Are We Headed To a Coronavirus Apocalypse In the Fall?

A laboratory technician of biotechnology company mAbxience is seen working, amid the outbreak of the coronavirus disease (COVID-19), in Buenos Aires, Argentina August 13, 2020. REUTERS/Agustin Marcarian
August 16, 2020 Topic: Security Region: Americas Blog Brand: The Reboot Tags: CoronavirusCOVID-19PandemicSchoolsFDA

Are We Headed To a Coronavirus Apocalypse In the Fall?

One former FDA head has some thoughts.

Hess: It’s a great question. You know, President Trump obviously saw — his pollsters presumably saw — an opening here in July when he suddenly started demanding that we send kids back to school. But in classic Trump fashion he did this in a reckless, unhinged way and was openly dismissive of the health concerns, in a way presenting the folks nervous about going back to school with the perfect foil. You’ve seen relatively few politicians stand up. Governor Polis in Colorado, I think, handled this really nicely, talking very deliberately in a disciplined fashion about, “Look, we can’t be scared out of doing what we need to do for kids, but we have to be cognizant of all the risks.” We’ve seen very little of that kind of political leadership.

Parents themselves are deeply split. Depending on how you ask the question, it’s really 50/50 between parents who want to send their kids back to school and parents who absolutely don’t want to send their kids back to school. So you haven’t seen a lot of energy there.

The advocacy and reform community is, right now, very caught up in questions of social justice, which turns out to play out very weirdly on this. On the one hand, as Mike mentioned, the kids who are suffering most from this are the kids who are in homes where they don’t have highly educated parents, where you don’t have a lot of resources to pay for supplemental materials, and that are in small homes without good learning space. These are exactly the kids on the wrong side of the opportunity gaps. But these are also parents who in many cases are the most nervous about sending kids to school. So the reformers and the advocates are on the sidelines.

And then you’ve got a mass culture, you have these pods emerging, especially in affluent, wealthy communities, where parents are getting together and figuring out how to pay money to hire tutors, to get their kids together. But instead of this being greeted as American ingenuity and parents being eager to stand up and find a way for their kids, what you’re generally seeing in The New York Times and NPR, is these parents lambasted as selfish examples of everything that’s wrong with privileged culture. So it’s right now really hard to see where that leading edge on making sure we’re being fully cognizant of what kids need is going to come from.

Scott?

Gottlieb: Well, Rick made a lot of good points. I think that the issue of who’s pushing back on trying to get schools open — first of all, I think you’re seeing a lot of parents want schools to reopen in some fashion. I think parents are appropriately nervous about the risk of outbreaks and epidemics in the school. And I think they should be nervous about that. But I think you are seeing some organized effort among the political class, certain elements of political class, and that was touched on, to try to get schools reopened for a variety of reasons. I think that push was not done in a thoughtful fashion. And I think it sort of stoked the kinds of anxieties that people, I think, legitimately should have, which is, how are we going to prevent outbreaks and epidemics in school? Because the reality is when we push to reopen schools, we should do it with the goal first and foremost to prevent outbreaks in the schools and prevent kids from getting infected, and prevent teachers from getting infected. And the two goals aren’t in conflict with each other.

I think that there’s a lot you can do to create a safer environment in the school for children, even in the setting of some spread in the community. First of all, you’ve got to get the major epidemics under control. It’s going to be hard to open schools against the backdrop of uncontrolled spread. But you keep the students in defined cohorts. You retrofit the HVAC systems. You try to move classes outdoors where you can. You open windows rather than run the air conditioning systems. You can have students wear masks. You certainly give proper PPE to the teachers. You can stagger the start time of the school day. You can go to hybrid models and have in-class and online learning to try to create more distance within the school. There’s a lot of things you can do to create a safer environment in a school.

And the dialogue was, “We have to reopen schools five days a week, mandated indoor learning 9:00am to 5:00pm. No hybrid model. Grin and bear it.” And that was the wrong approach. And, I think, the wrong message. And when you have the spectrum of CDC putting out guidance on how to safely reopen schools, and they do gymnastics to avoid having to make mention of what you would do to actually close the schools if the situation arose, that also doesn’t inspire confidence. And if you read that CDC guidance, there’s no mention of the circumstances under which you might consider closing the schools, how you would close the schools, what the threshold would be. The document literally says that in the setting of uncontrolled community spread of the virus or situations where the school itself is this source of the local epidemic, you should have a discussion about whether you might consider closing schools. I’m not quite quoting the document.

But I think we’ve got to address these issues. And the absence of addressing them actually is going to push more districts over the edge of closing their schools because of the uncertainty around it and the concerns. And so I think if we took these issues head on and acknowledged the fact that there need to be measures in place to protect the children, that some element of hybrid approaches may be appropriate in certain communities. And we need to more clearly define circumstances under which you might consider closing the schools. I think we’d have a more confident environment in which school districts would take the risk of going forward rather than the default position would be to close them because of the pervasive uncertainty.

Hess: Although I think it’s just an interesting piece. I think Scott is right. I agree. John Bailey and I rallied about two dozen former superintendents and state chiefs and Obama and Bush office holders to sketch a framework for thinking about these issues back in early May. And one of the things that was frustrating through May and June is, rather than seeing a really disciplined effort in the education space to start figuring out how to do the things Scott was talking about, it frequently felt like we were planning a version of the Washington monument strategy. You had superintendents in Los Angeles and San Francisco and San Diego signing letters saying, “Look, we can’t really figure out how to reopen until we get a promise of $200 billion in federal aid for schools.” And so what you saw was a huge amount of energy, it felt like, invested, not in saying, “How do we make this work two days a week right now?” but in saying, “Well, we don’t want to get ahead of ourselves until the checks start showing up.”

So for instance, Scott mentioned the possibility of starting school earlier. We’ve talked over the last several months about running split school shifts. You run a 9:00am to noon. So kids get time to teach. You clean the building for a couple hours, and then you run from 2:00 to 5:00. You run six days a week so you can have more space. So there’s a lot of this. But one of the things that’s happened is districts have been loath to ask employees to actually modify the terms of their collective bargaining agreements. And you’ve seen little indication from the teacher associations that they’re open to even temporarily working around any of the existing provisions.

In fact, what you’ve seen, for instance, was the Democratic Socialists of America — along with the Boston teachers, the LA teachers, the Chicago teachers, the Milwaukee teachers, the St Paul teachers, and the Oakland teachers — have now formed a coalition, which says, “Look, if we want to reopen schools, we need to raise taxes on the rich. We need to have a moratorium on evictions. We need to stop charter schools in standardized testing.” Flexible virtual learning has in many cases in the education space gotten caught up with regular wish list agendas and power politics that have shifted the ball entirely from kind of the practical problem solving that Scott was sketching.

Scott, you mentioned a number of things that could be done to make going to school in person safer. I’m not sure if you mentioned having the kids wear masks. I’m not sure, maybe you mentioned that. But if you did all those things and maybe wear a mask, would you be comfortable having schools open? If they did all those things, but the level of outbreak was what we see right now in Florida and Texas and Arizona and Georgia and California? Pretty substantial.