How the School Transmission Conversation Became So Muddled
Brooke Gladstone: Over the past 10 months, debates have raged over how to keep the coronavirus in check. What to open, what to close, where the virus spreads. When are we relatively safe? Through it all, one kind of space has been the subject of very vigorous debate, and yet, starting a few months into the virus, it yielded a kind of unexpected conventional wisdom.
Audio clip: The latest science suggests schools are not super spreaders.
Audio clip: We've discovered over the spring that children needed to go to school. They are not the super spreaders that we thought at first that they were.
Brooke: In the midst of the darkness, some welcome light: kids are safe from themselves and others. They can go to school. When other institutions closed, countries around the world, especially in Europe, kept their schools open. Yet, here we are, several months later.
Audio clip: Stricter lock-down measures have come into force across Germany. The measures will further limit social contact and keep schools and non-essential shops closed.
Audio clip: Schools and colleges in England are to be closed to most pupils until at least half term.
Brooke: It turns out, if you believe the epidemiologists, schools do, in fact, bring the risk of infection. How could we ever have thought otherwise? Rachel Cohen has been covering the debate around school closings and openings, most recently in The Intercept. Rachel, welcome to the show.
Rachel Cohen: Thank you. Happy to be here.
Brooke: Let's go back to the early part of the pandemic, March and April. Back then, we didn't know much about the virus, and one of the prevailing ideas was that kids couldn't really get floored by COVID the way that their parents, and certainly, their grandparents could. Right?
Rachel: Right. People started having different hypotheses for it. Maybe it's because they're just always in germy environments or maybe they've built up natural immunity. The first COVID child death in the US didn't happen until May, so that was already a few months into the pandemic. That really focused research priorities and thorough funding streams and there was definitely a sense that, for whatever reason, it's a blessing. We seem to not have to worry about kids right now.
Brooke: Then in summer, there was more speculation. Kids do get COVID, but they don't really transmit it, or they don't get sick, or they rarely show symptoms. A lot of these ideas came from research that was done in other countries.
Rachel: Over the summer, we started to get a little bit better picture. We started to say, all right, contrary to maybe what we thought in April, we definitely know kids get it now, and we actually know they definitely can pass it on to their siblings and their parents, but we don't really know how much they do it and it seems like they don't pass that often. A lot of these studies that were suggesting that, there were tons of caveats to them. We need to be careful before we make strong claims. Although there was some realizations in the summer, maybe the reasons we thought kids didn't catch in the spring is because we weren't really testing kids, because tests were in short supply and there was all this focus on seniors.
Also, kids were all home because all the schools were closed, so there wasn't really much opportunity for exposure amongst kids. That's why so much of our earliest understanding in the US was based on research and experiences internationally. We just didn't really have that much to go on here.
Brooke: Right. Let's talk about some of those studies, because some of them offered some really surprising conclusions. One that really stood out to me, I don't know how influential it was, that in Germany, school re-openings were actually linked with lower rates of COVID-19 spread. Then there was confusion about a report from the Israeli Health Ministry. Could you summarize that one?
Rachel: Israel found a report that showed children were more likely to be infected with COVID than adults. The ministry was warning that children can act as super spreaders and they were warning about asymptomatic infections. There were a lot of people who were trying to figure out how does Israel's study comport with Germany's, compared to Australia's, compared to Ireland, compared to India. There was another study published around contact-tracing in India that found, yes, there is evidence of more child transmission from really young children than we thought.
There was this period where we, in the US especially, were trying to make sense of all these studies coming out of Europe and Asia, that while feeling instructive in some way, we had to be like, what else is different about those countries that maybe might not be applicable here? How universal are these lessons? That was very challenging for policymakers.
Brooke: Two of the people who were trying to piece together all of these conflicting European reports and became very frustrated, a frustration they aired in a USA Today op-ed, were Laura Garabedian and Rebecca Haffajee.
Rachel: They are health policy researchers who were also parents and they had been attending these Zoom meetings over the summer to learn about their schools plans for re-openings. As they sat in on these presentations, they realized pretty quickly that leaders were citing studies to make claims about levels of safety that they felt based on their expertise, just wasn't supported by the kind of evidence that district leaders and other people were citing. They wrote this piece to say, listen, right now, the evidence on children rates of infection transmission is inconclusive. This came out late August.
They urged, at the time, aggressive mitigation strategies until we know more.
If you can stretch your mind back to mid to late summer, there was a growing pressure at the time to figure out what are we going to do when summer vacation ends? Most people, I certainly put myself in this category, perhaps naively thought, of course Congress will pass another stimulus package, because we're in a pandemic and we need that. Then May went by and then June went by. Now suddenly we're in July and Congress still hadn't passed a stimulus package which would have included resources to help make schools safer in September.
Now we're in late July, early August. There's no stimulus package. We still don't really understand what children transmission is like. Parents are getting really frustrated because they really thought their kids were going to get to go back in the fall. Then also, it's when we really start thinking about ventilation as a big factor in this pandemic. We started to use terms like hygiene fear and realizing all the scrubbing down and disinfecting that we thought was so important in the spring, actually maybe that's not the real way to reduce the spread of this virus.
Then people were like, wait, so many schools are poorly ventilated, and that became a big focus in August in a lot of these school district negotiations. Up to this point, you had had a lot of schools thinking, okay, we'll bring kids back and we'll do deep cleaning twice a week or things like that.
Brooke: Roundabout August, the scientific community was conceding that there were limits to what it could actually know about how the virus spread in schools and there was an effort to collect data about it. One of those collectors was a Brown University economist, Emily Oster, a popular writer on a variety of family-related issues. She collected some data, but as you observed, the problem with the data is that it wasn't representative of the schools that most of the kids were going to, or not going to.
Rachel: Emily Oster's database came at a time when parents, leaders, journalists frankly, everyone really wanted to answer the pressing question which is, can schools reopen? Are school safe? Everyone really wanted numbers and Emily's database gave some numbers. The problem was people really ran with these numbers without thinking very critically about them. By late October, it had about 1% of all K-12 schools in the country and about 150 school districts out of 13,500. There were very few traditional public schools. There are very few urban public schools. There was really no breakdown by race or resources.
When I interviewed Dr. Oster, she acknowledged that, okay yes, it is disproportionately higher income and more suburban. There were a lot of states that just had one school reporting data in some categories. This wouldn't have been a problem if she and others hadn't been going around then drawing really strong conclusions from it. In late September, the Washington Post covered her data. She was writing op-eds about her data. She made this argument, well, schools aren't super spreaders. This represented this new stage of the COVID conversation where we had gone from kids don't catch COVID to, well, kids catch COVID but they don't spread it in schools. Okay, yes, we know they spread in schools, but there doesn't seem to be super spreading events in schools and therefore, it's probably safe to move forward.
Brooke: She wrote an op-ed in something called The Insider with the headline School Infection Rates Are Low Even in Areas With High COVID-19 Rates according to data on 550,000 US students. That's pretty persuasive.
Rachel: Yes, that sounds like a lot of students and then if you read more closely, you learned that less than a third of that 550,000 students were actually learning in person.
Brooke: They were learning virtually and the headline refers to school infection rates.
Rachel: Right. At the end of her piece she acknowledged that more data would be needed to understand, but she didn't make mention of other important things. If it's information that is at odds with other things we're learning about the virus, like how this airborne disease travels in poorly ventilated buildings when people are close together. If it seems a little bit at odds with that, then you should definitely make clear the caveats to your findings so that people can really think about it. I think part of it is, it was saying what a lot of people wanted to hear.
Brooke: The Washington Post did a story that used her data. It was 550 public and private schools voluntarily reporting data as you said, but 200 of them were fully remote. A piece that Oster wrote for The Post this past summer, was called How the Media Have Us Thinking All Wrong About the Coronavirus. She's an economist. She's not an epidemiologist. Then economists have weighed in variously on the pandemic. You can certainly understand her desperate impulse to get some information in front of the public, but do you think this material was overused by prominent news outlets?
Rachel: I absolutely do. As an education journalist, I know there's a pressure to get experts' quotes and Emily Oster had become the go-to academic on schools and COVID safety. She was writing op-eds on the topic in The New York Times, The Washington Post, The Atlantic. She was being interviewed on FiveThirtyEight. There was a profile about her in Bloomberg for her work. Alec MacGillis had a very high profile story in late September where he quoted The Washington Post story that covered Oster's tracker that said, "So far there was little evidence of the virus spreading inside school buildings."
Brooke: That was in ProPublica?
Rachel: Yes. Chris Hayes had a tweet in October saying, "We now have pretty good data to show schools can open even in places with pretty high transmission." Oster was interviewed by The Wall Street Journal saying her data suggests the risk to kids from going to school are small.
Brooke: Now, a lot of what's been driving this conversation centers around what happens to kids, especially kids who are marginalized when they're kept out of school. You mentioned the Alec MacGillis piece in ProPublica which was criticized, but there have been conflicting data on what the parents of Black and Brown and low-income kids really feel about this. Some of them say, hey, I'd rather keep them home, but according to a Pew poll in October, the parents of K through 12 kids are far more worried about what happens to their kids if they're kept out of school, if they fall behind, and that they're likely to fall behind.
There's other data that suggest rural kids are really getting no education when they stay at home, and we know that a lot of public schools are terrible. That their ventilation is bad. That the classes are overcrowded and all of this will require money to fix, but we do have to calculate the cost to kids, especially kids who have it rough anyway, of not having the option to go to school. No?
Rachel: Absolutely. Districts need to be taking all that into account and I think they are. That's why in some districts you have it so that maybe they haven't reopened to all students. They allowed it that homeless students and students with special needs could come back. I think there's very little question that for most students, in-person learning circa 2019, is far preferable than remote learning, fall 2020. It's not surprising to hear that most parents of online learning worry about their kids falling behind because, well, there have been reports of some students finding that they actually do better on the whole.
No one wants to do this long term. No one's like, "When we get done the pandemic, actually let's keep doing this for most students." What we are seeing in survey after survey, state after state, and in terms of who actually signs up to go back to school, white and affluent families are disproportionately more likely to be sending their kids back to in-person learning. That doesn't mean that Black and Latino families aren't going. It doesn't mean that parents don't want to send them back when this is over, but it does send an important message.
Brooke: You're not saying that we shouldn't keep schools open. You're trying to make another point, right? That you can't do good mitigation, unless you're honest about what we know and don't know about the risks.
Rachel: For much of this pandemic, nobody really wanted to say that the risks to educators, to school workers, to community members, to parents, that if they get sick, or if a couple kids get sick, that is outweighed by the benefits to in-person learning. Instead, the argument was, well, it's just not very high-risk and so we don't even need to tread into that category because schools are safe. We can make school safe. Now the problem is, especially as this virus is really getting worse. Transmission is going up across the nation, hospitalization rates, we have this new variant, and we're getting better studies on how re-openings did affect infection rates and hospitalization rates.
It's getting harder to maintain that position. It's looking clearer and clearer that there is a link between community rates and school re-openings and hospitalization rates, and so we can't say there's no risk. We can't even say it's low-risk. What we can say is that there are things we can do to make it safer, but right now, there is a recognition that a lot of school districts have not done the recommended mitigation measures that would make it safer. Although you don't want to say safe, because that's putting it in a different category.
Brooke: You're saying that nobody wanted to say in-person learning is so important that it doesn't matter that a few people die. They just said it was safe, but you're saying it's more honest now. That's better, right?
Rachel: I think we are entering a more honest place. I'm glad for that. Although I will say, literally this morning, I saw the Chicago Public Schools Twitter tweet out something saying,"Fact: Across Illinois, the country the [unintelligible 00:16:50] public health officials have not found a connection between community spread and reopening schools."
That's not true. I really get worried about things like this because public trust is at such a low right now and we really need institutions and leadership to communicate the risks and what we're doing to tackle them, and not fuel this mistrust. When I saw something like that, I really just groaned. I said, "Oh no."
Brooke: Rachel, thank you very much.
Rachel: Thank you. It's really nice to talk to you.
Brooke: Rachel Cohen has been covering the debates around school closings and openings, most recently in The Intercept. For more OTM, follow us on Twitter, like us on Facebook, and above all, sign up for our newsletter, and wait for the big show that comes around dinner time on Friday. Thanks for listening.
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