In my pediatric practice, I am asked daily if it is safe to send children to school this fall. Clearly there is no perfect answer to this quandary. Families have different situations and no one solution will be right for everyone.

Over the past several weeks I have spoken with hundreds of students, from preschool through college, and from many different school districts, about their experience with virtual learning this spring. I applaud schools and teachers for all their work to support students and provide teaching. It was a shame to hear so much criticism while they faced the incredible challenge of reinventing themselves during a crisis. It was impossible for online school to be up and running on day one, and understandable that it failed to provide the same level of learning and support as in-person teaching. I also have no doubt that online school will be better this fall, as best practices are implemented.

In my large, but unscientific, sample of patients, most children did not like going to school online. They felt it was harder to learn and harder to connect with others. They often felt it was less interesting, less challenging, and less fun. They missed their friends. The organizational challenges of virtual classrooms, online assignments, and changing schedules were difficult for most families, and unsurmountable for some. Excessive screen time was a real problem.

Children who preferred virtual school generally fell into two groups: those who liked that there was less work but would almost certainly benefit from more teaching and structure, and those who suffer from social anxiety for whom the quarantine provided a respite from their real world stressors.

I believe schools should open in-person for two main reasons:

1. Schools provide so much more in-person than online and so much more than just academic learning. Children learn how to be part of a community and learn valuable social skills. Teachers and staff support students with learning difficulties, but also those with emotional problems and difficult home situations. Schools provide meals and a safety net to the most vulnerable children. Schools provide structure and keep kids engaged in productive activity throughout the school day. This supports their mental health and keeps them out of trouble. These valuable functions cannot be duplicated online. And learning is bound to be most successful for most students with face-to-face interactions.

2. Keeping kids out of school will not keep kids away from each other, and therefore it is unlikely to do much to prevent the spread of COVID-19, only where that spread occurs. Children have been asked to keep apart from their friends for almost five months already. Compliance with social distancing is far from perfect, but I can not imagine that children will continue even this level of effort for several more months, while many parents have returned to work. Moreover, children in a classroom will likely be much more compliant with masks and social distancing, than children gathering in a friend’s basement.

The American Academy of Pediatrics came to a similar conclusion: The AAP “strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.” Thankfully, healthy children are unlikely to get very sick with coronavirus and serious complications in children are rare. However, children with underlying medical illness and families who live with an elderly or immunocompromised relative may need to opt for virtual school.

To allow for social distancing most schools will need a hybrid model, so smaller cohorts of students can take turns meeting in the classroom. Of course plans will not be static through the year, and flexibility will be required for their success. Schools will no doubt have cases of COVID-19, just as anywhere else, and they will need to periodically suspend classes for certain groups, requiring seven to 14 days of quarantine and testing for potential contacts. This is the new normal.

I understand the legitimate concern that it is not without risk to open schools. It is also not without risk to open doctors offices. But we work hard to make it as safe as it can be, and balance the remaining risk with the paramount importance of providing medical care and life saving vaccines to our patients. The services that schools provide are no less essential to children than their medical care or groceries.

Schools should certainly open before bars and gyms and hair salons. Before we ask children to go without basic services and defer much of the personal growth that can only occur in a classroom, adults need to be willing to get along without some of our own conveniences. In order to help our kids get back to school safely we need to do all that we can to reduce the number of cases in our communities, including wearing masks, maintaining social distance, washing hands, and staying home when sick. We owe this to our children.

Dr. Ian Sklaver is a board-certified pediatrician, providing health care for children at Garden City Pediatrics in Beverly.

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