What PA Pediatricians Say About Schools Reopening In The Fall

PENNSYLVANIA — Reopening Pennsylvania's schools for in-person instruction this fall is strongly favored by a group of pediatricians who paint a dire portrait of the physical, emotional, and mental health of children who are not physically present in classrooms.

Yet the plan could be complicated by rising coronavirus cases around Pennsylvania, just a week after much of the southeastern portion of the state moved into the least restrictive green phase of Gov. Wolf's reopening plan.

The American Academy of Pediatrics' guidance for school re-entry states that all policymaking for the 2020-21 school year "should start with a goal of having students physically present in school."

"Lengthy time away from school and associated interruption of supportive services often results 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," the guidance reads. "This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality."

Dr. Susan Coffin, a physician at the Children's Hospital of Philadelphia's Division of Pediatric Infectious Diseases, said that the recent rise in cases in Pennsylvania could lead to a different mindset.

"The AAP guidance was written in early June, a time when we were observing success in control of coronavirus spread in many communities," she told Patch. "At that time, we were all optimistic that schools could and should reopen, while adopting a wide variety of strategies to keep students, staff, and teachers safe."

After trending downward for weeks, coronavirus cases in Pennsylvania are experiencing an uptick, particularly in southeastern Pennsylvania and the suburbs of Pittsburgh. (PA Counties Where Coronavirus Is On The Rise).

But Pennsylvania Secretary of Health Dr. Rachel Levine said despite the rise in reported cases, Pennsylvania's hospitalization rate is declining. There are currently 643 residents in the state hospitalized due to COVID-19. Of them, 104 are on ventilators. One month ago, there were more than 1,300 people hospitalized in Pennsylvania, and 284 were on ventilators.

"At this moment, Pennsylvania's prevalence of COVID remains relatively stable," Coffin said. "I suspect school administrators would very much like to see a renewed downward trend in our weekly case counts before school openings."

Teachers unions, such as the American Federation of Teachers, are adamant that areas reach certain milestones before reopening. Specifically, they want new cases to decline to 14 days straight; this is something that happened in much of the state, but has reversed in recent days.

Over in Montgomery County, where cases have steadily risen in the general population over the past week, Commissioner Dr. Val Arkoosh has regular meetings with the county's 22 school superintendents about reopening. She has repeatedly stated that the goal is to get students back in classrooms for as many days as possible in the fall. But the county has not yet released official guidance on school reopenings, and individual districts have been mum on specifics thus far, as well.

Bucks County has confirmed they plan on opening. The county is recommending that students be required to wear masks on buses and "possibly in hallways," but not in classrooms. Students and staff will be required to have a mask with them at all times in case it is needed.

Additionally, a minimum distance of three feet spacing is recommended for classroom seating, and seats should be configured to maximize on social distancing, the county recommends (Bucks Co. School Reopening: Your Questions Answered).

Meanwhile, the Centers for Disease Control and Prevention continues to advise that remote learning is the safest option. Their guidance for reopening also differs from the AAP, and is stricter on several specifics; for example, the CDC says that all desks should be six feet apart, while AAP says that three feet is acceptable.

Sean O'Leary, the medical doctor with the University of Colorado who helped write the AAP guidelines, said that the advice was informed by the belief that children are less likely to become infected and also less likely to spread the virus.

"It seems like in countries where they have reopened schools, it plays a much smaller role in driving spread of disease than we would expect," he told The New York Times in an interview published Tuesday. "It seems to be even more true for younger kids, under 10 or under 12. And older kids seem to play less of a role than adults."

The AAP also pointed to the impact on food security which the closures had, as well as the reduction in physical activity for some due to quarantine and social isolation. The public health impact of keeping children at home, the group implies, is greater than the risk of virus transmission posed by reopening schools to in-person instruction.

"Most pediatricians are advocating for safe school reopening with in-person instruction," Coffin said, but acknowledged the impact of the changing landscape of the virus. "However, there may be significant modifications about how this will occur in the fall."

Another issue raised was the lack of faith in the effectiveness of at-home instruction for schoolchildren.

"Schools are an essential part of the lives of children and communities," Coffin added, who noted frustration in the community regarding the closures. "We know many educators, parents, and students were disappointed with the virtual learning experience provided this past spring."

Pennsylvania has issued its own state-level guidance for what a return to school this fall should look like.

Plans must encompass several elements, including identifying a pandemic coordinator or team to lead response efforts. There must be steps in place to protect high-risk children and staff, as well as processes for monitoring students and staff for symptoms.

The plans must be approved by local boards of directors and posted on the school or district public website before a school reopens. The plans must also be submitted to the Pennsylvania Department of Education.

The full guidance from the APP on school reopening can be viewed online here.

As of Wednesday, Pennsylvania has reported 87,242 COVID-19 cases and 6,687 total deaths.

Finding Our Way Forward: See more stories about Pennsylvania's coronavirus recovery