Sophie A. Lukashok is an infectious disease medical doctor and mother of three children in the DeKalb County School District.
With parents wondering how and if schools will reopen their doors in the fall, Lukashok offers ideas in a guest column about how to do so safely. But it will depend on getting students on board with critical safety practices, she says.
By Sophie A. Lukashok
As a mother of three adolescent children in DeKalb public schools, I have given much thought as to how my children’s education should resume in the fall. As an infectious disease specialist, I have considered how this process can happen safely.
We have two tools to diminish the spread of COVID-19: masks and social distancing. We know from our experience working in the hospital that when all individuals wear face masks, there is virtually no transmission of virus. We also know that social distancing helps prevent the spread of the virus.
Face masks are straightforward. Everyone needs to wear one in public, and that means school. Social distancing is more subject to interpretation, so we need to make sure we are implementing it in a rigorous enough fashion so it works. If we implement the mandatory donning of face masks, and the standards of social distancing, schools can safely reopen their doors in the fall.
When I suggested to my 17-year-old son that in-person school could happen if all teachers and students wore masks, he responded, “Good luck with that.”
But, if students and teachers alike wear a mask at all times, the risk of passing or acquiring coronavirus is diminished by at least 95%.
Unfortunately, teens are our super-spreaders and are the least likely to wear a mask. Adolescents often exhibit no symptoms or mild symptoms when they get infected with coronavirus. They are very social, so likely to spread the virus to many people. They are rebellious and often cannot be controlled as easily as elementary school students, who are under closer supervision by their parents. They surrender to peer pressure easily; when their peers do not wear masks, neither do they.
Teenagers feel invincible, and many are far removed from our health care settings and have not experienced COVID-19, known someone who has had the illness, or lost any loved one to it.
For these reasons, it’s hard to get teenagers to wear masks. So, how do we implement universal mask wearing in our high schools?
As a mother, I have learned the best way to get children to buy into new rules is to explain to them why these rules are important. Although many adolescents are usually rebellious, self-centered, and, dare I say, reckless, they are also often smart, intellectually curious and passionate about improving their world.
In addition to distributing masks to each student, I propose the public school system work with the Centers for Disease Control and Prevention to design three or four short documentaries that would be shown to students during the first two weeks of school, and which would illustrate and explore various aspects of COVID-19 and the pandemic.
For example, a first video could show footage from a hospital emergency room during the pandemic, such as the short film made by The New York Times about St. John's Episcopal Hospital in Far Rockaway, and link the video to a brief documentary on the pathophysiology of coronavirus and how it is transmitted.
Perhaps, a second video could discuss COVID-19 from the patient's perspective, and include interviews with patients who contracted serious cases, spent time in an intensive care unit, and survived. Link this video with an educational video on who is at risk of serious disease.
A third video could discuss why masks are important, and why social distancing is effective. Maybe, a fourth video could report on COVID-19 in other countries and the global spread of this infection.
Why so many videos? Because it takes time to understand and digest so much information, and it is only when our teens fully understand how COVID-19 is transmitted, how serious it can be, and how much heartache and damage it can cause that they will be willing to wear masks all day at school and in public.
These videos should not be assigned as online homework that students watch at home. They should be viewed in class with a discussion after each session, so students can discuss the material with each other and internalize it.
Another challenge in reopening schools is maintaining the social distancing recommended by our medical and public health advisors. How can we do this in our overcrowded schools?
I propose educators devise a curriculum that is a hybrid of online and face-to-face education. Maybe, we could consider splitting the student body into two groups. All students have two days of in-person classes, where they can see their teachers and peers, and two days of independent online study -- more time to read, write papers and work independently on science projects.
For example, Group 1 Monday and Wednesday in class, Group 2 on Tuesday and Thursday, such that each class is only about 15 students and students can sit at every other desk. Splitting the student body into two shifts would also allow for more physical distance between students in hallways, stairways, auditoriums and bathrooms.
As for lunch, it could be eaten in the classroom or outdoors. The cafeteria and library could be reserved as a study hall for students who don’t want to stay at home or don’t have internet access at home. Students need to be six feet apart in these areas as well.
The last requirement to consider for reopening schools safely is that of a school nurse and a small infirmary where students can be isolated when they get sick. If a student is noted to have a cough or feel ill, the student should be sent to the nurse for evaluation. If there is a suspicion for COVID- 19, that student should be isolated, sent home, and reevaluated for resolution of symptoms and fever upon their return to school. We should consider COVID-19 testing in the school.
If every student and teacher wears a mask, if school time is split in shifts, if social distancing measures are observed, and, if students are monitored and tested for illness, schools can reopen safely.
We are lucky we live in Atlanta where the CDC is close by and easy to access. I am sure our various boards of education are working closely with these entities to figure out effective and safe ways for our precious children and valued teachers to move forward into the new academic year.
And what about the fifth day of the week? How about reserving that day for deep cleaning the school and give our teachers and students a three-day weekend?
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