Planning for Recovery: Part Four: Re-opening Public Schools

July 14, 2020 by David Nitkin | Categories: Healthcare Series Two: Futures | Tags: education

What form does recovery take? What is the right strategy for government, companies, and our families as we begin to reopen but the virus is still on the loose? When and where do we citizens under lockdown regulation get a chance to engage in shaping societal decision choices whose efficacy is a matter of debate? This blog article is one in a series of recovery choice reviews that looks at some of the lessons learned from the first months of the COVID-19 pandemic and examines what alternatives exist right now about how Canada might move forward with various aspects of recovery.

The Issue

The spring semester (March-June 2020) saw the closure of most schools, with thousands of public-school students learning from home. The stresses this raised on stay-at-home parents are discussed in four EthicScan blogs– one dealing with self-educating your children; “Family Pressure Cooker” (May 23); a second with competing time pressures, “Work at Home Balance” (April 7); a third, “Talking to Your Child About the Pandemic” (May 3); and another on health-related screen access limitations, “Screen Time and Home Schooling” (April 29). Currently parents, governments, paediatricians, infectious disease specialists, and school boards are all anxiously looking to September 2020 in order to assess the options on re-opening schools. Essentially there are three very different major choices:

Schools closed: Full remote or distance education
Schools re-open: Full face-to-face teaching
School partly open: A hybrid or blend of the two, with limits of hours and days of instruction, and class size.

This blog article explores three questions:

What form should elementary and secondary school teaching take in September 2020 in the face of our best but uncertain and evolving knowledge of COVID risk?
What are the educational, health, financial, ethical and other arguments favouring or rejecting the choice of one of these three options?
And what are the lessons learned in other jurisdictions – notably physical distancing versus enhanced testing– that might help in making such a choice?

Trends and Implications of Involuntary Closure

School communities desperate for normalcy are hoping that the new school year will be more stable than the last, when the coronavirus forced schools to close and launched widespread remote learning overnight. But that seems like wishful thinking, as September-December 2020 is shaping up to be even more problematic. Some governments and school districts are refusing to re-open schools. Others are embarking on novel experiments in learning, unveiling plans to reopen with new procedures for just about everything. But none of these plans are set in stone because the unknowns about how things will work far outweigh the knowns.

Schools are fundamental to child and adolescent development and well-being. They provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental-health therapy, after-school enrichment programs, and opportunities for physical activity, among other benefits. Beyond supporting the educational development of children and adolescents, schools play a critical role in addressing outcomes like racial and social inequity, civility and links to communal identity.

Public school enrollment in Canada before the virus was about 50.7 million students, the highest enrollment ever reported. In Canada and the U.S. an estimated 3.5 million and 27 million workers respectively depend on schools for childcare. Here is a selection of comments from educational psychologists, educators and others about our experience with closure over the past four months

Many children lost direct experience with play-based learning and peer interaction.
We are training our children to see others as threats. If we develop a vaccine and thus achieve immunity, we will have to re-learn all sorts of once-natural, trust-based, inter-personal, social reflexes. If we don’t, our children’s way of relating to one another might be forever changed.
None of the 22 European nations that have reopened schools have observed an increase in infections among children, parents, or staff. In time, best practices and successful implementation strategies from some of these countries could be adapted here.
Lengthy time away from school and associated interruption of supportive services has resulted in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality.
Virtual (on-line) learning has proven to be a widely-practiced but inadequate substitute for in-class instruction in the long term, even with teacher time to prepare.
Physical distancing measures and school closures may have exacerbated the symptoms of students who already have mental health conditions, such as anxiety, depression, and substance abuse.
Beyond the educational impact and social impact of school closures, there has been substantial impact on food security and physical activity for certain children and families.

Arguments Pro and Con: The School Reopening Options

Introducing change in education is more difficult in the context of crisis and when predictability is already severely compromised. Here are the pros and cons of the options:

CHOICE ONE: School closure: No students at school. Full remote or distance education

Highlights:

(a) failures of distance education;
(b) measurable regressions in academic gains, especially in math and science,
(c) heightened student depression and anxiety symptoms;
(d) greater digital dependence;
(e) gaps between wealthy and poor families in their ability to give devices to their children;
(f) a measureable impact on food security, social integration, and physical activity for many children and families;
(g) dozens of reopened schools in Israel, Japan, and South Korea had to close and revert to virtual learning when new COVID-19 clusters emerged; and
(h) many British parents voluntarily kept their children at home, with estimated school attendance ranging from 40% to 70%.

Arguments	Pros	Cons
Parents	Relieve parents of time-consuming teaching responsibilities	Parents aren’t trained educators
Teachers	Many teachers need to markedly improve distance education skills	Requires pre-prep and planning, including new lessons that work in school and at home, with backup plans in case schools close again
Education: Pre School	Parents are not be required to send pre-K kids to school	Neurosurgeons currently have no way of predicting the long-term effects of e-learning on pre-school-age children
Education: Primary (Elementary)	These children should be given the choice to opt out of face-to-face instruction to accommodate their own health needs or those of high-risk family members	Lengthy time away from school and associated interruption of supportive services often results in social isolation. Home schooling makes It difficult for school boards to identify and address important issues like learning deficits, child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation
Education: Secondary school	Opportunity for customized education and mentoring from parents, grandparents, retired teacher neighbours, and students in gap year	The mental, behavioural, and developmental health of secondary school children not going to school, not being exposed to in-person teaching, and not being with their friends and peers is enormous
Education: Special needs	Schools can provide special accommodations and education plans at home for medically and behaviourally complex children	Children with underlying medical conditions, such as immunocompromised states or chronic medical conditions such as cardiac and lung disorders are underserved
Health	Parents are well suited to monitor and observe compromised health status and behaviours of their children	Concerns about the potential impact of staying out of school on family discord, exposure to domestic violence, child abuse and neglect
Financial	Students with special needs can and should be provided with remote learning opportunities should schools be closed	What happens when parents decide, after school starts, that this option isn’t working? How many changes can districts make quickly?
Ethical	It is morally essential that parents have the right to home school. Schools have to provide children with content, lest kids fall behind	Families who choose to not send their children to school need to receive remote learning opportunities and not lose access to home care and respite supports

CHOICE TWO: School open: All students physically present in school: Full face-to-face teaching

Highlights:

(a) Option supported by HSC (Sick Kids Hospital) and American Academy of Pediatrics);
(b) urgent need to reopen and start making up for lost time rather than seeing further pedagogic regression;
(c) children are out of the house so parents can work,
(d) for many students, school is a place of stability and safety, and there is a strong imperative to get them back into school buildings;
(e) a daily school model is thought to be best as it allows for consistency, stability and equity regardless of the region in which children live.

Arguments	Pros	Cons
Parents	Relieve or reduce parents of at-home multiple responsibilities and stresses	Fear of greater infection risk for their children
Teachers	Get teachers back into professional career mode. Have teachers rotate instead of students when feasible	Personal fear especially among older teachers of infection from children, but also from custodians and parents
Education: Pre School	Allow focus on more effective risk mitigation strategies: hand hygiene; infection prevention education for staff and families; and adult physical distancing from one another	Is it feasible for a 3-year-old to keep a mask on for longer than a few minutes, other than on Halloween? In Pre-K, the relative impact of physical distancing among children is likely small based on current evidence and certainly difficult to implement
Education: Primary (Elementary)	Allow application of risk mitigation strategies: wear face coverings; cohort classes to minimize crossover among children and adults within the school; utilize outdoor spaces when possible	Need to prioritize testing of symptomatic and exposed children. Desks placed 3 to 6 feet apart may not be feasible (if this reduces the amount of time children are present in school, harm may outweigh potential benefits)
Education: Secondary school	Experiment with streaming: Block schedule lessons (much like colleges, in intensive time blocks). Eliminate use of lockers or assign them by cohort to reduce need for hallway use across multiple areas of the building	Restructuring elective offerings to allow small groups within one classroom may not be possible in a small classroom: Need to ensure students are not carrying home an unreasonable number of books on a daily basis
Education: Special needs	Ensure that students continue to receive access to therapy and nursing services while in the school. Maximize continuity amongst those providing services and/or use virtual care for service provision, to decrease contact exposure	It may not be feasible to adhere both to distancing guidelines and the criteria outlined in a specific IEP (individual education plan). Special education students will likely be more negatively affected by cohorting and streaming
Health	Allow staggered drop-offs and pickups, and drop-offs and pickups outside when weather allows. Facilities are being cleaned and disinfected at least once a day by personnel taking protective precautions	Some schools in Germany are providing self-administered viral tests with overnight results and allowing attendance only if the child has a negative result. China, Taiwan, Vietnam, and Japan are also checking students’ temperatures at school exits and entrances and sending them to nearby clinics in cases of fever
Financial	Take advantage of creative staffing (athletes, students on college gap years, retired teachers as aides, supplements, and volunteers)	Resources such as teacher Employee Assistance Programs (EAPs) are needed to provide support and mental health services for teachers and essential hygiene workers
Ethical	Allow for development of new, necessary pandemic awareness and etiquette classes	There is potential for increased risk of infection with improper mask use.

CHOICE THREE: School partly open: Some students at school in a pre-determined pattern. A hybrid or blended model with limits to hours, days of instruction, and class size

Highlights:

(a) School districts can plan for various safety contingencies—local and district variations in virus threat,
(b) starting with one plan and having to revert to another during the year most impacts the most vulnerable students;
(c) Israel and Japan stagger arrival times on campus;
(d) kids would get a lot more online Zearn badges if they were supervised in school rather than being asked to do it at home;
(e) schools must decide which cohorts of children should attend first. Denmark and Norway started with elementary schools, whereas Germany opened their schools to graduating high school seniors.

Arguments	Pros	Cons
Parents	Spend part of engaged day at home with children	Second choice for those favouring full day schooling
Teachers	More chance to experiment with innovative and individualized lesson plans	Complex orchestration is required (technology, bussing transport, equipment, resources)
Education: Pre School	Opportunity to customize cohort classes; Utilize outdoor spaces when possible; Limit unnecessary visitors into the building	Reducing classmate interactions/play in Pre-K aged children may not provide substantial COVID-19 risk reduction. Alarm about the effect of less face to face teacher time on kids from lower-income families, especially those whose parents don’t speak English
Education: Primary	Opportunity to target kids whose parents can’t work from home, and others who are most vulnerable to breakdowns in the standard education system	The risk reduction of reducing elementary class sizes may be outweighed by the challenge of doing so. Reducing their classmate interactions/play may not provide enough COVID-19 risk reduction to justify potential harms
Education: Secondary school	Attendance could be alternated between coming to class and learning remotely with 1-day-on, 1-day-off schedules, as is being done in many German schools	If students must move between classrooms it may be necessary to limit or stagger the number of students in the hallway when changing classrooms
Education: Special needs	Once in class, these children could stay there through the day while teachers rotate	Schools in Norway reduced their class sizes to groups of no more than 15 students and use unoccupied classrooms to maximize physical distancing.
Health	Reduce risk by assigning lockers by cohort or eliminate lockers altogether	Greater difficulty in decontaminating physical plant with so many shift schedule students
Financial	Precautionary measures in several Chinese schools include increasing the number of bus routes, and diversifying pick-up and drop-off locations	It is not always possible to use existing, private transportation services or maintain physical distancing measures in transit
Ethical	British, Israeli, and Danish schools give remote work options to whoever (teachers, custodians) self-identify as more susceptible to infection	While unequal, allows prioritizing the educational need of children of front-line care givers and essential workers

The Deconfining Debate: Means Versus Ends

Public-health agencies are aggressively promoting a mandatory range of physical distancing requirements on any school re-openings. Educators, school administrators and others say this negatively affects education. One serious limitation in this debate is the failure to distinguish physical determinants (distancing) from public-health ones. Most of the literature to date focuses on the need for “deconfining” or physical distancing in time and space.

Here is a simplified summary of the two conflicting approaches to minimize virus risk. As space considerations are tight, a much more detailed table and Strategy for Re-opening is available from EthicScan’s Resource Kit.

	Distancing Approach	Testing Approach
Strategy	6 foot distance; staggered drop-offs and pickups, and drop-offs and pickups outside when weather allows	Health status testing of children, teachers, and custodians; access controls; decontamination sprays
Logic model	Aim to maximally limit movement and contact. Most countries are encouraging students to wear masks while on school premises, although this may hamper certain learning efforts, like assessment of phonation.	Aim to ensure children are healthy and well. Temperature and saliva testing before school, at school and after school, with isolation where necessary
Stress	See proximity to others as threat	See ill health of others as danger
Application	Strict adherence to a specific size of student groups (eg, 10 per classroom, 15 per classroom) should be discouraged in favor of other risk mitigation strategies. Once in class, children could stay there through the day while teachers rotate	Schools should have a policy regarding symptom screening and what to do if a student or school staff member becomes sick with COVID-19 symptoms. Temperature checks and symptom screening are necessary to identify symptomatic persons to exclude them from entering buildings and business establishments
Pre-arrival entry testing	CDC says No	HSC (Hospital for Sick Kids) says Yes
Daily testing	Lesser frequency (once every two weeks)	Greater frequency (as much as twice a day)

Conclusion

There has been much written about the pandemic causing a generation of public-school students that could be academically lost, socially stunted and emotionally scarred. Navigating new territory to disprove that dire forecast always brings with it some disarray, but this coming school year will present a new, unprecedented in present memory, and difficult path for our schools.

We have to accept that COVID-19 will stay with us for a long time, perhaps a year, maybe longer. Experts in a variety of specialty areas involving the health and well-being of children and youth seem to agree that-we must move on with certain activities in our lives, such as schooling, while keeping in mind that there are a lot of ways to assess and mitigate risk.

The Issue

Trends and Implications of Involuntary Closure

Arguments Pro and Con: The School Reopening Options

The Deconfining Debate: Means Versus Ends

Conclusion

Further Reading