On reopening schools, scientists say proceed with caution

Public health experts say that Massachusetts can safely reopen schools in the fall, but only if community transmission of COVID-19 is kept to a minimum over the summer.

Schools across the state are preparing to reopen in the fall. But public health experts say doing that safely will require a lot of preparation in the months ahead.Jim Davis/Globe Staff

In order for schools to safely reopen in the fall, public health experts say we’ll all need to do some homework over the summer.

As Massachusetts starts down the months-long road to reopening public schools, scientists say success and safety require caution both inside and outside the classroom — and preparation must begin now.

The plan that Governor Charlie Baker released on Thursday laid out several requirements and recommendations for limiting and monitoring the risk of COVID-19 transmission in schools: masks required for children in second grade and up, desks spaced at least 3 feet apart, and regular hand-washing, among others.

And though the plan did not include a date for reopening, the state’s target is clear: “the safe return of as many students as possible to in-person school settings” in the fall.

Scientists say that goal is reasonable, but only if Massachusetts continues to contain community transmission of COVID-19 throughout the summer and schools have robust contingency plans in case of a resurgence of infections in the fall.

They also raised concerns about the possibility of children transmitting the disease to adult staff and family members, saying the state should not be too optimistic about preliminary data suggesting such transmission is rare.

“Schools don’t operate in a vacuum. A large part of how safe they’re going to be in the fall depends on the local levels of transmission,” said Helen Jenkins, an assistant professor of biostatistics at Boston University.

Jenkins also warned that the start of the school year coincides with the time that some epidemiologists expect to see an uptick in cases.

“The fall particularly worries me because with the change in weather, people will be spending more time indoors, and we know that transmission is more likely indoors rather than outdoors,” she said. The return of college students and increased travel throughout the late summer add to the risk of a spike of COVID-19 just in time for the fall semester, Jenkins added.

Part of staving off that possibility, Jenkins said, might be making tough choices about which types of venues should and should not open ahead of schools.

“I think we may be in a situation where we have to choose which things we want to prioritize and which things may need to just wait longer. My hope is that schools would take high priority,” she said. “If we can’t reopen everything, what’s the most important thing to reopen? Do we want bars to reopen or schools?”

Policymakers should use summer break to make clear contingency plans that address the possibility of a new wave of infections during the fall semester, said Samuel Scarpino, an epidemiologist at Northeastern University.

“We’ve been very reactionary in terms of our response to COVID, and we have an opportunity to be thoughtful around how we’re going to handle the fall as we try to reopen schools. Part of that means having clearly articulated, thoughtful plans around what will trigger a school closure,” Scarpino said.

State guidance asked schools to be flexible and said districts will be responsive to changes in the pandemic’s trajectory: “Districts and schools must be prepared to be flexible and ready to pivot if circumstances change significantly. For this reason, districts and schools must plan not only for in-person learning” but also full remote learning and a combination of the two, the document says.

Scarpino called for specific, public guidelines for how school districts would respond to increased transmission. “What are the contingency plans for if staff members start to get sick? How is that going to be handled, and what are the specific epidemiological triggers around, say, a school having to close?”

Each of the epidemiologists who spoke with the Globe said that schools could spark community outbreaks, and they warned that data suggesting children are less likely to transmit COVID-19 is not yet conclusive. Most countries were quick to order school closures as the virus spread, and research on infection within schools and between children and adults is still in early stages.

“Though there is some suggestion that they’re less likely to transmit the disease than adults, I wouldn’t say that’s confirmed,” said Dr. David Hamer, a professor of global health and medicine at Boston University and physician at Boston Medical Center. “It’s still possible for children to transmit the virus at home and within the school setting.”

Hamer said strict adherence to detailed plans for reducing the likelihood of transmission in schools is key. In addition to the guidance for classroom safety the state has already released, he said officials also need to consider how they will regulate school-related group activities like sports and the performing arts.

Hamer also suggested one simple summer assignment for parents and caregivers: Make your kids wear masks.

“Getting children used to that and getting that to become a part of their behavior” is important, he said. “If children are used to wearing masks over the summer, by the fall, it’ll be second nature.”

Scarpino added that in addition to unanswered questions about how often children transmit the disease, it is also too early to know the long-term impact of contracting COVID-19 — even in the mild and asymptomatic cases most common in children.

“We are of course making a big assumption that just because the immediate health effects to children are low that there are no longer-term health consequences. And there may not be, but at this point we don’t know.”

“We need to be honest about the fact that we still don’t know enough yet. We’re still learning more every day,” he said.