Reopening Schools: Is New York City Keeping Its Most Vulnerable Kids Safe?

Reopening Schools: Is New York City Keeping Its Most Vulnerable Kids Safe?

Reopening Schools: Is New York City Keeping Its Most Vulnerable Kids Safe?

The mayor calls the city’s Covid-19 protocols the “gold standard,” but epidemiologist Michael Osterholm says there’s a lot more the city can and must do.

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On the morning of September 13, shortly after the New York school system’s Covid-screening website crashed, Mayor Bill de Blasio stood outside PS 25 in the Bronx celebrating the reopening of the city’s public schools. It was a heady occasion: For the first time in 18 months, the largest public school system in the country—nearly 1.1 million students—would be back in swing, and de Blasio was intent on proving that it was not only the right but also a safe decision.

“It’s so good to see all our kids coming back to school in person where they can learn best,” de Blasio said as a collection of multicolored balloons bobbed in the background. Dressed in a trim blue suit, his face mask temporarily stowed, he touted the Department of Education’s Covid-19 precautions and vowed that students would be safe. “Kids coming to school today, all across the city, are going to experience a gold standard of health and safety measures,” he said.

De Blasio seems to like the phrase “gold standard,” as he repeats it frequently when talking up the DOE’s Covid-19 protocols. But two days later, my son offered a more, well, tarnished assessment of the situation. “My school is a Covid petri dish,” he said, citing the 25 to 30 kids crammed into his classes; the clustered seating arrangements, with four kids to each worktable; the teeming hallways in which “everyone is bumping into everyone else”; and the haphazard masking by some friends and classmates. “It’s a bit scary,” he confessed.

Since my 11-year-old son is too young to be vaccinated, I wasn’t thrilled by this report, but I wasn’t all that surprised either. In the weeks leading up to de Blasio’s Bronx appearance, I had watched the DOE roll back safety measure after safety measure as the mayor repeated his “gold standard” mantra.

True, the city does have a mask mandate, and it’s just implemented a vaccine mandate for staff, both of which put it ahead of the many districts that have pushed back against basic science. But social distancing appears largely notional, thanks to the mass overcrowding of many public schools. Testing is spotty (less than a quarter of kids have consented to getting tested) and applies only to the unvaccinated in any case (never mind that vaccinated people can be carriers). Quarantine protocols have been weakened to the point of farce—or at least confusion. And the city’s priorities seem out of whack—as seen, for instance, in its decision to chisel the funding (and hours) of the Situation Room, the multiagency brain trust that’s supposed to track Covid-19 outbreaks in schools.

Taken together, all of these issues raise questions about how seriously the DOE and the mayor are taking the crisis—particularly for unvaccinated kids—even as we all understand the mayor’s argument about the importance of consistent, in-person education. So, as the number of positive Covid-19 cases ticks up each day—a total of more than 4,000 as of October 7—I can’t help but wonder: Are families getting the full safety story? And I can’t help but worry—not only about my own kid, but also about the many other kids who might get sick and bring the virus back to their family members who may be at risk of severe illness.

To help get some clarity, I reached out to Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Dr. Osterholm became something of a guru to Covid obsessives after his “hair-raising, accurate prediction” of the early course of the pandemic, followed by his prescient warnings about this summer’s surge. Our interview, which took place over two sessions, has been edited for length and clarity.

Lizzy Ratner: So how should I feel about sending my kid back to school?

Dr. Michael Osterholm: Right now, schools are probably our single biggest challenge in terms of trying to reduce transmission. It is a very different world with Covid and kids this year than it was last year. The arrival of Alpha and then subsequent Delta variants fundamentally changed how we look at the risk of transmission in and by kids.

LR: Can you say a little bit more about how it’s changed?

MO: As of September 30, there have been 5.9 million children in the US who have tested positive for Covid. A hundred and seventy-three thousand occurred just in the last week. This, however, was good news in that it was the first time in six weeks that we have seen fewer than 200,000 pediatric cases reported. If you look at what’s happened as of this last week, based on American Academy of Pediatrics data, which is 24 states and New York City, there were 615 new hospitalizations. Last week, there were 22 child deaths, the highest number of deaths in the previous six weeks.

Overall, between October 1 of 2020 and September 30 of 2021, for one year there were 408 deaths in kids. Seventy-six of those deaths, or 18.6 percent, have occurred in just the last month.

LR: In terms of what these high caseloads mean for reopening schools, I want to ask about social distancing. At my son’s school there’s none of it. The principal has said we are relying on masks [to keep the virus from spreading], that’s what we’ve got. So I’ve gotta ask: Is my son’s mask going to do it?

MO: No, no, it’s not—and cloth covers in particular are not. The data that even exists in supporting the three-feet rule actually came about from the pre-Delta era. We’re writing a piece right now, a commentary on masks and schools and day care, and we’re basically laying out how much leakage occurs and what the challenges are. So you cannot count on cloth coverings for students to stop transmission in a school. We surely think you should use higher quality masks, the N95s and KN95s.

LR: The city is now testing 10 percent of the kids once a week, but the caveat is that they’re only testing the kids whose parents have given their consent. Is that adequate?

MO: There is no scientific evidence at all that testing any group once a week makes any difference in reducing disease transmission. None. You need much more frequent testing. The data we do have says that if you’re not testing at least five times a week, you’re going to miss anybody who is positive and potentially capable of transmitting. So, you know, it makes one feel better to do that kind of testing, but there are no data that support that that reduces disease transmission at all. There’s zero data supporting it.

LR: So that leads to my next question: The mayor has relaxed the quarantine rules so that any student that is three feet or more from any student that tests positive does not have to quarantine. Does that make sense to you?

MO: That is the CDC recommendation. And again, the data came from a single study done prior to Delta, done last year, for which we believe that there are very serious methodological flaws. And it just defies logic. Imagine if somebody was three feet away from you and you both had a face covering and they were smoking. Could you smell the smoke? Of course, you could. Well, if you can smell the smoke, you also can transmit the virus. So that just makes no sense.

LR: That was my fear.

MO: Yeah, you’re right. To think that you’re going to stop transmission—an aerosol-related transmission—between two kids three feet apart with face cloth coverings, you need a dose of pixie dust.

LR: It’s incredibly frustrating because you have the mayor and the DOE telling parents that we’re safe.

MO: Everybody wants kids back in school, and I understand that. I want my five grandkids back in school. But I want it done safely. And right now, we are, for the purpose of getting kids back in school, totally missing the safety.

Our kids have basically become pawns in an effort to get kids back into in-class learning—which I fully support. I want that too. But we have to look at the safety—not only of the kids but of the teachers, the staff.

LR: So, what would a safe version of this look like?

MO: You’d have school rooms that would have at least five to six air exchanges an hour. You’d have additional filtration present, such as the HEPA filters that I’ve talked about [on my podcast]. You’d have a density of no more than kids at 3-6 feet apart. Every child should be vaccinated that can be, 12 and older, and all the faculty and staff should be vaccinated. You need to test, and the more you can test the better it is—antigen testing at least every day, or no later than every other day. And basically, quality masking—KN95s or N95s on the kids. Short of that, it’s going to be good luck. And, unfortunately, we shouldn’t be betting our kids’ health on good luck.

A few days after our initial conversation, I called back Dr. Osterholm to ask him about several new Covid-related developments. The first was that New York City had instituted a vaccine mandate for all school staff, which the mayor touted as a way to “keep kids safe and the whole school community safe.” The second was that, despite the return to schools and the cases popping up all across the system, New York’s overall Covid-19 rate hadn’t increased. I wanted to know what he made of both.

LR: So, in New York, the mayor has instituted a vaccine mandate for school staff. Should we expect that to help slow transmission? And does that make up for the other holes in the safety protocols?

MO: We’re seeing several things happen. Number one is that the number of people that need to be vaccinated in a given area needs to be exceedingly high to really reduce transmission. Second of all, we’re seeing an ever-increasing number of breakthrough cases that also may be infectious. We have schools where we’ve had a number of both staff and faculty who’ve actually been breakthrough cases just in the last week. Clearly, they could be infectious at the time during the school, even though they’re vaccinated. So this is why this whole concept of an additional dose of vaccines is going to be very important.

LR: While we’re seeing a lot of transmission in schools, the numbers in New York City are not going up. What’s going on?

MO: I talked about that in the podcast: Why is Southern California and the New York to Boston metroplex seeing so few cases? And there’s no answer to that. This is part of the mystery of this virus. Why did it miss those two areas? It has nothing to do with the populations’ being fully protected [meaning fully vaccinated], because they’re not. And this has happened before. I’ve talked about the sprint versus marathon virus: Why does it basically go for four to six weeks and then just boom, it drops? We don’t know that. And I can tell you that New York and Southern California are not done with this virus. They will see sizable increases in this virus at some point in the months ahead.

LR: I can’t say that makes me happy.

MO: I know, but I think we need to be prepared for it, both from a psychological standpoint and a practical standpoint. You always prepare for it.

LR: Would you send your kid to school? What does a parent like me do?

MO: Well, my grandkids are in school right now. They happen to be in a school district that is really doing a good job of trying to adhere to the best protection, but we’ve already had infections transmitted in the school. Kids have already been sent home. All I can say is they’re doing their best. My grandkids are in KN95 masks—and I can’t wait for the vaccine to be approved for the younger ages. I can’t wait.

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