Global Health Expert Lists Challenges Facing Schools During COVID-19

By Kathryn Luft & Christian Mendoza

Will your school welcome students back to campus this fall? Or will COVID-19 require more virtual learning? The answer depends on how well your community has responded to the pandemic.

According to global health expert and Harvard professor, Dr. Ashish Jha, communities that have successfully managed the spread of COVID-19 can welcome students back to school with safety guidelines. But in communities where the virus is still spreading rapidly, students are better off learning from home.

“We’ve got to make sure that the level of virus in the community is not very substantial,” Dr. Jha said in a Salmon Exclusive Interview. “There’s a lot of work that schools need to do to get there, but…if your community gets the virus under pretty good control, then yeah, I think we can make it relatively safe for kids to get back.”

Many schools plan to reopen with social distancing by having fewer students in classrooms. Some will also require students to wear masks, and according to Dr. Jha, there aren’t many effective substitutes for slowing the spread.

“I think we now have…very good scientific evidence that masks really help a lot,” Dr. Jha said. 

But what if a student struggles to wear a mask for a long period of time? 

“We should try to figure out why you can’t wear one: Is it something about fitting? Is it something that may be causing some irritation? – and try to solve that problem,” he added. “It does help a lot if you’re in a well-ventilated place, if you’re in a room which has good airflow, let’s say the windows are open, all of that will help if one person cannot wear a mask.” 

Having school virtually lowers the risk of students getting sick, but Dr. Jha acknowledged that not being in school has negative consequences.

“We send you to school not just because it is important for your social development, but it is also good for your mental development and mental health and learning,” he said, “but there are some communities in America where the outbreak is so bad that despite the cost of keeping kids at home, it is just not safe to get kids back to school.”

Schools will face the challenge of determining if COVID-19 cases show up. Schools have long been hosts for spreading viruses such as influenza. It will be difficult to determine what is and isn’t COVID-19, especially in the flu season, Dr. Jha said.

“It’s very important [to get the flu vaccine] this year….because we want to keep the levels of flu in the community as low as possible,” he said. “So imagine a kid gets sick, isn’t feeling well, has a fever, gets a flu test, and is negative. What do we do?”

Another challenge for schools will be dealing with asymptomatic spread, which means an infected person who has no symptoms gets other people sick.

According to Dr. Jha, there is no easy answer. He said as many as 20 percent of those who get COVID-19 have no or very mild symptoms. Around 60 to 70 percent of infected people develop moderate symptoms, which include a fever, cough, and sore throat. The remaining 10 to 20 percent will have very severe symptoms, which may result in hospitalizations and possibly deaths.

“I don’t know any virus that has such an incredibly broad range of effects,” he said.

Dr. Jha believes that having adequate testing is crucial, but tests will have to be plentiful, cheap, and quick in order to truly make schools safe. He said the United States has done nearly enough with testing.

“Imagine that there was a cheap and easy test that you can test everybody 2-3 times a week,” Dr. Jha said. “We just haven’t built the kind of testing we need to make America safe, open up our economy, and get our kids back to school. And it frustrates me because we have lots of great scientists and business people and companies that do this. We just haven’t done it and that bothers me.”

Dr. Jha warned about the way misinformation spreads on social media and the internet. He said that it is important to trust experts such as Dr. Anthony Fauci, the nation’s leading infectious disease expert, instead of people who have little experience in public health. Some people have used misinformation to downplay the severity of the pandemic, and that leads to people being less cautious.

“It is hard for most people to know who to trust and who not to,” Dr. Jha said. “And I’ve always said, look at people who have worked on these issues for a long time…who have real expertise.”

Despite these challenges, Dr. Jha is optimistic that science will prevail. He said accelerated vaccine trials around the world are producing positive results. “I am very optimistic that sometime in 2021, there won’t just be one vaccine, but multiple vaccines, and that they will work in preventing severe infection and be safe,” he said. 

Young people may also benefit from an effective vaccine, he said.  “I’m hopeful that the vaccine will be tested in kids and that will give us direct evidence of whether the vaccine works in kids or not,” he added. 

Although Dr. Jha admires Dr. Fauci’s experience, he was not overly impressed by the expert’s first pitch attempt for Major League Baseball’s 2020 Opening Game between the Yankees and Nationals on July 23, which bounced very short and far off target.

“This is not meant to throw any shade on the greatest infectious disease doctor in the world…who is brilliant, but his pitches could use a little improvement,” he said. 

He also said that he is confident he could throw the ball over the plate and into the catcher’s glove if given the same opportunity at a Pirates game.