School reopening plans should focus on disease control | Expert Opinion

On Wednesday, Gov. Tom Wolf and the state Department of Education announced “Preliminary Guidance for Phased Reopening of Pre-K to 12 Schools,” which requires all public and charter schools (and encourages private and parochial schools) to develop a health and safety plan for reopening during the ongoing COVID-19 pandemic.

Each school or district health and safety plan must address 16 requirements for a return to in-person instruction. The preliminary guidance document also offers 81 possible considerations for addressing plan requirements, noting that these “should not be considered exhaustive.”

Not exhaustive, but probably exhausting. While we applaud the emphasis on flexibility in tailoring plans to each school’s unique needs and context, we worry that schools may struggle to prioritize what matters most. Based on our experience in infectious-disease control, here is where we would focus when formulating a school health and safety plan for COVID-19:

Group students into small, closed “pods.” This concept extends our household “quaranteams” to school, and works on the same principle: A small group of students with one teacher that doesn’t mix with other pods during the day drastically limits the ability of the virus to spread throughout a large group and facilitates contact tracing in case of an outbreak.

Keep pods outdoors as much as possible. Transmission of SARS-CoV-2 is much reduced in outdoor compared with indoor settings. While many schools are not set up for extended outdoor time, getting outside is an easy way to mitigate exposure due to poor ventilation in aging buildings.

Turn hygiene practices into easy, mindless habits. Young children, teens, and adults need prompts to wash hands, avoid face-touching, and follow masking guidance. We are all still forming new habits. Building several default hand-washing breaks into the school day alleviates the cognitive burden of remembering to wash hands. Likewise, providing simple surface cleaning checklists, routines, and supplies to classroom and custodial staff will help maintain a clean environment.

Plan now for nimble cycling between in-school and remote learning. Even with the best plan in place at your school, there will be outbreaks at other schools and elsewhere in the city this fall, and these will likely result in city-wide closures at some point. Be prepared to help families cope with at-home learning.

Set up trusted, transparent communication channels with families. Parents and caregivers need to know at the start of the school year about new routines, transitions to remote learning, and, importantly, how closure decisions will be made. Parents also need to know how exposures and cases in the school community will be reported, what will happen in the case of exposures or cases, and how “alerts” about COVID-19 will be handled.

Reopen planning committees are furiously tackling a long and daunting list of concerns right now: Desk spacing, school calendar changes, staggered attendance, touchless sinks, daily temperature screening, contact tracing apps, one-way traffic flow within the building, and cafeteria operations.

These are all important but secondary epidemiological considerations for COVID-19 control. We encourage planning committees to prioritize the five strategies we highlight above -- all of which are mentioned, but not emphasized, in the state’s recent guidance. These key strategies can best decrease the risk of a large outbreak and facilitate the control of a smaller one.

Alison M. Buttenheim, Ph.D., M.B.A., is associate professor of nursing and health policy at the University of Pennsylvania School of Nursing. She studies the behavioral aspects of infectious-disease prevention. Michael Z. Levy, Ph.D., is associate professor of epidemiology at the Perelman School of Medicine at the University of Pennsylvania. He studies disease ecology and the control of infectious diseases.