Op-Ed: A Plea to our Schools and our Community- continued


. During the Fall 2020 school year, we saw a layered approach also worked in schools in, for example, Missouri,20, Utah,21 rural Wisconsin,22 and Florida.23

Why should we care about transmission if most cases are not severe?

Aside from the very real concerns24 about Long-Covid as discussed above, allowing the virus to spread unchecked throughout our community has several serious consequences. Each time the virus replicates, small changes known as mutations can arise. This is how new variants develop. Increased transmission increases the opportunity for new variants to emerge which may be better able to escape vaccine-mediated immunity and put us all at increased risk.

Additionally, as children infect household members, many parents will be required to miss significant time at work which can have severe financial and career repercussions.

 But everyone has antibodies…

Some schools are making policies based on the assumption that “everyone already has antibodies.” I must stress that this approach is also without true scientific and medical basis and should not be informing policy decisions. Even checking antibody levels is not informative as we have no established level of antibodies deemed “protective.” Antibodies can vary in quality, there are different kinds of antibodies, and antibody levels wane over time. A child who recovered from COVID-19 more than 90 days ago (and with Delta some say even less than 90 days) should not be considered to have immunity and thus absolved from quarantine. This approach has not been recommended (and has often been explicitly discouraged25 as it is unreliable and difficult to apply) by any established professional body or medical organization that I am aware of (i.e.: CDC, Food and Drug Administration (FDA), World Health Organization (WHO), AAP, MSDE, Departments of Health).

What about Mental Health and Child Development?

We don’t give kids enough credit for their resilience. There is currently no scientific evidence that wearing a mask results in poor physical or mental health. In the over 18 months the pandemic has been raging, we have accumulated data showing the benefits of masking, yet studies showing the harm have not been forthcoming.

As far as developmental concerns, most children spend significant time at home where they are seeing caregivers’ faces without coverings. Kids are able to understand that there are different rules in school than at home, and they are able to adapt accordingly.

Children are highly influenced by peers and teachers and are very in-tune to the attitudes and messaging they pick up from parents and authority figures. Teachers and administrators serve as role models whether or not they are wearing masks. Their actions directly influence their students. Additionally, if all peers are required to wear masks, social pressure will play a factor in compliance. Other schools have successfully masked children ages two and up since last year.

I also have to wonder why my own mental health and the mental health of my children matter less than the mental health of those opposed to taking any preventative measures. I am extremely grateful my children have the fortitude to wear their masks despite being the only ones in their respective classes to do so. Yet they have been teased, questioned, had masks pulled off, and they have to struggle with the burden of feeling unsafe and wondering why their school is not protecting their physical health. Parents and staff members have mentioned struggling with anxiety, depression and despair as they feel powerless to protect themselves and their children according to the advice of their doctors. Additionally I have heard from numerous people that they are experiencing a significant crisis of faith as they feel betrayed and disappointed by their community.

Conclusion

The fact is that we are now at a time of very high community transmission. Although it is nice to say “don’t send sick kids” and to “encourage” vaccination, the past year has shown us that we cannot rely on people to do the right thing of their own volition.

Popular opinion should not hold equal weight to data and expert guidance from specialists in the field. Schools are not being transparent about how their decisions are being made and by whom. The committees involved often contain doctors whose specialties are not pediatrics, virology, epidemiology, immunology etc. While there is always a role for rabbanim in these discussions, it must be recognized that, for the most part, they too are not experts in the relevant fields. If schools are choosing to go against the world, national, state, and local expert consensus guidelines, the burden of proof lies with them to show the studies and data supporting their approach. I have not seen any.

Hashem has given us the chochma of science to keep ourselves healthy so as to better serve Him. Taking mitigation actions recommended by all the leading experts is a level of hishtadlus that is our achrayus (responsibility). Ignoring them displays a lack of hakaras hatov (gratitude) for what He has provided us.  

 To the schools: I beg you to implement more safety measures immediately. The time for relying on people to just do the right thing and for gentle encouragement is not now....now we need actions to keep our children and community safe. 

I am concerned about the health of my children, the health of the family members they can infect, and the huge potential for chillul Hashem created when the yeshiva schools do not follow established public health guidelines. It is these guidelines that allow schools to operate and children to stay in class with minimal disruption. I entreat all concerned parents to not give up trying to advocate for your children’s safety and demand the schools do better…at least until the children’s vaccine is approved, G-d willing, in the next month.

 

Dr. Michal Millrod received her Ph.D. from the Immunology program in the Molecular Biology and Genomics Department at The Johns Hopkins University School of Medicine. She taught science at Bais Yaakov High School and at Maalot/WITS before pursuing postdoctoral research at Johns Hopkins. Dr. Millrod currently works as a research scientist for a stemcell biotech company. Dr. Millrod is an advocate for public health and child safety. She has been a Child Passenger Safety Technician for over five years and is currently serving as a Baltimore City Department of Health Vaccine Peer Ambassador for the Orthodox Jewish Community. Dr. Millrod has four young children ranging in age from six months to ten years old.

 

References

 

1.        Children and COVID-19 Vaccination Trends. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-vaccination-trends/.

2.        Your Guide to Masks | CDC. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html#print.

3.        Maryland Coronavirus Map and Case Count - The New York Times. https://www.nytimes.com/interactive/2021/us/maryland-covid-cases.html?fbclid=IwAR1ZVP-SOsEuga_vg-uj4iStFlVbLjbQoh0ylTd5ZyP6p7NknEzKu30IRbQ.

4.        A Colorado Town Is About as Vaccinated as It Can Get. Covid Still Isn’t Over There. | Kaiser Health News. https://khn.org/news/article/a-colorado-town-is-about-as-vaccinated-as-it-can-get-covid-still-isnt-over-there/.

5.        Provisional COVID-19 Deaths: Focus on Ages 0-18 Years | Data | Centers for Disease Control and Prevention. https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-Focus-on-Ages-0-18-Yea/nr4s-juj3.

6.        Maryland hospital beds for kids are filling up with COVID and other virus cases. When school starts, doctors say it could get worse. - Baltimore Sun. https://www.baltimoresun.com/coronavirus/bs-md-pediatric-covid-20210818-qkruyn754nesbm3ghwgdlyixrq-story.html.

7.        Parri, N. et al. Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks. Eur. J. Pediatr. 179, 1315–1323 (2020).

8.        Nogueira López, J., Grasa, C., Calvo, C. & García López-Hortelano, M. Long-term symptoms of COVID-19 in children. Acta Paediatr. Int. J. Paediatr. 110, 2282–2283 (2021).

9.        Ludvigsson, J. F. Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19. Acta Paediatr. Int. J. Paediatr. 110, 914–921 (2021).

10.      Buonsenso, D. et al. Preliminary evidence on long COVID in children. Acta Paediatr. Int. J. Paediatr. 110, 2208–2211 (2021).

11.      Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557. https://www.ada.gov/long_covid_joint_guidance.pdf (2021).

12.      Guidance for COVID-19 Prevention in K-12 Schools | CDC. https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html#print.

13.      COVID-19 Guidance for Safe Schools. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/.

14.      Supporting Students During the COVID-19 Pandemic: Maximizing In-Person Learning and Implementing Effective Practices for Students in Quarantine and Isolation | U.S. Department of Education. https://www.ed.gov/coronavirus/supporting-students-during-covid-19-pandemic.

15.      Maryland Department of Health and Maryland State Department of Education. K-12 School and Childcare COVID-19 Guidance. https://health.maryland.gov/phpa/Documents/07.23.2021 MDH MSDE School Childcare Guidance FINAL.pdf.

16.      Parks, S. E. COVID-19–Related School Closures and Learning Modality Changes — United States, August 1–September 17, 2021. MMWR. Morb. Mortal. Wkly. Rep. 70, (2021).

17.      Lam-Hine, T. Outbreak Associated with SARS-CoV-2 B.1.617.2 (Delta) Variant in an Elementary School — Marin County, California, May–June 2021. MMWR. Morb. Mortal. Wkly. Rep. 70, 1214–1219 (2021).

18.      Jehn, M. Association Between K–12 School Mask Policies and School-Associated COVID-19 Outbreaks — Maricopa and Pima Counties, Arizona, July–August 2021. MMWR. Morb. Mortal. Wkly. Rep. 70, (2021).

19.      Budzyn, S. E. Pediatric COVID-19 Cases in Counties With and Without School Mask Requirements — United States, July 1–September 4, 2021. MMWR. Morb. Mortal. Wkly. Rep. 70, (2021).

20.      Dawson, P. Pilot Investigation of SARS-CoV-2 Secondary Transmission in Kindergarten Through Grade 12 Schools Implementing Mitigation Strategies — St. Louis County and City of Springfield, Missouri, December 2020. MMWR. Morb. Mortal. Wkly. Rep. 70, 449–455 (2021).

21.      Hershow, R. B. Low SARS-CoV-2 Transmission in Elementary Schools — Salt Lake County, Utah, December 3, 2020–January 31, 2021. MMWR. Morb. Mortal. Wkly. Rep. 70, 442–448 (2021).

22.      Falk, A. COVID-19 Cases and Transmission in 17 K–12 Schools — Wood County, Wisconsin, August 31–November 29, 2020. MMWR. Morb. Mortal. Wkly. Rep. 70, 136–140 (2021).

23.      Doyle, T. COVID-19 in Primary and Secondary School Settings During the First Semester of School Reopening — Florida, August–December 2020. MMWR. Morb. Mortal. Wkly. Rep. 70, 437–441 (2021).

24.      As students with long-haul covid return to school, many districts don’t fully know how to help - The Washington Post. https://www.washingtonpost.com/health/2021/10/03/long-haul-covid-kids-schools/.

25.      Interim Guidelines for COVID-19 Antibody Testing | CDC. https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html.

 

 

 

 

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