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COVID-19: Beyond Tomorrow
June 1, 2020

The Urgency and Challenge of Opening K-12 Schools in the Fall of 2020

Author Affiliations
  • 1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 2Johns Hopkins School of Education, Baltimore, Maryland
JAMA. 2020;324(2):133-134. doi:10.1001/jama.2020.10175

The sudden closure of kindergarten through 12th grade (K-12) schools nationwide this spring likely helped to avert a medical catastrophe from the coronavirus disease 2019 (COVID-19) pandemic. This decisive step, however, is casting a long shadow. By the time the school year ends in June, more than 55 million US children will have missed months of in-class instruction.1 The educational effect to date represents only one dimension of the harm to children.

More than 20 million children rely on school breakfast or lunch; surveys now indicate that 1 in 5 mothers with children younger than 12 years old report that their children are going hungry.2 Millions of children have lost access to health services through school-based health centers. There are major divides by race/ethnicity, geography, and economic class in access to home computers and high-speed internet.3 When prolonged school closures are combined with summer break, some children may to fall behind normal academic growth by as much as a year in mathematics.4

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    1 Comment for this article
    Missing Component
    Theresa Hartel, MSN, BSN, ANP | Boston College High School, Boston, MA
    Thank you for the presentation and valuable input regarding the challenges of opening US schools in the fall. There was, however, one component that was missing in the process-the role of school nurses in planning and implementing procedures to provide safe operations and care for their communities. Currently, 75% of US schools, both public and private, employee a school nurse. School nurses care for and manage students with acute and chronic illness. We work with primary care providers and specialists to plan and implement safe care and education for students with health issues and staff who require information in assisting with educating these students and keeping them safe. In addition we serve in a public health role identifying and, in communication with local authorities, managing communicable issues in our schools (pertussis, TB, etc). The reality is that, historically, we have seen students with Covid-like symptoms every day. We are very concerned about what this means moving forward for attendance, exclusion, time away from learning and management of students. We could use help from pediatricians and primary care providers in establishing a national standard of care for students which would provide an algorithm so that students may be tested and returned to school, if safe. Establishing the criteria for attendance, exclusion and return to school is what schools also need to safely return and maintain optimal schooling.