DISCLAIMER: The following is my personal opinion. It may differ from recommendations given by some policymakers, medical organizations, and educational institutions. I do not speak as a representative of any organization, medical or otherwise. And this is not medical advice, tailored to your individual situation – for that, you should consult your personal medical practitioner. The following are conclusions that I have reached based on my own analysis of the evidence at hand, which I present for your consideration.
To parents/students who have a choice:
CHOOSE ON-LINE CLASSES FOR THIS FALL, NOT IN-PERSON.
This applies to all levels of education, from Early Childhood Education to post-graduate work.
As a family physician, my patients know that I never give guarantees. “Will my surgery resolve my symptoms?” “Yes, 99.9% … but I never give guarantees”. “If I take this medication to lower my cholesterol, will that prevent a heart attack?” “Yes, all the studies indicate that it will lower your risk. But I never give guarantees.”
But in this case, I will give a guarantee:
If one student in an in-school class has COVID-19, all the other students in the class will eventually have COVID-19 as well.
It’s not a question of whether; it’s only a question of when.
Risk mitigation measures like reduced class size, physical distancing, mask-wearing, hand-washing, and disinfection of surfaces, may reduce the speed of spread from one student to another. There is much controversy about how these measures should be implemented, and how effective they may be. But even if all these combined measures are all used perfectly, they will not reduce the risk to zero.
And factoring in human psychology, there is no possible way that they will all be used perfectly.
People of all ages break rules. Young children may not understand the rules, or may choose not to follow them. Adolescents may defy authority and choose experimentation over obedience. Adults may break rules that they intend to follow, in moments of distraction or fatigue.
I can think of numerous examples of people breaking rules, intentionally or accidentally, and I’m sure you can too.
The only circumstance in which COVID-19 will not spread is if there are zero cases in the community. For example, New Zealand may have eradicated COVID-19 from its island nation, to which it has not allowed any visitors for quite some time. Canada does have regions in which the numbers are very low, but influx from neighbouring regions can occur at any time.
Contact tracing and shutting down the classroom, by the way, is like closing the barn door after the horse has bolted. The students and families who have been infected may not be able to infect anyone else, but in the meantime they may become seriously ill, possibly even die.
So (unless you live in New Zealand): if a student goes to classes in-person, expect that at some point they will bring COVID-19 home.
The next question is, how serious are the potential consequences of bringing COVID-19 home? What if the student, or the student’s family, are apparently low-risk for developing serious illness?
The problem here is that even low risk people – including young children, and apparently-healthy young adults – can become extremely sick, need extended hospitalization, even die. And if they don’t die, they could have life-long severe multi-organ illness.
Even if someone is apparently healthy, they could become an asymptomatic carrier & pass the infection on to others, causing them to become extremely sick / hospitalized / die.
And there is no way of predicting which of these groups any given person is going to be in.
Is it worth taking these risks, when there are other alternatives?
WHAT ABOUT THE EDUCATIONAL, SOCIAL, AND PSYCHOLOGICAL NEEDS OF THE STUDENTS?
There are many ways in which these needs can be met without in-person attendance in school. More about that in another post.
MY PERSONAL OPINION is that the risks of in-person classes far outweigh the possible benefits.
Hence my recommendation, for all levels of education, from Early Childhood Education to post-graduate work:
If you have a choice, choose on-line classes for this fall, not in-person.
Dr. Roslyn Schwartz, M.D., C.C.F.P.
09 August 2020
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Please consider this as permission to share the above analysis.
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