National Academies Offers Guidance on Reopening Schools Amid COVID-19 Pandemic | Global Health | JAMA Health Forum | JAMA Network
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National Academies Offers Guidance on Reopening Schools Amid COVID-19 Pandemic

  • 1Consulting Editor, JAMA Health Forum and JAMA

As a national debate rages over whether US schools should reopen amid the coronavirus disease 2019 (COVID-19) pandemic, a report from the National Academies of Sciences, Engineering, and Medicine (NAS) urges school districts to prioritize reopening schools full time, especially for kindergarten through grade 5 (K-5) classes and for students with special needs.

Noting that states, districts, and schools are wrestling with “complex and high-stakes” questions about whether to reopen schools and how to do so safely, the NAS says the new report responds to the need for evidence-based guidance about COVID-19 and the effects of school closures on students and their families.

In addition to providing an updated review of evidence from around the world about COVID-19, the report offers several recommendations designed to help districts and schools make the complex determinations about reopening school buildings, keeping them open, and operating them safely during the pandemic, using mitigation strategies to curb infection in school settings.

First, while conceding that completely eliminating the risk of COVID-19 in schools “is impossible,” the report says because of the importance of in-person interaction for learning and development, “districts should prioritize reopening with an emphasis on providing full-time, in-person instruction in grades K-5 and for students with special needs who would be best served by in-person instruction.”

Younger children in grades K-3 will be particularly affected by the absence of in-person learning, because they are still developing the skills needed to maintain attention and regulate their own behavior and emotions. In addition, research has shown long-term negative consequences for children who are not reading at grade level by third grade, particularly those from low-income families.

Children and adolescents with special needs may also be at greater risk from long-term distance learning, missing out on services such as career and technical education, physical therapy, and medical care provided when in-person contact is possible.

In addition to potential academic losses, the report said that the “collective trauma of the pandemic should not be underestimated,” including that stemming from severe illness or death among close family members and serious economic setbacks. Providing a supportive response that includes school counselors and other specialized staff, as well as teachers, is an important priority.

The report recommends high-priority mitigation strategies for schools and school districts, including

  • Providing surgical masks to all teachers and staff and hand-washing stations or hand sanitizer for all individuals who enter a school building

  • Limiting large gatherings of students, such as during assemblies or in the cafeteria, and avoiding overcrowding at school entrances, possibly by staggering arrival times of students

  • Prioritizing cleaning, ventilation, and air filtration

  • Reorganizing classrooms to promote physical distancing, by measures such as limiting class size or holding classes in larger spaces.

One physical distancing strategy cited in the report and used in some other countries that have reopened school buildings is cohorting—having the same small groups of students (10 or fewer) remain with the same staff as much as possible. In Denmark, for example, when schools were reopened, class size was limited to 10 to 11 students, and staff were limited to working with 1 or 2 classes.

The report’s authors advise local public health officials to partner with school district leaders to, among other things, develop a plan for monitoring COVID-19–related data to track community spread of severe acute respiratory coronavirus 2 (SARS-CoV-2) and make decisions about whether changes to mitigation strategies are needed and when school closures might be necessary in the future.

Another recommendation addresses the financial burden of implementing mitigation strategies, estimated by the Council on School Facilities to potentially cost $20 billion for schools nationwide. Federal and state governments will need to provide significant financial resources to districts and schools to enable them to reopen. “Underresourced districts with aging facilities in poor condition will need additional financial support to bring facilities to basic health and safety standards,” the report notes.

To inform decisions on reopening schools and school operations, the report’s authors also advise state and local leaders to form decision-making coalitions that seek input from representatives of school staff, families, local health officials, and other community interests. School districts should also prioritize equity in reopening schools and implementing mitigation strategies, taking into account existing disparities.

“As part of the planning process, districts will need to understand how existing inequities (in school facilities, staffing, access to resources, etc) are likely to interact with the lived realities of communities disproportionately affected by COVID-19, so that the plans can identify where additional resources or special considerations are necessary,” the report says.

Additionally, the authors urge the scientific community to conduct research into the role of children in transmitting SARS-CoV-2, the role of airborne transmission of the virus, how reopening schools might contribute to community spread of SARS-CoV-2, and the effectiveness of mitigation strategies.

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