Should you send your kids back to school this fall?

It’s hard to follow “the science” when it’s inconclusive.
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It appears that most school systems are on a path to open their schools either fully or partially (e.g. rotating students every other day or every other week) … and, to mitigate the risks by capacity limiting busses, socially distancing students in classrooms, wearing masks, etc.

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In a couple of weeks, many parents will be forced to make a very big decision: Do they send their K-12 children back to school or not?

Classical public health thinking would say to focus on four questions:

1. Are kids susceptible to the coronavirus?

2. If yes, will mitigation actions sufficiently reduce the risk?

3. Are infected kids vulnerable to severe outcomes?

4. Do infected kids transmit the virus to others?

Unfortunately, “the science and the data” don’t provide much guidance…

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During this week’s White House briefing on school reopening…

Sally Goza – President of the American Academy of Pediatrics said:

Children are less likely to become infected and they are less likely to spread infection.

But, White House health advisor Dr. Deborah Birx countered that there’s not enough data to arrive at that conclusion:

The U.S. data is incomplete, because the country has not been testing enough children to conclude how widespread the virus is among people younger than 18 and whether they are spreading the virus to others.

If you look across all of the tests that we’ve done, and when we have the age, the portion that has been the lowest tested portion is the under-10-year-olds.

Our data is skewed to people with symptoms, and then skewed to adults over 18.”

Bottom line: “The science” doesn’t know whether kids are susceptible to the coronavirus or not.

The mitigation actions are likely to reduce contagions risks, but it’s unrealistic to expect that they will eliminate the risks.

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Perhaps the best news so far is that there have been practically no coronavirus deaths among children.

A lot of people are hanging their hats on the apparently low fatality rate as an indicator that severe outcomes are unlikely.

But, keep in mind that kids have been sheltered-in-place since schools closed in the spring, so they have been minimally exposed to the virus.

Some health “experts” warn that’s a double-edged sword since kids haven’t had a chance to develop immunities that counter the coronavirus.

So, when schools open, the proverbial dam may break.

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That gets us back to whether or not infected kids are likely to transmit the virus to others.

This is, in my opinion, the pivotal decision factor.

Again, the evidence is, at best, equivocal.

“While some scientists fear schools could act as accelerators for the pandemic, no country where schools have reopened has so far reported a sharp increase in infections.” WSJ

That said, I side with Dr. Birx that “there’s not enough data to conclude whether kids are spreading the virus to others.”

So, I’d apply a variant of Pascal’s Wager to the transmission question.

See HITS: Pascal’s Wager … perhaps, we should be more righteous.

That is, assume that kids are susceptible to the virus, that mitigation actions will reduce but not eliminate contagion, and that infected kids do transmit the virus.

Then, the critical question is:

Are there vulnerable people potentially exposed to infected kids?

If there are vulnerable caretakers at home (e.g. are elderly or suffer co-mobidity factors) … or anyone with compromised or underdeveloped immune systems (e.g. chemo patients or newborns) … then Pascal’s Wager kicks in.

In those cases, the risks of going back to school increase substantially, maybe reversing the decision calculus.

It may be less about whether the kids will suffer bad outcomes … and more about who the kids might infect — and what the consequences will be on them.

Hmmm…

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