Schools and the Path to Zero: FAQ about latest guidance
January 14, 2020 — In December, a group of experts convened by the Justice, Health and Democracy Rapid Response Initiative, a collaboration between Harvard’s Edmond J. Safra Center for Ethics, New America, and the Brown University School of Public Health, released updated guidance for how to open schools safely.
The report, “Schools and the Path to Zero: Strategies for Pandemic Resilience in the Face of High Community Spread,” has received a lot of interest and some frequently asked questions have emerged, which we answer in this post. Please reach out to Lily Jacobs with additional questions.
The report has fifteen authors whose expertise spans epidemiology, medicine, health policy, public health and space use, educational ethics and research, democratic practice and procedure, governance and organizational ethics, and policy. They are: Danielle Allen at Harvard’s Edmond J. Safra Center; Joseph Allen at Harvard’s Chan School of Public Health; Helen Jenkins at Boston University’s School of Public Health; Meira Levinson at Harvard’s Graduate School of Education and Edmond J. Safra Center for Ethics; Ashish Jha and Stefanie Friedhoff at Brown’s School of Public Health; Emily Oster at Brown University; Michael Murphy at MASS Design Group; Elena Silva at New America; Jacob Fay at Harvard’s Edmond J. Safra Center; Ben Linville-Engler at MIT System Design and Management; Nien-he Hsieh at Harvard Business School; Natasha Warikoo at Tufts University; Todd Rogers at Harvard Kennedy School; Thomas Tsai at Harvard Chan School of Public Health.
A subset of our research network had released an earlier Path to Zero report on July 20, 2020, “Path to Zero & Schools: Achieving Pandemic Resilient Teaching and Learning Spaces.” This earlier report had recommended tiered priorities for returning students to in-person learning and had also used measures of community spread to provide guidelines for when to re-open or close. Since the release of that July guidance, our evidence-base for understanding the interaction between in-person learning and schools has increased, and given changes in knowledge, the July guidance is no longer appropriate. We released the new report to summarize learnings over the fall and to synthesize our best judgment for how to think about the relationship between covid-risk and in-person learning.
No, the goal is to help decision-makers focus on what is required to create a safe environment for in-person learning for educators, staff, and students in conditions of high community spread.
The main take-away of the report is that schools need to develop the organizational capacity to deliver infection control with the goal of achieving zero or near-zero in-school transmission even in contexts of high community spread. Achieving such organizational capacity depends on healthy partnerships among school and district leaders, educators and school staff, and public health officials. This organizational capacity for infection control will be necessary for many months to come, quite probably including in the fall — regardless of how vaccination processes unfold. This focus on developing the organizational capacity for ongoing, continuous work on infection control has been under-developed in previous work, including our own. We seek to rectify that here.
Even when teachers are vaccinated, rigorous infection control protocols will continue to be necessary for many months and are likely to be necessary into the fall. Even once teachers are vaccinated, neither students nor all families will be. It will continue to be important to block the transmission of COVID in school so that students do not contract the disease in school and carry the disease home to their families.
Masking should be mandated and is an essential component of infection control. If it is not possible to achieve a culture of adherence to infection controls, then it will not be possible to achieve safety. That said, educators can bring their own risk down to very low levels by focusing on their own masking and the quality of the mask they wear. Please see these recent pieces which emphasize the benefits to the wearer of layered masks or double-masking:
https://www.cell.com/med/fulltext/S2666-6340(20)30072-6
The contexts for lunch vary greatly across schools. This underscores the importance of having school infection control teams that can work in close concert with a district level situation room that includes public health officials as partners. Every school will have to pay close attention to the design of its approach to lunch. The basics pertain: be outside if you can, avoid congregating, stay distanced, eat quickly and put your mask back on when not actively eating. Other elements may also be pertinent depending on the school setting. Again, this is why it is so important to develop local understanding of and expertise in infection control.
The new variant simply makes infection control protocols all the more important. The goal needs to be achievement of high rates of adherence to all infection control protocols.