Dear Superintendent Thomas: (Knox County Superintendent Of Schools)
I am writing in response to the KCS COVID-19 survey and today’s email communication about possible alternatives to a traditional schedule and educational setting for the fall. I graduated from Farragut High School in 1993, I am the proud father of three children who attend Knox County Schools, and I have practiced as a board-certified Pediatrician in Loudon for 16 years. Be assured that my heart certainly seeks the best interests for our area youth.
To begin, I think it is important to understand the actual disease burden of the current novel coronavirus in children. To date, there has not been a single patient admitted to East Tennessee Children’s Hospital with a positive test. My clinic has not had even one positive test. There have been roughly 20 children diagnosed with COVID-19 in the entire area, none of which were sick enough to warrant hospitalization. In fact, there have only been a single-digit number of pediatric deaths in the United States, most of whom had significant comorbidities. This pattern is consistent worldwide, where larger countries have reported anywhere from 0.8-2% of their diagnosed COVID-19 infections to be in patients <18 years old, and hospitalizations and deaths are so infrequent that it has been difficult to even study those trends.
Contrast this with seasonal influenza: there have been 179 pediatric deaths in the U.S. for the 2019-2020 season, and children’s hospitals and ICUs are extremely busy with these ill children every winter. There are days that we see 10-20 positive flu tests in my outpatient clinic, alone. I do not ever remember a discussion of ceasing traditional education or dramatically altering the school day, even during the H1N1 pandemic, aside from dismissing school when student or teacher absenteeism reaches a critical point.
I would also like for you to consider both the adverse physical and psychosocial repercussions that the proposed “alternatives” would have. For many children, school is a much-needed safe area for them to learn, make friends, develop social skills, eat breakfast and lunch, and exercise. Many single-parent or dual-income households depend on schools to watch after their children so they are able to work. Breaking this routine has led to a great deal of stress, anxiety, depression, economic hardship, . . . and we are now seeing reports of increased domestic and spousal abuse, neglect, suicidality, malnutrition, and health consequences of the prolonged “shutdown.” In reality, the toll from this collateral damage will most certainly outweigh the disease burden of the coronavirus.
As far as the ideas of cloth masks and “distancing,” both are completely ridiculous for the pediatric population. There remains no convincing science that cloth masks slow or block the spread of respiratory viruses (which is why we have never recommended them in the past for flu or other illness outbreaks). There is also ZERO doubt that inappropriately wearing them actually increases risk due to fingers and hands being continuously soiled by respiratory flora by handling/adjusting/pulling down the mask. In essence, it is the equivalent of having all of our children pick their noses and bite their nails all day without washing their hands. My experience has been that at least 80-90% of adults misuse cloth face coverings, and that number is 100% for young children.
Distancing is
impossible in the classroom, cafeteria, and on busses, and (as I have
earlier explained) completely unnecessary. Most of our children are
already congregating again, playing and swimming together, and have
begun to resume sports. You can’t send them back to school in three
months and tell them to stay apart! Teachers and staff would have to
spend most of the day fussing at kids with a 6-foot ruler, completely
disrupting the day.
In closing, I completely understand the fear and hesitation that comes
with resuming school in the fall. There have been inordinate amounts of
misinformation, inexcusably-inflated illness and death projections, and
public attacks and shaming toward those who are eager to reopen
businesses, churches, and recreational activities. I will refrain from
giving opinion here on the motivations that may explain why this has
continued.
It is time to move beyond fear, continue to protect the at risk/elderly population, and return to normalcy – which is completely supported by two-and-a-half months of good data. I hope you thoughtfully consider the points I have made, seek counsel of other area providers and health officials that are qualified to discuss the disease burden in children, and make the best choice for the students of our Knox County Schools.
Please do not hesitate to call or email if I can be of any further assistance.
Respectfully yours,
Rob Schaerer, MD
