It is official. The Centers for Disease Control and Prevention has alerted the American public that it is only a matter of time before we will see community transmission of coronavirus in the U.S. The CDC asked Americans to start preparing now for the major disruptions of daily life that are likely to occur.
Dr. Nancy Messonnier, the CDC’s director of the National Center for Immunization and Respiratory Diseases, specifically called out the possibility of school closings. And with good reason.
All schools in China are closed indefinitely, affecting 200 million school-aged children, as well as schools in Hong Kong. There are also significant school closures in Japan, South Korea, Mongolia, Vietnam and Iran (including in Tehran, the capital). Thus far, Italy has closed schools in the Lombardy region, including Milan, and as a result of local decisions some schools in Turin and Venice are closed as well.
Dr. Messonnier cautioned Americans: “You should think about what you would do for child care if schools or day cares closed.” She said that she has already asked her children’s schools about their plans for instruction in the case of school closures.
It is important that parents of preschool and school age children heed Dr. Messonnier’s advice. It is also important, however, to recognize that parents are not equally positioned to protect their children on their own. As in all public health emergencies, poor children and poor families will suffer the most. An ethically defensible policy of government school closures needs not only to meet the bar of public health necessity; it must also include active measures to mitigate the disproportionate burden that will fall on our most vulnerable children.
Consider food security. For many poor children, school meals are critical to their nutritional needs and thus their health. There are 11.2 million children, about 15% of all children, who live in a food-insecure household. During the 2017-2018 school year, 22 million children received free or discounted school lunches. About 12.5 million received free breakfast and 1.3 million children participated in After School Supper Programs.
Schools also provide critically needed stability for the 47% of low-income families who are housing insecure. Children who are homeless or who live in emotionally or physically threatening environments will now find themselves exposed to these threats without the respite the school day provides.
As public health officials contemplate the prospect that school closings may be necessary, it is not enough for them to urge parents to start planning for this contingency. Government agencies and community organizations in education, nutrition assistance and housing, as well as public health, must also be planning for how to mitigate the harms that will fall heavily on our most disadvantaged children, most of whom are children of color or live in rural areas.
At minimum, home-based instruction plans need to account for those children who do not have reliable internet access or adult supervision. Alternative emergency food assistance strategies need to be implemented, as well as emergency housing. And steps should be taken to minimize the likelihood that low income parents feel compelled to leave their young children home alone because they fear losing their jobs or cannot sustain even a temporary loss of parental income.
Home alone, hungry and scared, is not an ethically acceptable outcome for any child during a pandemic.
Ruth R. Faden (firstname.lastname@example.org) is founder of the Berman Institute of Bioethics and Philip Franklin Wagley Professor of Biomedical Ethics at Johns Hopkins University. Her most recent book is “Structural Injustice: Power, Advantage and Human Rights."