What endemic Covid-19 will mean for schools
By Andrew and Mario
For children, parents, and school communities across the country, it is time for rational exuberance. Critical Covid-19 indicators, including cases per 100,000 people, deaths per 100,000 people, infection rates, and test positivity rates confirm that vaccination is working. Add to this the historic infusion of federal funding to help schools recover, and there is reason to celebrate. We cannot, however, rest on our laurels. Now is the time to prepare for the likelihood of Covid-19 becoming an endemic virus, one that circulates in pockets of the population for years to come, in order to preempt future disruptions in schooling.
More than 60% of Americans have received at least one vaccination dose, inching us closer than we have been in the last 16 months to fully returning to pre-pandemic rhythms of life.
Enough people are protected from severe illness and death that masks mandates have been lifted, we're congregating again in larger numbers, and we’re collectively asking whether we have reached the penultimate phase of the pandemic.
So, what happens next? The scientific community has coalesced around the idea that Covid-19 will not be eradicated. Instead, it is likely to become endemic. Its trajectory, however, remains unclear.
A combination of human and virus behavior will determine its course. This is good news. In the United States, we have been able to control endemic viruses—including influenza—through vaccination, acquired immunity, and in rare instances, protective measures such as masking.
The existing science on global coronavirus behavior suggests that there is a risk of seasonal Covid-19 waves. Additionally, the potential for mutations in the virus’s spike protein, which vaccines target, cannot be overlooked, particularly with severe Covid-19 hotspots raging in South American and on the Indian subcontinent. Finally, young children, who will not be eligible for vaccination for months, may continue to contract Covid-19, but experience minimal or no symptoms. This scenario is likely. Existing endemic coronaviruses thrive in preschools and elementary schools. While it’s possible to mitigate against the risks of seasonal variation, mutation, and childhood disease, not nearly enough people have immunity to do so entirely.
Vaccination uptake varies wildly. Aside from the challenge of vaccine penetration, there remain serious questions around vaccine durability. Data shows the Covid-19 vaccines remain effective at six months. Beyond this time frame, the efficacy of vaccination is unknown. Both the vaccine manufacturers and federal officials have noted that they believe boosters will be needed after a year.
This leaves the education ecosystem with an incredibly ambiguous situation to plan for. Education leaders already have an enormous challenge in front of them. They need to spearhead a massive recovery effort that addresses the whole child using once-in-a-generation federal funding, while at the same time, engaging in advanced planning to ensure that if cases do surge, there will be no reason to close schools for in-person instruction.
At a minimum, the following strategies should be considered and debated locally.
1. Monitor the status of the pandemic in the Southern Hemisphere. While the absolute Covid-19 case counts in India have rightfully captured the world's attention, the per capita case counts and deaths in South America actually exceed those on the Indian subcontinent. What will be critical to monitor is breakthrough infections in vaccinated South Americans as the Covid-19 strains circulating in South America are likely to make their way into the Northern Hemisphere in the fall and winter.
2. Prepare a Vaccination Booster Campaign. As noted, drug manufacturers and the Biden Administration have given strong signals that vaccine boosters are likely to be needed as immunity wanes and new variants circulate. Local education leaders should prepare to implement on-going awareness campaigns to educate and inform their staff and eligible students about the need for vaccine boosters as they become available.
3. Conduct table-top and planning exercises with local health departments. The pandemic exposed shortcomings in the collective ability of public health and education officials to respond efficiently and comprehensively. Now is the time to address these gaps. White papers and after-action reports are helpful, but meaningful scenario planning for a seasonal recurrence or limited outbreak, with the people who will be tasked with making decisions, will build capacity, teamwork and the necessary muscle memory.
4. Efficiently and cost-effectively stockpile materials that are proven to prevent the spread of infection. Frequent hand washing, masks, and physical distancing remain the cornerstones of infection control. Rather than invest in new or experimental technologies, develop a one-month supply of infection control materials that are proven to work.
5. Share contingency plans proven to reduce transmission. Education leaders now know what works to prevent transmission. They should set expectations with community stakeholders now, about the actions that will be taken in the fall or winter should a localized outbreak occur.
The CDC, which has had an uneven few months in the eyes of education practitioners and policymakers, should provide updated guidance that clearly codifies processes and procedures to preempt issues associated with endemic Covid-19. For example, quarantine, a leading cause of shuttered schools over the last year, needs to be addressed, particularly as states declare that there will be no virtual option for students in the 2021-2022 school year.
All of us hope that school will take place in-person, everyday, for every student in America next year. For that to happen, we need to prepare for a different kind of Covid-19, one that we can manage if we act now.