Rx: Close schools and prevent deaths
Students leave New Rochelle High School after classes are dismissed March 10. State officials are shuttering schools and houses of worship for two weeks in part of the New York City suburb New Rochelle in response to a cluster of coronavirus cases. Credit: AP/John Minchillo
Hospitals across Long Island are concerned about being overrun with patients suffering from COVID-19. One way to slow the spread is to close the schools.
Our elected officials and school district leaders on Long Island need to take the advice of public health experts and act now to implement social distancing.
Already, many of our hospital beds are filled with patients under investigation for COVID-19 and several hospitals have staff members out due to self-quarantine for COVID-19 exposures, all of this placing more stress on an already stressed health care system dealing with a high volume of seasonal flu patients. Hospitals cannot curb the spread of coronavirus without help from the community and community leaders.
While COVID-19 infection is typically a mild disease in children, schools represent an important source of spread of the virus into the community. And as efforts to limit mass gatherings are underway, many school districts are undecided about the next best steps. Many school districts state that since they have no confirmed cases of COVID-19, that no closures are needed. The challenge to this is that to date, we have had limited access to testing and testing itself can take four to seven days, creating a significant lag between testing and confirmation. This lag can allow for continued exposure for those in contact with the infected individual. In addition, due to limited testing availability, we cannot determine the true incidence of the disease, so the numbers reported grossly under represent the actual situation.
The Los Angeles Unified School District closed all schools last week, following the announcement of statewide school closures in Wisconsin, Michigan, Ohio, Utah, New Mexico, West Virginia, Virginia and Pennsylvania. This is not an easy decision and has significant impact on the daily lives of children and their parents who now have to figure out child care solutions. But this mitigation strategy is consistent with the strategy forwarded by Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. This strategy is designed to prevent a spike in COVID-19 cases that would overwhelm the health care system and result in significant mortality for COVID-19 patients. Fauci hopes to “flatten the curve” so that demand and capacity are better matched, and sparing the United States and its citizens from the horrors seen in other countries.
Inevitably, many parents will elect to keep their children home, but this is not optimal or coordinated and will negatively impact the students' education. Ideally, we would plan to close schools as an early spring break and utilize snow days now, allowing the weather to warm and hopefully providing some containment. If so, we might see a sharp decline in new cases and see some return to normalcy.
All around us we are seeing action by major companies and industries, and it is time for Nassau and Suffolk school districts to act. The situation in other countries is dire, many acted too late. Italy shut down after the virus overwhelmed that country’s health care system. Hospitals there have been struggling to keep up with more than 21,000 confirmed cases, resulting in more than 1,000 deaths. We cannot make the same mistakes, only to suffer the same outcome that is potentially avoidable.
Business as usual is not a responsible strategy.
Dr. Adhi Sharma is chief medical officer and executive vice president at Mount Sinai South Nassau Hospital.
