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--:-- Sean Rameswaram: Everyone in this country knows someone who's dealing with some back-to-school drama right now, whether it's a student, a parent, or a teacher. My neighbor just told me his daughter's entire class had to get tested for COVID after just two days back in the classroom because someone got sick. I was FaceTiming with family in Utah, and one of the kids there told me a grown-ass man yelled at her brother to stop wearing a mask. A teacher I know in Missouri says she's going to go back to in-person classes, but if things get really bad and the district doesn't do anything to protect her, she's going to quit her freaking job.
--:-- Sean Rameswaram: The situation is tense, it's high stakes, and it's pretty confusing. So on the show today, we're going to try and figure out where we stand and how going back to school can be as safe as possible. To help, we reached out to Anya Kamenetz. I cover education for National Public Radio, and I'm the author of the forthcoming book, The Stolen Year, about kids and COVID.
--:-- Anya Kamenetz: All across the country, kids have been heading back into the classroom for a few weeks now, in many cases for the first time in 18 months. Give us a sense of how this massive social experiment is going.
--:-- Anya Kamenetz: Well, it has been hard for a lot of reasons that have nothing to do with the fundamentals of sending kids back into school. So school can be opened safely. That has been the sense of public health authorities around the world for many, many months now with the proper measures in place. You can reduce transmission or spread of COVID within schools to lower levels than the surrounding community.
--:-- Anya Kamenetz: But there is a lot of resistance to taking those proper measures. And there is a lot of fear and a lot of uncertainty and doubt around those measures because of the way that various communities relate to their local public schools. Can you give us a sense of the spectrum of experiences students, teachers, and parents are having across the United States? Because I know it can vary greatly depending on where you are.
--:-- Anya Kamenetz: Oh my gosh, yes. So a very large proportion, about 60% of students across the country, had in-person schooling by last November. So partisanship was the leading indicator of whether schools opened up or stayed closed last fall. I want to open the schools. We have to open our country. We're not going to have a country. And in the school districts that stayed open, they had a variety of experiences, right? Some did an OK job with mitigation and or got lucky and they were able to stay open most of the time.
--:-- Anya Kamenetz: Most of them closed during the worst of the surge last winter. And then there were districts that because of local political constraints, the strength of unions, the particular kind of lack of trust in the school system because of a lot of historical reasons, they did not open up. Today in Chicago, public schools are expected to announce plans to switch to an all-remote semester amid a strike threat from the teachers' union. And they didn't open up all the way into the spring, and in some cases, like in California, they're opening up now for the first time.
--:-- Sean Rameswaram: It was all smiles at Peabody Elementary School for pickup after school. Students saying they were happy to be back in class. My best friend hasn't been in the same classroom with me for the whole time I've been at the school, and now he finally is, which is super exciting.
--:-- Anya Kamenetz: I mean, obviously one of the big differences between schools that reopened, say, during the last school year and this school year is the Delta variant. How badly is Delta hitting kids right now? Do we know?
--:-- Anya Kamenetz: Okay, so you have to be really, really careful in how you talk about the impact of Delta on kids. The Delta wave has been a wave of unvaccinated people, right? So the cases that we're seeing are in unvaccinated people. And children are a big proportion of the unvaccinated. So you would expect to see, and in fact we are seeing, children make up a larger proportion of all cases during the Delta wave than they did in previous waves.
--:-- Anya Kamenetz: There are more sick kids. More than 252,000 children diagnosed with COVID last week. the highest number of pediatric cases since the pandemic began. However, and I just looked this up, the American Academy of Pediatrics, they track hospitalizations, right? Consistently throughout the pandemic, of all the kids that test positive for COVID, less than 2% end up in the hospital.
--:-- Anya Kamenetz: In fact, of all the kids testing positive for COVID, depending on the state, the percentage in the hospital is between 0.1 and 1.9%. So more kids are sick from COVID because of Delta, because Delta is more transmissible. It's more contagious, right? And because kids are unvaccinated. However, Delta is not worse for kids when they catch it.
--:-- Sean Rameswaram: So I guess that just makes me wonder, is this, broadly speaking, safe to return kids to school? So I guess the question is safe for who? That's number one. The other question is, what is the safety versus the risk of sending kids to school versus keeping them home for a third school year?
--:-- Anya Kamenetz: Yeah. So number one, safety versus risk. The risk of death of an unvaccinated child is very similar to or perhaps lower than the risk of death of a vaccinated 40 adult So the risk of death to children from COVID is unfathomably low So if we really just worried about kids getting sick from COVID it always been pretty safe for them to be in school.
--:-- Anya Kamenetz: Is that the only risk we're looking at? Well, it's possible, and in more and more districts, it's required for the adults in the schools to be vaccinated. And the teachers unions have endorsed a vaccination requirement. Randy Weingarten, head of the American Federation of Teachers, who once said members should not be coerced into getting the shot, told NBC's Meet the Press that teachers should be vaccinated, especially to protect kids under 12 who aren't eligible for the vaccine.
--:-- Sean Rameswaram: If the adults are able to be vaccinated and they're able to be masked and the kids are able to be masked, you can run a school with fewer cases in the school than in the surrounding environment. I also want to underline that there are very severe risks to keeping schools closed.
--:-- Anya Kamenetz: So this is a third disrupted school year that we're heading into. My daughter, my younger one, she was in overnight diapers in March 2020, and now she's starting kindergarten. This is a childhood, right? And mental health professionals and pediatricians are so concerned about the risks to children of the extended social isolation, the time without meaningful learning, the kinds of mental health issues that I'm seeing and hearing about both anecdotally and in studies of kids that are suicidal, kids that have developed OCD type complaints, kids that have ADHD that's almost manic because the amount of screen time is not something that they can really contend with.
--:-- Sean Rameswaram: So we have to understand that there are serious public health risks to keeping schools closed indefinitely as well, even though there may be risks to keeping them open. Okay, so with that in mind, knowing that there are these serious risks to keeping kids at home any longer than the country already has, what are the safety precautions schools can put in place to keep kids, parents, teachers safe while the country returns to school?
--:-- Anya Kamenetz: So the toolbox hasn't really changed very much since early 2020. We're looking at masking. We're looking at distancing to the extent possible. Distancing requirements have been softened a little bit, but some distancing is good. Ventilation, definitely to the extent you can. Air purifiers, open windows. And testing and quarantining.
--:-- Anya Kamenetz: What's different in the fall of 2021 versus the fall of 2020 is we have more access to tests. And there's been a lot of federal money appropriated to testing. At the high end, what some private schools do is they test all the kids. They test all the kids every week or maybe even twice a week. And if you do that, it's like you're running a movie set, okay? Like everybody's clean, everybody's tested, and you can pretty much run school like normal.
--:-- Sean Rameswaram: Los Angeles is doing a version of that. They're testing pretty much all the kids. A big change for students returning to school this fall, vaccinated or not, they are going to have to get tested for COVID on a weekly basis. The same will go for- New York is doing something that's more common, which is surveillance testing, which is testing a randomly chosen selection of children. City officials have said this 10% testing plan is the floor. It's not the ceiling. And if they need to, they have the ability to expand.
--:-- Sean Rameswaram: But the more testing you have, the quarantining, the contact tracing, the masking, the ventilation, to a certain extent, hand washing. These are the basic tools to keep kids safe. So it sounds like we know what works on safety. It's just a matter of resources. But the decision makers are anything but unified on this front, right?
--:-- Anya Kamenetz: So reopening schools has been an incredibly polarized issue from the jump. So we had President Trump last year pushing, pushing, pushing to reopen schools. And we hope that most schools are going to be open. We don't want people to make political statements or do it for political reasons. They think it's going to be good for them politically so they keep the schools closed. No way.
--:-- Sean Rameswaram: And so now we've been through a whole new iteration where, OK, there's a new consensus that kids do need to be in school. So actually, a Republican talking point from last year became something that everybody is joining in now. Everyone now says kids have to be in school. Ultimately, I'm always right.
--:-- Anya Kamenetz: What's happened now is, of course, there are many people who say, yes, I want my kids back in school. But then now the Republican-led districts or the very Republican-led states, they're going a step further and saying, well, we want everything back to normal. Therefore, we don't want our kids to have masks. We're not doing that in Florida, OK? We need our kids to breathe.
--:-- Sean Rameswaram: So when you start opening schools without masks and without vaccines, it's a very scary situation. You can have a lot of cases. You have a lot of kids getting sick. A lot of adults. I mean, there are many cases of teachers dying in states where they're not vaccinated, in states where they're not wearing masks.
--:-- Sean Rameswaram: So, you know, safe is safe with an asterisk. It's not just safe de facto to send kids back to school. You have to do things to make it safe. I mean, this is getting pretty vitriolic. People are threatening school board members. People are threatening school administrators over safety guidelines during a surging pandemic.
--:-- Sean Rameswaram: I'll second. We have a motion to adjourn. The scene just last night, the Granite School Board abruptly ending their meeting while angry parents chant their opposition to masks for students. A lot of people still... Actions have consequences. If you vote for this, we will come for you in a non-violent way. We know who you are. We know who you are. You can leave you really, but we will find you and we know who you are. You will never be allowed to come again. You will never be allowed.
--:-- Sean Rameswaram: I have a friend who's a district superintendent in a small town and in sort of a purple state. And she cries every day. She's brave. She puts on a happy face with the parents, with everyone she talks to, but she goes home and cries because her staff is refusing a vaccine mandate. She won't be able to staff her school because the lunch ladies and the bus drivers are so opposed to vaccines.
--:-- Sean Rameswaram: The parents, you know, half of them want to wear masks and half of them don't. So it's just incredibly combative. And, you know, we're all super tired of the pandemic. I don't think there's a single person, no matter what your political persuasion, that's not sick of this stuff.
--:-- Sean Rameswaram: And for parents who have had to watch their kids bear the brunt of this, whether through closed schools, canceled activities, in some places shuttered playgrounds they seeing other people get back to normal and they like why can my kid get back to normal I sympathize with that I don want to send my kid to school in a mask I wouldn do it if I didn you know believe science But not everybody does.
--:-- Sean Rameswaram: Do you think as, you know, days turn into weeks and weeks turn into months, it'll sort of take the temperature down on some of these issues? People will get used to protocols and people will get sort of used to the new normal? Or is it going to be this vitriolic and divisive in the months to come?
--:-- Anya Kamenetz: I do think these things are cyclical. You know, one really steady finding and pulling data over the decades is that even when people hate, you know, the education department, they love their local public schools and they love their teachers. And this is a red state, blue state thing. You know, people mostly go to public schools.
--:-- Sean Rameswaram: And so as the school year goes on, we are starting to see a little bit of the peaking of the Delta wave, perhaps in some places. If cases start coming down, perhaps the temperature and the rhetoric can come down. Everybody wants kids in school.
--:-- Sean Rameswaram: Quick break and then we're going to figure out when one of the largest unvaccinated groups in the country, kids under 12, might finally get the shot.
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--:-- Sean Rameswaram: Support for this show comes from Macy's. It's almost fall and that means it's time to cycle your wardrobe to the cold setting. Because while everyone loves a breezy summer outfit, let's be real. Layering is even more fun. That's why Macy's Fall Fashion Guide has everything you need to piece together the perfect look for you.
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--:-- Sean Rameswaram: You can even throw in some textural layers for contrast, like a faux fur bomber jacket from Karl Lagerfeld Paris. Whether your old favorite sweater or coat is on its last threads, or you're just craving a new vibe to switch things up, Macy's has got you covered this season.
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--:-- Sean Rameswaram: You know what could make school super safe for the kids? Vaccines. Pfizer is the furthest along in the process. Lauren Gardner covers the FDA for Politico.
--:-- Lauren Gardner: The FDA, you'll recall, approves vaccines. They are expected to submit their data on their oldest kid vaccine trials, so children ages 5 to 11. They're expected to submit that data later this month.
--:-- Lauren Gardner: So once that happens, the top vaccine regulator at FDA, Peter Marks, he said a few weeks ago that once they get that data, it will take at least a few weeks for FDA to make a decision. So a few weeks is a bit of a squishy timeline. But from what other Biden health officials have said, probably not till end of the year, early 2022.
--:-- Lauren Gardner: And what about the other vaccines? That's just Pfizer? That's just Pfizer. Moderna is on track to submit their data by the end of the year, they've said. And J&J, I don't believe, has started their children's trials.
--:-- Sean Rameswaram: Is there a sense that it takes a lot longer for kids than it does for adults? And if so, is that sense, you know, correct?
--:-- Lauren Gardner: Even in the course of a pandemic, you can't treat children as what a lot of pediatricians like to call little adults. They're smaller, developing bodies. They process drugs differently. So they may need a different dosing compared to what adults and older teens get already in the vaccines that are already on the market.
--:-- Lauren Gardner: Because of that, they may develop different side effects than an older person would develop. There may be rare and severe ones that they need to watch out for. So it's definitely a trickier process because you don't want to approve anything for children that could potentially harm them.
--:-- Sean Rameswaram: What kind of severe side effects might we be seeing in kids? One of the things that FDA is looking out for is a heart inflammatory condition called myocarditis.
--:-- Lauren Gardner: Myocarditis. Myocarditis is basically inflammation of the heart. The symptoms of myocarditis are generally chest pain, sometimes with shortness of breath and swelling of the ankles.
--:-- Lauren Gardner: The cases of this have cropped up among some recipients of the Pfizer and Moderna vaccines. They're the two vaccines that are made with messenger RNA technology. So innovative new vaccine technology been found to be very highly effective in terms of safety and efficacy, but this condition has been found in some folks who have gotten the shot.
--:-- Lauren Gardner: It rare but it been predominantly found in younger people particularly under 30 and particularly male So older male teens young male adults some females but mostly males The cause of myocarditis in people who have received the mRNA vaccines is not yet known.
--:-- Lauren Gardner: We believe that it is likely an immune reaction to the components of the vaccine, which is also what is needed to protect people from the virus itself. There may be other conditions they're looking out for, but that's one that they've already seen among younger populations that they want to make sure they adequately suss out before authorizing vaccines for younger kids.
--:-- Sean Rameswaram: How serious can this be? Most of the cases have been mild, according to CDC officials. So symptoms tend to clear up within a couple of days. With rest and medicine, people get back on their feet pretty quickly.
--:-- Lauren Gardner: Some cases may not be so mild, but on the whole, it hasn't been super, super serious. However, it's still a heart condition, so you want to take great care to make sure that nothing more severe could happen, especially when you're looking at a younger population.
--:-- Sean Rameswaram: And especially with the amount of skepticism we already see around these vaccines in adults, right?
--:-- Lauren Gardner: Exactly. So one of the ways FDA tried to address that was by going back to Pfizer and Moderna and asking them to increase the size of their trials for children. So enroll more kids so that hopefully they could pick up on any potential adverse reactions to the vaccine that while they still may be rare, if you have more kids enrolled, maybe you'd find them quicker.
--:-- Lauren Gardner: The problem with that, though, from pediatricians and other health experts I've spoken to is that you would need the trials to be a lot, a lot bigger to be able to detect something. As rare as we've seen in older people with myocarditis, you would need potentially tens of thousands of people at a trial to be able to pick that up.
--:-- Sean Rameswaram: So they're still probably not going to detect something like myocarditis in the populations they already have enrolled. But if you get more kids in the trials, you still have more data, and that may help assuage parents who are concerned about the things they've read about in the media about these side effects that, you know, they don't want their kids to get but also are still exceedingly rare.
--:-- Sean Rameswaram: So I imagine the FDA is balancing the need to be as careful as possible and to have the biggest trials possible with the immense political pressure to get this vaccine approved for kids.
--:-- Lauren Gardner: You're starting to see more politicians be vocal about the fact that nothing has been authorized for kids under 12 so far. Governor Larry Hogan, a Republican from Maryland, he specifically called out FDA saying. With more and more children heading back to school, we're also pushing federal officials to expedite approval so that five to 11 year olds can begin receiving the vaccines.
--:-- Lauren Gardner: We're being told that disapproval is still months away, but that is simply not soon enough and not good enough. You're seeing members of Congress write to FDA asking for briefings and information about what it's going to take for them to approve or authorize a vaccine for kids.
--:-- Sean Rameswaram: So you're starting to hear more calls for that. I'm sure that's tied to back to school season. And also because more kids are coming down with COVID.
--:-- Sean Rameswaram: And the other big question is, once these vaccines are approved, are they going to be just as divisive as the vaccines have been for the adults, right? Do we have any sense of how much of this country is actually going to get on board with vaccinating their kids?
--:-- Lauren Gardner: That's likely going to break down along geographic lines, as we've seen across the country already. Every state has different requirements or guidelines for how children can and can't get vaccinated. In some places, kids need parental consent to get vaccinated down to a certain age. Other places, they can be relatively young and still show up to a pharmacy or doctor and get a vaccine for whatever they feel they need a shot for.
--:-- Sean Rameswaram: So it's going to depend. If a child's parent is inherently against the COVID vaccines, the likelihood that they would ensure their children get vaccinated is probably pretty low.
--:-- Lauren Gardner: It is worth remembering here, though, that for decades upon decades in the United States, children have had vaccine mandates before they could even enter public schools. Mind you, they were vaccines that have been around a little bit longer.
--:-- Sean Rameswaram: So what remains to be seen is whether school districts, cities, states mandate COVID vaccines for younger kids while the vaccines are still authorized for emergency use.
--:-- Lauren Gardner: Let's say Pfizer gets the green light later this year. It's under emergency use authorization. it's been approved that way with the same rigor of data that it would to be fully licensed. It's just not as much data. So it's essentially the same regulatory process.
--:-- Sean Rameswaram: But there are some folks who don't think it would be legal to require a vaccine to attend school. So if any went that route, there would probably be a bunch of lawsuits.
--:-- Sean Rameswaram: So we can look forward to fighting about this for months to come. It'll never end.
--:-- Sean Rameswaram: Gardner, Politico, Kamenetz, NPR, Ramas Verum, Today Explained, produced by Brian, Patrick, Miles, one of those, all of those. Protect the children. More tomorrow. So long for now. Bye.
