As of May 17, 2020, there are approximately 1.5 million documented cases of COVID-19 in the United States. Of those infected, 90,000 have died. The current population of the United States is estimated to be 331 million. This means COVID-19 infections have only been confirmed in less than one-half of 1 percent of Americans. This number does not include those who have acquired the virus but not had their infection verified by laboratory analysis. No one knows if the number of unconfirmed cases is statistically insignificant or higher than the number of confirmed cases. Regardless of the actual number of COVID-19 cases in the United States, it is safe to assume an overwhelming number of Americans have not acquired COVID-19 and are still susceptible to the disease. Even if the number of unconfirmed COVID-19 infections equals the number of confirmed cases, less than 1 percent of Americans have acquired the infection, and more than 99 percent of Americans can still become infected. Understanding the mathematical reality of the COVID-19 pandemic becomes especially important as states decide when to reopen schools. Many governors are being pressured by concerned parents to reopen schools as soon as possible, but no one knows if such a task can be accomplished with safety for all. Many Americans are content to have their children remain at home until a COVID-19 vaccine becomes available or until some other discovery or development signals the safety of school reopenings. Many other Americans believe schools must be reopened by this fall, regardless of the risk of COVID-19. Those who insist on their schools being reopened by this fall should consider a few important questions. First of all, even if COVID-19 is a disease that is well tolerated by children and only rarely fatal in the pediatric population, who is going to be teaching the children when schools reopen? Are children going to be taught by other children or by adults? If children are going to be taught by adults who cannot handle COVID-19 infections as well as children and are prone to higher mortality rates, what will be done to ensure the teachers’ safety? Will teachers be supplied with N95 masks, and guaranteed classrooms that permit the enforcement of social distancing, or will school districts abandon safety measures in the name of cost containment? Will school districts that employ safety measures be able to afford the extra teachers required to teach the increased numbers of classes that result when class sizes are significantly reduced to comply with social distancing? Will school districts be able to afford the substitute teachers needed to replace teachers who start missing large blocks of time because of illness or start using inordinate numbers of sick days because of their fear of contracting COVID-19 in their classrooms? Will these districts be able to afford the many ancillary personnel required to sanitize classrooms and school equipment at the end of each school day, respond to the increased number of medical, psychological and social emergencies related to the ongoing threat of COVID-19, and ensure the security of the school campus during a period of increased vulnerability? Will children exposed to COVID-19 in the classroom carry the virus home and infect their parents, grandparents, or neighbors, thus prolonging the COVID-19 pandemic? Similarly, will exposed children infect school bus drivers, cafeteria workers, and other school personnel who, in turn, will infect their families, neighbors, and friends? Will greater numbers of children acquire Multisystem Inflammatory Syndrome when they return to school? If they do, will their families and an overburdened health care delivery system be able to effectively diagnose, treat, and rehabilitate them? Clearly, the COVID-19 pandemic has given us more questions about the feasibility of reopening schools than answers. Fortunately, there may be ways for American children to continue their education this fall without being unnecessarily exposed to COVID-19. Most American homes already have computers and internet service. What’s more, desktop computers, laptops, and iPads have become very affordable, and applications like Zoom, Skype, and FaceTime, which allow video conferencing, are free. School districts could safely reopen this fall by allowing teachers to teach from their classrooms, and students to learn at home with the aid of the previously mentioned devices and applications. A number of schools that have already taught classes with live videoconferencing have been impressed with its capabilities, especially the ability of students and teachers to interact. The federal and state governments could provide financial aid to large families who needed additional computers for their children or upgraded internet services. The purchase of such equipment and services would give a much-needed financial boost to technology companies adversely affected by the pandemic. A legitimate argument against keeping schools closed is the need for many children to go to school to receive their daily meals. The federal and state governments could pay restaurants to prepare daily meals for such needy children. Many unemployed Americans could be employed to deliver meals to these children, and underutilized transportation services could be contracted to aid in the delivery of meals. Feeding school children would allow many closed businesses to reopen and unemployed Americans to find jobs. What is important for everyone to understand is that any alternative to traditional education would only be temporary. What is just as important to realize is that potentially effective vaccines and treatments for COVID-19 are being tested as we speak, and could be available within the next 12 to 18 months, if not sooner. With this in mind, we must accept the fact that as many as 99 percent of Americans can still become infected with COVID-19 and need to avoid human contact until a vaccine is developed. Until we have a vaccine, homeschooling, with or without videoconferencing, may prove to be an economical and immediately-accessible short-term alternative. Athletics, school plays and concerts are important parts of our children’s education. Learning how to stay healthy, safe, and out of harm’s way is even more important. Bernard Leo Remakus is an internal medicine physician. Source
