RLNC COVID-19 #18 - Our children’s return to school is the latest COVID-19 debate.

Serving nearby areas by Palm Beach and West Palm Beach, Florida

RLNC COVID-19 #18

 

Our children’s return to school is the latest COVID-19 debate.

It is mid-July and most school systems should be gearing up for the start of school in the next month or two.  Now, all of them are trying to determine what school in 2020-2021, during the COVID-19 pandemic will really look like.  On top of that, the number of cases is rapidly rising with record-breaking numbers of positive cases. There are new hot spots of COVID-19 daily. Until we have a vaccine, it will not be completely safe to reopen schools.

Children are not immune to coronavirus

Children also test positive for coronavirus — there’s no question about that. And while they don’t get as sick as adults, they can still become dangerously ill, experts say.

In Florida, four children under age 17 have died of coronavirus complications. At the height of the pandemic, New York saw a growing number of children hospitalized with troubling symptoms linked to coronavirus. Several of them died. And in Texas, about 1,335 people have tested positive at child care facilities — about a third of them children.

 

“We shouldn’t be complacent and think that if a child contracts coronavirus all will be fine. Chances are all will be fine, but we just don’t know. This is particularly true for children who have underlying conditions, such as obesity or lung disease,” said Elizabeth Cohen, CNN’s senior medical correspondent.

Children are not the only concern when schools reopen. With nearly a third of teachers nationwide over the age of 50, they are more vulnerable to fatal infections. Asymptomatic transmission of the virus is a major concern — and the teachers can then pass the disease to more vulnerable people. A surge in schools can translate into a broader uptick a few weeks later.

 

Children symptoms can differ from adults

Children have been known to get a whole set of different symptoms — adding to the uncertainty of the virus that has killed more than 133,000 people nationwideThe varying symptoms make it especially harder to pinpoint.

 

In the United States and the United Kingdom, hospitalized children between ages 2 and 15 had a condition doctors called multisystem inflammatory syndromeThe symptoms are similar to toxic shock syndrome and Kawasaki disease, which cause inflammation in the walls of blood vessels. In rare cases, it can lead to deadly limitations in blood flow.

 

Many of the children tested positive for COVID-19 or had its antibodies but they didn’t necessarily have typical coronavirus symptoms such as respiratory distress. Their symptoms included a high temperature along with a rash, swollen neck glands, hands and feet, dry cracked lips and redness in both eyes.

Coronavirus causes a wide variety of symptoms in children, according to a study published in an American Academy of Pediatrics journal.

In that study, Dr. Rabia Agha and colleagues from Maimonides Children’s General Hospital in Brooklyn studied 22 children with coronavirus. They found most did not have classic symptoms. Fifteen patients had a fever and nine had respiratory symptoms. Two had seizures and two were entirely asymptomatic.

Issues

 

As most parents have experienced, children are little disease vectors. However, it is not clear how efficient children are at passing on the virus that causes COVID-19, but it’s a big concern.

It is well known that schools provide more than just academic learning to children and teenagers. The American Academy of Pediatrics’ latest regarding this topic is that they believe children learn best when they are in school, however returning to school needs careful steps in place to keep students and staff safe.  The Federal Government is pushing schools to reopen for in class learning. The State of Florida is pushing for in class learning. Yes, the economy needs some help and a return to school makes for a stabilizing force for the economy. We must ask, should that return be at the expense of our children and educators?  The latest debate is upon us.  

COVID-19 is forcing governments and educational governing bodies to make decisions that trade off different risks and harms based on unclear and evolving science.  The muddy water that is COVID-19 is not an easy foe.  These decisions are not easy ones.  How to keep children as safe as possible from the COVID-19 virus is one of the hardest issues for governments to grapple with.  Of course, it is not just the children who must be kept safe, there are also other participants/school employees that come together to keep schools open and running who we must keep safe. 

So, not surprisingly, what exactly those steps in place to keep students and staff safe really means is precisely the current struggle for educators and parents alike all over the country.  This is the new normal.  As we have been saying week after week, our lives must change in light of the pandemic. Both sides of the debate have protests throughout the country going on this week.

The rising number of positive cases complicate any decisions regarding what school will be in each local community.  How serious the local outbreak numbers are presents another important factor to include in planning for potentially re-opening schools in a safe way.  No matter what the reopening plan is, all schools will have to be prepared to switch quickly to remote learning in the case of a local breakout.  Doctors and researchers all agree, there will be more local breakouts. We are only beginning to see outbreaks as a result of the July 4th holiday.

Regardless, and understandably necessary, many school districts are coming out with their plans for the upcoming school year and evaluating the feasibility of in person learning. Every aspect of schooling will include safety measures in place to prevent the spread of COVID-19 and most places will include some sort of hybrid model of learning - essentially combining in person and remote learning. Continuing to provide remote access to all children is essential yet costly. Of course, opening safely will require increases to already dwindling education budgets. 

Can schools afford the costs associated with keeping students and staff safe from this virus?  As it is, local and state governments have less revenue to work with due to the virus’ effect on the overall economy. As a result, most school districts have been asked to cut their budgets. Keeping schools safe will cost money.  Where will that money come from?

In March, Congress passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, which included around $13 billion for K-12 schools, but school districts say that is only a fraction of what they need. The House passed the Health and Economic Recovery Omnibus Emergency Solutions, or HEROES Act, which includes about $58 billion that is supposed to go to K-12 schools — far less than lobbying groups and educators say they need for the school year. The Senate shows no signs of taking up the bill anytime soon so that is a problem as well. 

Other questions come to mind in terms of reopening schools. Can you truly keep children socially distanced?  Will teachers feel personally safe to be in their classrooms with groups of children? Many teachers are afraid to put themselves in danger, never imagining that being a teacher would be a risk to their health.  Should all children and teachers be tested for active COVID-19? Should all children and teachers be tested for COVID-19 antibodies? How long will it take to check every student’s temperature? Will there really be enough sinks for hand-washing? Can young children be expected to keep their masks on all day or refrain from jumping out of their seats to visit their friend sitting at the next desk? What about bus riders - how do you socially distance on a school bus?  There are many older, more at risk employees at schools, how do they stay safe?  Is it right to ask them to put their lives in danger?  

Many teachers and teachers’ organizations have weighed in, including the Philadelphia Federation of Teachers who sent out a survey to its 13,000 members about returning to school. The results echoed a common theme that if the actual school facilities were not in better condition (conducive to safety), they would not return.  These surveys cited things such as broken faucets in sinks, empty soap dispensers, poor air quality with windows that could not open and other such concerns that were evident before COVID-19.  Experts agree these types of problems are common in many places throughout the country. Even with safety rules in place, will they be possible to follow?

There are harms associated with keeping schools closed. There are children in abusive situations at home without the safety net of school, where teachers can raise concerns and involve social services to protect them. Vulnerable children need to be out of their homes and in the school to have chances of getting help. Further, not all children have home environments that are conducive to remote learning.  The availability of technology, a quiet place to work and concentrate and parental supervision is not equal for all children.  For all children, the social aspect of school is another area of learning that comes from in person school.  How far behind will our children fall and how much wider will the disparity be for those from economically disadvantaged backgrounds? Some experts warn that continued remote learning will create ongoing mental health problems for many children.

Other considerable issues arise with working parents.  This past spring, many parents were home during the coronavirus pandemic when their offices closed, trying to help their children with remote learning while still doing their own jobs. Most parents cannot do that indefinitely. Other parents still report to their jobs and would need child care, another system that has been hit very hard with this pandemic and also has to grapple with keeping children in their care safe. 

Locally, last week, The Florida Department of Education ordered that all brick and mortar schools should remain open for at least 5 days a week for the next school year beginning in August. This is an interesting order given that Florida is currently considered the new epicenter of COVID-19 in the United States.

Answers are required to many of these issues/questions before any school should be required to “open” to traditional classroom learning.    

Sources

https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/

https://www.usnews.com/news/education-news/articles/2020-06-04/schools-plan-to-reopen-as-watchdog-finds-major-facility-problems

https://www.washingtonpost.com/education/2020/06/18/its-mid-june-schools-still-arent-sure-how-they-will-open-2020-21-heres-why-whats-likely-happen/

https://www.theguardian.com/commentisfree/2020/may/17/the-observer-view-on-how-the-debate-on-schools-has-been-dangerously-mishandled

 

Welcome to Romano Law Nurse Corner

We are Susan Ramsey and Amie Goldberg, both practicing attorneys and nurses here at the Romano Law Group.  Here is a little more about each of us:

Susan

Susan Ramsey is both an attorney and an RN. Ms. Ramsey’s professional experience began as a Registered Nurse in the Intensive Care Unit at Yale New Haven Hospital. While pursuing her Bachelor’s Degree, she was a counselor with the New Haven Rape Crisis Program. During her time with the Program, Ms. Ramsey counseled sexual assault survivors and performed seminars for local police departments, universities, and high schools. During her time working as a registered nurse, Ms. Ramsey decided to attend law school. Ms. Ramsey graduated from CUNY Law School, and has practiced law in several different State and Federal Courts.  She is a Florida Heath Care Risk Manager and a member of the Palm Beach County Sober Home Task Force.  Ms. Ramsey actively litigates cases involving catastrophic injuries and wrongful death on behalf of survivors, cases include injuries suffered by victims of professional negligence, product liability and medical negligence.

Amie 

Amie Goldberg is both an attorney and a certified APRN.  After completing a Bachelor of Arts Degree at Whittier College, Ms. Goldberg attended nursing school at Emory University.  Ms. Goldberg’s professional experience started as a Registered Nurse at Egleston Children’s Hospital taking care of children with congenital heart disease. After a few years, she continued working in all areas of the hospital while attending Kennesaw State University on weekends in order to get her Master’s Degree in Nursing with a specialty of Primary Care Nurse Practitioner/Family Nurse Practitioner.  During her time as an APRN, Ms. Goldberg decided to attend law school at St. Thomas University in Miami, Florida.   Since graduating, she has mainly practiced in the areas of personal injury and worker’s compensation, fighting for the rights of injured people. Since joining the Romano Law Group, Ms. Goldberg has been the Director of the Opioid Litigation Project.  Ms. Goldberg also practices in the area of medical malpractice and nursing home negligence, bringing an inside perspective and knowledge to help get justice for our clients. 

 

Stay Safe,

Susan

Amie