Vaccinations prevent severe illness and save lives, with an almost tenfold reduction in deaths.
Vaccinations prevent severe illness and save lives, with an almost tenfold reduction in deaths.

For more than two years, school administrators and staff have strived to meet the needs of students and families in the face of enormous challenges wrought by the Covid-19 pandemic. Now, with nearly all K–12 schools open nationwide and the Omicron variant in retreat, educators must tackle the enormous job of helping students catch up on lost learning time.

People across the nation have endured loss, anguish, and anxiety during the pandemic, and Covid has killed nearly 950,000 people. School closures and other mitigation strategies have taken a huge toll on children and educators. Students are now in a state of crisis, significantly behind in their learning and suffering from acute mental-health challenges. At the same time, many educators report feeling overwhelmed, demoralized, and ill-equipped to handle these new challenges. Fifty-five percent of teachers say they plan to leave the profession sooner than they originally intended, according to a January 2022 survey by the National Education Association.

Children need in-person schooling if they are to thrive. And while the normal rhythm of schooling has resumed, some districts in historically “blue” communities have maintained restrictive Covid-19 prevention policies such as mandatory masking, asymptomatic testing, socially distanced lunches, and the suspension of certain athletics, performing arts, and other extracurricular activities.

Today, as the CDC has eased its guidance on some of these restrictions, we seem to have reached an inflection point in the pandemic. Administrators and teachers now deserve clear direction and resources to meet the needs of their school communities. At the same time, to ensure public-health plans are equitable and comprehensive, decisionmakers must recognize that immunocompromised staff, students, and family members bear a nontrivial risk that must also be addressed.

Over the course of the pandemic, public-health officials have learned a great deal about the virus and effective mitigation strategies. We believe that schools now have all the necessary tools to protect vulnerable staff and students, enabling the entire school community to experience the normalcy that has evaded them for two and a half school years.

Educating School Communities on a “New Normal”

Misinformation abounds in the media. News outlets may minimize or exaggerate the risks of the virus at any given time. As schools have returned to some semblance of normal operations, leaders should pay keen attention to creating a communication and information plan directed at staff, parents, and students.

Paramount to any policymaking is the clear and transparent communication of a defined goal. During the 2020–21 school year, before the vaccines were widely available, that goal was quite clear: minimizing instances of person-to-person transmission to flatten the hospitalization curve. In the current school year, with vaccination available to everyone over the age of 5, that goal is no longer necessary or feasible. A more reasonable goal would be the prevention of serious and widespread outbreaks that could once again strain our healthcare system.

School leaders should define their goal and clearly communicate it to staff, students, and parents. They should also explain how and why steps toward a new normal are not only possible but also essential—and that this transition can take place without compromising the health of the extended school community.

This effort should emphasize three foundational principles:

Covid is here to stay. The Omicron wave has solidified our conviction that Covid-19 will exist in perpetuity. It cannot be eradicated, and it mutates, potentially into forms that evade vaccines. An ebb-and-flow of cases is unquestionably our new normal, and nearly all of us will become infected with a current or future variant at some point. Our objective must be to ensure that, when people are infected, they have as much immunity as possible.

The vaccine is our best available tool. Vaccines remain our strongest weapon in the fight against death or serious illness from Covid-19. Although their effectiveness against infection wanes over time and has been weakened by the latest variants, all the currently authorized U.S. Covid-19 vaccines remain highly effective in preventing hospitalization and death. Efforts to
get every member of the school community vaccinated must not cease. Vaccine education for families and staff is critical, as are onsite vaccine clinics for school communities.

We must prioritize the holistic well-being of children. Children have shouldered a disproportionate burden from our efforts to limit the spread of the virus through school closures and other restrictions. The acute mental-health challenges and learning losses they have experienced cannot be overstated. It’s critical that we focus on the academic, mental, social, and emotional health of our students.

Proactive communication of these messages is vital to the successful phasing out of the more-restrictive mitigation efforts that still exist in some places. Ultimately, taking steps toward normalcy requires the trust and support of staff, students, and parents. School-system leaders and administrators will need to dedicate considerable time and resources to educating their respective communities on the benefits and costs associated with maintaining versus easing restrictions.

Protecting the Vulnerable

Thankfully, we now possess all the tools needed to maintain the public-health benefits previously achieved with more-restrictive mitigation measures, and at less cost. In addition to vaccination, other critical strategies include therapeutics (both for prevention and treatment), testing, and “one-way masking.”

Importance of therapeutics. In the early days of the pandemic, some leaders foresaw that effective therapies for Covid-19 would allow life to return to normal. That day has finally arrived. Antivirals and injectable medications are widely available, and in fact the supply of therapeutic agents and ability to administer them exceed demand. The pill nirmatrelvir/ritonavir has demonstrated an impressive efficacy of nearly 90 percent at preventing hospitalization in high-risk individuals and is authorized for ages 12 and up. Anyone with Covid who has even a single risk factor is eligible to receive this medication. It will be critical to maintain this access even if cases surge again in the future.

Testing and contact tracing. At the beginning of the pan-demic, it was reasonable to expend time and resources on asymptomatic PCR testing for schoolchildren and staff. However, that testing has often come at the expense of symptomatic testing. During the Omicron wave, while many districts were conducting weekly pooled PCR testing of asymptomatic school-community members, those who developed symptoms were often unable to find an appointment for a lab-based
test or a store with home-based tests in stock.

We cannot prevent every person-to-person transmission, and as schools adopt the goal of blocking serious illness and widespread outbreaks, families will need access to at-home antigen test kits that household members can use when a close contact develops symptoms. In-school rapid antigen testing should be available for those who develop symptoms during the school day. During periods of high transmission, schools might consider adding an asymptomatic screening program using PCR or home antigen testing, but such efforts should be targeted toward vulnerable individuals who would most benefit from an early diagnosis. Students and staff with Covid-19 should isolate according to public-health guidelines.

We believe the time has come to stop contact tracing and post-exposure quarantines, as well as school and classroom closures based on case rates. Monitoring for development of symptoms after a known exposure remains an important part of preventing outbreaks, but we are no longer in a containment phase of the pandemic. In-school exposures have consistently been shown to result in very low rates of infection, and post-exposure quarantines are unlikely to move the needle on case rates in the current climate.

One-way masking. This new approach to masking became possible with the recent upsurge in consumer access to medical-grade personal protective equipment. While healthcare workers have always worn medical-grade masks and respirators when caring for Covid-19 patients, others were urged not to purchase such items because of global shortages. With medical-grade masks now available for all, there is simply no need to mandate masks. Those who are at high risk by virtue of vaccination status, underlying disease, or age, or those who are simply risk-averse, can safely wear a high-quality mask or medical respirator and will be well protected regardless of what others do. Because medical-grade equipment costs significantly more than washable cloth masks, these masks and respirators should be made available for free to members of the school community who want or need them, accompanied by information on their effectiveness, how to wear them properly, and who would benefit the most from using them.

Equity Considerations

By targeting mitigation and education strategies toward our most vulnerable populations—chiefly those who are immunocompromised—schools can develop a plan that’s equitable and addresses the needs of a diverse community of staff, students, and families. Blunt, one-size-fits-all solutions are no longer needed. Schools can now deploy a toolkit of strategies to meet stakeholders where they are. Further, by allowing people to take personal responsibility for their health and educating them on effective practices rather than imposing mandates, schools can help lessen the polarization over Covid-19 protocols that is now so prevalent in schools and communities.

To be clear, the pandemic has exposed our country’s longstanding structural racism and systemic health inequities. Black and Hispanic populations continue to be disproportionately affected by Covid-19. What’s more, Black, Hispanic, and low-income individuals are less likely to be vaccinated, particularly within younger age groups. There is legitimate concern that any loosening of mitigation measures in schools could lead to an outsize burden of illness among those populations.

Ultimately, though, equitable solutions must consider the tradeoffs and unintended consequences of our most-restrictive measures. Students from historically marginalized communities, for example, are likely to be disproportionately affected by learning loss during school closures. English language learners are acutely impacted by mask mandates. And shutdowns place an enormous weight on working families. We believe our proposed approach could help center the pendulum after a period of extreme swings.

Beyond the New Normal

As schools consider easing restrictions, they should also consider how they will respond in the event of a new variant or surge in cases. Any plan to phase out mitigation policies should include contingencies to recognize when those prior restrictions will be necessary once again.

While we believe that a shift back to virtual instruction should happen only in the most extreme circumstances, we urge policymakers and administrators to develop criteria that would require schools to reinstate certain protocols, such as mandatory masking and quarantining for close contacts of infected individuals. Outlining such a plan would serve both to reassure those who are concerned that a return to normalcy is too dangerous and to forewarn proponents of such a return that the relaxation of mitigation measures might and should not be permanent.

We urge policymakers to deploy more-stringent measures not solely in response to case counts but only when a variant is causing a surge that is likely to strain hospital capacity. In some states, the rise in cases from the BA.2 subvariant of Omicron is already leading to the reinstatement of more-restrictive measures, even in the absence of high Covid-19 hospitalization rates. We believe this is an overreaction. Still, we must prepare for a scenario, however unlikely, where a new variant is vaccine-evasive and leads to higher death tolls.

Today, thanks to the many miracles of modern medicine and healthcare, including vaccines, therapies, tests, and personal protective equipment, we have an opportunity to relevel our approach to Covid-19 and ensure our mitigation strategies are proportional to the actual risks faced by students and staff. Our children and educators deserve nothing less.

This is part of the forum, “Covid-19 Precautions in Schools“. For alternate takes, see “Tie Precautions to Community Risk Levels,” by Gerard Bossard and Dr. Douglas Rothman, and “Reset Strategies Now, Prepare for the Future,” by Jon Bailey.

Last updated April 26, 2022