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CDC's New Guidance For Reopening Schools May Not Be Effective

STEVE INSKEEP, HOST:

We next hear an expert who questions the guidelines for reopening schools. The Centers for Disease Control offered those guidelines, advice that came out even as the Biden administration pushes for schools to reopen this spring with in-person learning. The CDC says schools can reopen when they have proper mitigation measures, of course, and when the level of community spread of COVID goes way down.

Dr. Joseph Allen argues those guidelines are wrong. He is an associate professor and director of the Healthy Buildings Program at Harvard University, and he says the level of community spread is often unrelated to the safety of a school.

JOSEPH ALLEN: On its surface, it sounds great. Who wouldn't want a good metric of community spread that predicted in-school transmission? The reality is these community spread metrics don't predict that. Right? We've seen examples where schools have stayed open and have been effectively open with very little in-school transmission, even in communities with high community spread. In fact, CDC's own report has shown that. We've also seen the opposite. We've seen low community spread, poor controls in school and cases.

So the community spread metric idea sounds great, but the reality is it doesn't really tell us what's happening in schools. Ninety percent of the schools right now in the U.S. are in what CDC deems the red zone, even schools that have been open with no cases or very little to no transmission in the schools. So essentially, reliance on community spread metrics means schools will stay closed, or they won't get back to full in-person learning any time soon.

INSKEEP: It sounds like you're telling me that some schools, if they strictly followed these guidelines, would actually close, schools that are open now.

ALLEN: That's right. And that's the problem. And to get to the blue zone, which is the best of the four color codes they use, essentially comes down to having one case per 100,000 people per day. Now, we may never get to that place. In fact, it's unlikely we'll get to it in this fall. I'm sure of it. So if you followed this strictly, that's what it means. Wake-up call to parents - if schools start following this new guidance strictly, kids are not getting back to full-time school.

INSKEEP: Why is it that the community spread does not match what happens in a given school?

ALLEN: We've seen great research, for example, out of Duke University - followed almost 100,000 kids with in-person instruction, and you find very little transmission. In fact, they found zero cases of student-to-teacher transmission. So you can have conditions where you have high community spread, but not really - doesn't really reflect what's happening in the building.

Take what's happening in hospitals, for example. Very high-risk environments - right? - but we've driven down risk to health care workers since March. Doing what? Really the basics, right? Strict masking, good hand hygiene and the one that they forget to talk about often but is true - hospitals take care of their buildings - good ventilation, filtration. So regardless of community spread, highest-risk environment in a health care setting, we've still driven down risk to adults. So we know what it takes to keep people safe indoors.

INSKEEP: Many of us have presumed that it would be impossible to get kids to follow the proper guidelines - to wash their hands, to wear their masks, to stay 6 feet apart. But you're actually telling me that in a controlled environment, schools can do that, and the real problem is grown-ups who refuse to wear a mask when they go into a store.

ALLEN: You know, I think you're right. I have three kids of my own, and I kind of laughed early on when people said, well, kids won't be able to do it. The kids do it all the time. And actually, they do it when they don't even need to. They'll be out playing by themselves, and they grab their mask. It is really the adults where we see this - the bigger problem. And we have some benefits when it comes to kids. The virus hasn't spared us in many ways - in any ways, except with kids. Looks like they're less likely to transmit it, less likely to get it than adults - and certainly if they do get it, much less likely to die on the order of one in a million.

INSKEEP: The Biden administration has said it is a national priority to get K-8 schools open by late April. This is an emergency thing that really needs to be done according to the administration. What would those guidelines, if they're followed across the country, mean for that goal?

ALLEN: Well, you know, I support the Biden administration, but doesn't sound like a national emergency to me. A hundred days is too slow. That puts us into May. And let's be clear, it is a national emergency. Hundreds of thousands of kids are missing from schools - billions of missed meals due to schools closed, drops in literacy gains. We see mental health clinics that are being overrun, even reports of increased suicide ideation for younger children. This is all expected and known when you have kids out of school for an entire year - millions of kids - that there would be devastating consequences. And our country has not treated it like the emergency it is.

INSKEEP: In your mind. Is the essential question, what are the protocols, the rules in the school, and what is the building like? Are those really the only questions about whether a school should open?

ALLEN: I'd add one more. I think we're getting very narrow when we talk about risk in terms of risk in the classroom, but we have to think about risk and what's happening when kids are out of school. How is it that restaurants and bars and even indoor water parks in some states are open and casinos, for that matter, and schools are not? So it's essentially - comes down to strict adherence to the infection control playbook that we know works. Right? It's evidence-based. We know it needs to be done. It doesn't have to be expensive. It can be implemented right now.

INSKEEP: Dr. Joseph Allen, thanks so much.

ALLEN: Thanks for having me. I really appreciate it.

INSKEEP: We asked the CDC about Dr. Allen's critique, and the agency replies by standing by its finding that the level of community spread should be a factor in reopening schools. CDC says studies do indicate higher levels of disease in the community increase the risk that a case will be introduced in the school setting. Transcript provided by NPR, Copyright NPR.