramatic surge in coronavirus infections with less than two months to go before the start of the school year. With little indication that the country has even started to flatten the curve, there are serious questions about which areas of the country are positioned to open schools safely. But, for reasons that remain unclear, the Trump administration has a firm answer: all of them.

Over the past couple weeks, the administration exerted pressure on the Centers for Disease Control, instituted restrictive rules for foreign college students, and had several senior administration figures, including Trump himself, join in the push to have schools open. The push places the administration at odds with public health experts and its own CDC, which advises a far more cautious approach, as revealed in an internal document that leaked over the weekend.

Pro open

At an event on Monday, President Trump reiterated his administration's message, saying, "Schools should be opened—kids want to go to schools." But, in keeping with his administration's approach to health policy, he followed that up with an evidence-free and likely false statement: "You're losing a lot of lives by keeping things closed."

Unlike many of Trump's public statements, which often have few consequences, the push to reopen schools has been backed by extensive policy work. Last week, Trump threatened to cut federal funding for schools if they did not open in the fall, while making irrelevant comparisons to countries that had, unlike the US, largely managed to control the pandemic. Over the weekend, Education Secretary Betsy DeVos reiterated that threat. The threat of limiting funding is critical, as the federal government has no authority over public schools, which are largely under local control.

One potential barrier to this push is the CDC, which has put together advice for educators about how to handle the possibility of kids contracting the virus and falling ill or serving as vectors to carry it to others. The CDC has highlighted in bold the phrase "Staying home where appropriate," which is followed by advice on things like offering tele-learning and eliminating things like attendance awards and penalties for absences for both students and staff.

Trump viewed the CDC advice, formulated by public health experts, as a barrier to his goal of reopening schools. "I disagree with @CDCgov on their very tough & expensive guidelines for opening schools," he tweeted, ending it with the veiled threat "I will be meeting with them!!!" In the end, however, the task of forcing the CDC into line was given to Vice President Mike Pence, who promised that the agency would be issuing new guidelines for schools later this week.

But public schools are not alone in being pressured to open despite the surge in infections. Last week, Immigration and Customs Enforcement announced that international students would be forced to leave the United States if their university classes weren't held in person. That decision has prompted lawsuits from hundreds of universities and over a dozen states that are seeking to block its implementation.

What the experts actually think

A greater window into how the experts at the CDC view the issues with school reopenings was provided this weekend as The New York Times obtained an internal CDC document meant to be shared with federal health response teams sent to areas where the COVID-19 cases were flaring up. On its very first page, the document labels the sort of full reopening envisioned by Trump, with "full sized, in-person classes, activities, and events," as potentially being in the category it labels "Highest Risk." In contrast, the remote learning that Trump is trying to force schools away from is labeled "Lowest risk." Hybrid models, with smaller groups of students attending in shortened weeks, supplemented by remote classes, is intermediate.

The guidelines are upfront about the limits to our knowledge. We know both that younger children appear less likely to end up with severe COVID-19 symptoms, the document acknowledges, but we also know cases where they have become severely ill; the CDC acknowledges both. Similarly, the document recognizes there are uncertainties regarding the ability of young children to transmit the virus on to others. "Universal SARS-CoV-2 testing of all students and staff in school settings has not been systematically studied," its authors write. "Therefore, CDC does not recommend universal testing of all students and staff." Overall, it's appropriately provisional about our current state of knowledge.

But the CDC document does contain extensive advice on how to limit the spread of infections, something we do know a fair bit about. This includes schools being able to isolate anyone who starts to display symptoms and that they should consider what would be needed in order to have someone capable of coordinating virus tests and performing contact tracing. Schools should also be prepared to shut immediately for several days to allow social distancing and disinfection if a person known to carry the virus has been in the building. If there is any sort of active spreading in the community, multiple means of social distancing should be introduced, from greater space between students in classrooms to limitations on out-of-classroom activities.

Similar advice is given to universities, with the added complication that these may be responsible for residence halls and thus may need to limit the number of people who can be housed in them.

The bulk of the document, however, includes outlines of the plans made by a variety of state-level departments of education, local school districts, community colleges, and universities of various sizes. This provides a wealth of information about options that have already been tailored toward schools of different sizes and needs, allowing similar institutions to get a sense of what is going to be tried. And the CDC helpfully points out some limitations of these plans (for example, some entities plan on using testing, but they don't describe how the school will respond to a positive test).

Overall, the document appears to be well grounded in our current state of knowledge both of the SARS-CoV-2 viru, and of the plans being made by educational institutions. Many of the public health officials that the Times shared the documRead More – Source