Enlarge /. WASHINGTON, DC – JULY 2: Dr. Robert Redfield, director of the Centers for Disease Control and Prevention (CDC), takes off his protective mask before speaking.
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The Trump administration has pushed for a return to normal behavior, despite the fact that the number of COVID-19 cases in the USA has risen to new records. The focus of these efforts was the reopening of schools in the fall, which would normally start in a little over a month. It is a move that has been opposed by a number of large school districts and has met with great skepticism in public. And it doesn't necessarily seem to agree with the United States government's advice that the Centers for Disease Control gave.
This leads to a conflict between the administration and the CDC. Trump said he disagreed with the CDC's guidelines, which he described as "very tough and expensive," and the Department of Education threatened to draw funds from schools that were not open. These CDC guidelines advised schools to improve their remote offerings, emphasized that the decision to reopen should be under local control, and discussed the reasons why schools should consider temporary closings even if they start the school year as usual.
In a temporary ceasefire, the CDC was instructed to issue updated guidelines for schools. These arrived yesterday and were discussed at a press conference by CDC director Robert Redfield today. Overall, the updated material retains some of the original documents – including one that describes the resumption of normal school activities as the "highest risk". However, there are significant additional materials that highlight the value of restarting the school and detail the lower risks that the pandemic poses to young students.
A bit old, but a lot new
The previous documents were released in mid-May, and at least some of them were prominently placed on the new landing page of the policy. This includes advice on how to prepare schools for the return of students. The document describes normal school activities as "highest risk" as opposed to distance learning, which falls into the "lowest risk" category. This includes advice that is likely to fall into the "very hard and expensive" category with which the President was dissatisfied, e.g. For example, changing classroom layouts to allow greater distance, installing physical barriers, and thorough cleaning and disinfection.
However, newer documents, such as those addressed to school administrators, have a clear change in focus. There are still a lot of good practices, like wearing face masks, social distancing for students, and extensive disinfection. However, there are now large sections on the "critical role of schools" that show that "(t) the unique and critical role that schools play makes them a priority for openness and openness and enables students to: to receive both academic instruction and support as well as critical services. "
If that wasn't enough, there is a section below in the document entitled "Why is it important to open schools for personal instruction?" It follows: "Schools play a crucial role in supporting the whole child, not just the students' academic performance." In total, around a quarter of the 5,000-word document is spent on text, which promotes the importance of opening schools for personal instruction.
The document also includes a detailed section on how COVID-19 affects the school-age population, which is found to account for 6.6 percent of COVID-19 cases, but only a very small proportion of deaths . There are also some preliminary data on children who are less likely to transmit the disease. All of this is correct, but it is also an area where high quality data on many of the issues is scarce and different countries have achieved different results based on a combination of local conditions and factors that have not been identified.
A slide into the legal profession
There is still good information here – the checklist for parents and the associated decision-making tool provide excellent information in an easily digestible form so that parents can feel more confident that they have taken all relevant information into account when dealing with risks for their children.
But it is now mixed with an obvious push to reopen schools. There is now a whole document entitled "The Importance of Reopening American Schools This Fall". Unlike most other CDC documents on the subject, which focus on providing information that parents and school administrators should consider, this document reads like advocacy. Hardly any risks are discussed, but passages like the following include:
The best evidence available shows that children who are infected are far less likely to experience severe symptoms. Mortality rates among school-age children are much lower than among adults. At the same time, the short-term and long-term damage attributed to closed schools for social, emotional and behavioral health, economic well-being and school performance in children is known and significant.
The best evidence available from countries that have opened schools shows that COVID-19 poses a low risk to school-age children, at least in areas with low community transmission, and that children are unlikely to be a major driver of the spread of the virus . The reopening of schools provides an opportunity to invest in the education, well-being and future of one of America's greatest assets – our children – and to take all precautions to protect students, teachers, staff and all of their families.
The contrast is staggering. The first quote that minimizes the risk of opening schools is the only place in the document where the risk is considered.
How this document was created was made clear at the press conference on the introduction of the material. In it, Erin Sauber-Schatz, head of a CDC COVID-19 task force, emphasized that opening schools shouldn't be an easy decision, as it has advantages and risks. She mentioned that as a mother, she was "broken" in the number of people under the age of 18 who died from COVID-19 in the United States, and stressed that the risks for teachers and staff are even higher.
CDC director Robert Redfield emphasized that society as a whole must play a key role in limiting the pandemic, and he discussed how evidence of an area suffering from a high level of infection should be used to determine that keeping open from schools is probably unsafe.
All of this is reasonable and is consistent with the previous CDC approach to the problem. However, the two were joined by Deputy Secretary of Education Mitchell Zais, who had a radically different message. "President Trump is leading a big recovery in the US, and part of it is getting students back to school," he told reporters, adding, "The default setting should be schools that are fully open." He said unequivocally that science says that opening schools is "healthier and safer for children", "not whether it should be done, but how it should be done".
But Zais & # 39; respect for research is limited. In spring there was almost no data on the prevalence of SARS-CoV-2 in school-age children or on the effects of COVID-19 on them. Still, Zais said that schools that closed in response to their proliferation "failed their students." Zais repeated Trump's threat that school systems that are not open to personal instruction would not receive federal funding. (Trump has at least changed this threat to recognize the CDC's ruling that schools in areas with high levels of infection must be closed.)
The press conference gave the impression that some documents or sections of the new documents were written by the Ministry of Education and not by the CDC.
Developing these documents even under normal circumstances would have been a challenge. Personal school attendance is clearly very important for children's health and development, but these concerns must be weighed against the known risks and significant unknowns regarding the prevalence and impact of COVID-19 in both children and teachers. The end result in this case, however, is a discussion in which the balancing of these risks has been skewed in favor of a result that is the result of a political campaign wishing to return to normal. And that not only serves the US public badly, it also threatens to damage the CDC's long-term credibility by appearing as another campaign tool.