Mandate masks, not metrics, to reopen Maryland schools | COMMENTARY

Coronavirus vaccines are incredible scientific achievements, but with rollout moving at a snail’s pace, it may be well over a year before life is back to normal. Maryland’s students, suffering from extended school closures, cannot wait for universal vaccination to reenter their classrooms. And they don’t have to.

Remote instruction is a failed experiment. Student performance on MAP standardized tests has dropped significantly this fall. Failing grades have become more common, and attendance, social isolation, and mental health problems are endemic.

Despite this cascading crisis and data demonstrating school closures do little to control spread, Maryland, as one of only six states, as of October, with minimal to no in-person classes, is a sad outlier. Some districts have made modest but mostly ineffectual efforts. Worcester County plans to bring small, targeted groups back this month, helping only a minute fraction of its 7,000 students. Baltimore City has opened some schools, but with capacity for less than 2% of students. Considering that 40% of city residents lack reliable internet access, which trends along the lines of race and income, this is grossly inadequate and disproportionately harms minority students. Carroll County recently announced its return, which is great news for its students, but the last time they reopened it was only for a mere few weeks. Montgomery County, closed since March, also recently loosened its strict reopening thresholds from a daily average of five new cases per 100,000 to 15 under pressure from parents. Unfortunately, with cases far above the new level, this is too little too late. These minimal actions continue to hold more than 99% of Maryland’s public school students hostage to remote learning.

And therein lies the problem. While recent changes in plans and metrics are improvements, they remain arbitrary, harmful and ultimately unjustified restrictions of live instruction. Officials in Montgomery County and too many other school districts are putting bureaucratic inflexibility and pressure from outside sources above students and science. Safe reopening is possible, even amid serious community outbreaks, because masks, distancing and other basic mitigations work. For example, experiments conducted by the Mayo Clinic show that universal cloth or disposable masking reduces exposure to virus-laden respiratory droplets by over 99% — even at close distances. Opening windows a few inches and a 3-feet distancing rule have also been shown to be sufficient to curb spread. In fact, The Institute for Health Metrics and Evaluation has found that simple mask-wearing can curb virus spread significantly more rapidly than even vaccines. And this new research is why the opinions of public health officials have decisively shifted since the summer.

Infectious disease expert Anthony Fauci has said repeatedly that in-person classes should be “the default position.” CDC Director Robert Redfield, Ashish Jha of the Brown University School of Public Health, and Nina Schwalbe of the UN Institute of Global Health, have echoed that with data that now shows schools can be reopened safely and it is essential to do so. Likewise, a collaboration of health professionals wrote recently that “schools should be open even at very high levels of spread, provided that they strictly implement strategies of infection control.”

Governors across the U.S. are heeding this expert advice and are encouraging districts to reopen, stressing mitigation over metrics. The Maryland state superintendent and head of our Department of Health have also expressed similar views, yet our schools largely remain closed.

Money is not why public schools remain closed. Many public schools have sufficient PPE and upgraded HVAC systems. In comparison, area Catholic schools are open despite similar class sizes, facilities and spending per student. The Archdioceses of Washington and Baltimore developed strict, yet simple mitigation procedures, which minimized in-school spread at a cost that public schools can afford. Ample funds may explain why Maryland has yet to spend 70% of the Education Stabilization funding granted under the CARES Act in March.

With basic mitigation, public schools can reopen too. Elementary schools, in particular, are low-risk because young children are naturally less likely to spread disease than adults. Recognizing this, the list of states and districts that have appropriately decided to keep, at a minimum, their elementary schools open independent of community metrics is growing by the week.

Middle and high schools are also reopening with minimal student-to-student and student-to-staff spread, even amid states with elevated community rates. Schools in south Florida are open, with very little evidence of spread in schools, despite surging cases in the community. Tucson, Arizona, with a daily average nearing 100 new cases per 100,000, reports low transmission in schools. The CDC has similarly found low transmission in Mississippi schools, and additionally, those schoolchildren who were infected typically caught the virus elsewhere or attended schools with lax mask policies. An Ohio study found that close contacts of infected students rarely became infected themselves. North Carolina has similarly reopened their schools with minimal in-school spread. Health experts at Duke University estimate that for every 10,000 students and faculty in open North Carolina schools, between one and three will be infected in school per month. In contrast, over the last month, 190 of every 10,000 Americans got infected with coronavirus. Data out of Sweden showed that students attending school during the spring outbreak had no more ICU visits than previous months and that teachers were at no higher risk of hospitalization than any other profession.

Those who argue schools should remain closed claim they are protecting the well-being of teachers and students, but they simply do not have the evidence on their side. Leaders around the country are beginning to appreciate this reality. Governor Hogan must update official reopening guidance to reflect this new consensus and push harder for school districts to follow these insights. Each day, our students are kept in virtual-learning environments is harming them. All who care about the future of Maryland’s students should demand we recognize the facts and safely reopen our schools.

Margery Smelkinson is an immunology and infectious disease expert (sites.google.com/site/margerysmelkinson; msmelkinson@gmail.com).