The Centers for Disease Control and Prevention on Friday called for the K-12 schools to reopen soon, offering a phased plan to get students back into classrooms and resolve a debate that is dividing communities across the country .
The guidelines highlight growing evidence that schools can safely open if they take steps to slow the spread of the coronavirus. The agency said that even in communities with high transmission rates, elementary school students can at least safely receive some personal instruction.
Middle and high school students, the agency said, can safely take in-person classes if the virus is less common, but may need to switch to hybrid or remote learning in communities with high-intensity outbreaks.
"C.D.C.'s operational strategy is based on scientific evidence and the best available evidence," said Dr. Rochelle Walensky, director of C.D.C., speaking to reporters on Friday.
The guidelines arrive in an intensifying debate. Even when parents in some districts with closed schools are frustrated, some teachers and their unions refuse to return to classrooms they consider unsafe.
Public school enrollment has declined in many districts. Education and civil rights activists are concerned about the harm to children who have been out of the classroom for nearly a year.
The recommendations strike a middle ground between those who seek resumption of personal learning and those who fear that reopening schools will spread the virus.
In advice that may disappoint some teachers, the document states that vaccination of educators should be a priority, but not a requirement for schools to reopen.
Nevertheless, both national unions thanked the C.D.C. for clearer guidance.
"For the first time since this pandemic began, we have a rigorous, science-based roadmap that our members can use to fight for a safe reopening," said Randi Weingarten, president of the American Federation of Teachers and ally of President Biden.
However, Ms. Weingarten and Becky Pringle, president of the National Education Association, argued that schools might find it difficult to implement the C.D.C. to implement without additional federal funding.
The agency's guidelines reiterate the idea that schools should be the last to close and the first to reopen in a community. But the C.D.C. has no power to force communities to take steps to reduce high transmission rates – like closing unnecessary businesses – to reopen schools.
According to the agency's new criteria, schools in more than 90 percent of the US states were unable to return to personal classrooms full time, according to Dr. Walensky. Even so, the majority of districts offer at least face-to-face learning, and about half of the country's students study in classrooms.
However, there are big differences in the people who have access to in-person tuition. The neighborhoods are mainly educated to poor, non-white children, who are more likely to have closed schools than in suburban and rural areas.
Researchers are not only concerned about the academic consequences of dropping out of school so long. Although the data are still very limited, many doctors and mental health experts report unusually high numbers of children and adolescents who are depressed, anxious, or have other mental health problems.
The agency's approach struck the right balance between the risks and benefits of in-person teaching, said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.
"We have accumulated a tremendous amount of damage by not opening schools," said Dr. Nuzzo. "This document is important in order to identify the risks related to this damage and to find a way forward."
The C.D.C. offered school administrators advice tailored to four levels of virus transmission in surrounding communities.
The agency said elementary schools could stay open regardless of virus levels in the surrounding community, suggesting evidence that young students are the least likely to be infected or spread the pathogen.
Only in communities with the highest levels of transmission should elementary schools switch to a hybrid model of distance learning and in-person tuition, the agency said. In any scenario, elementary schools should remain at least partially open. Middle schools and high schools should close completely and switch to virtual learning when transfer levels are highest, the agency said.
The guidelines also prioritized personal instruction over extracurricular activities such as sports and school events. If there is an outbreak, these activities should be restricted before classrooms are closed, officials said.
Some experts expressed concerns about the strategy. Many schools in communities where virus transmission is high have been open to face-to-face classes without the virus breaking out.
The agency's guidelines lacked detailed recommendations for improving ventilation in schools, an important protection.
In a short paragraph, the C.D.C. suggested schools open windows and doors to increase circulation but said they should not be opened "if it poses a safety or health risk".
Feb. 12, 2021, 7:34 p.m. ET
"CDC. Pays lip service to the ventilation in its report, and you have to look to find it," said Joseph Allen, an expert on building security at Harvard's TH Chan School of Public Health in Boston. "It's not as prominent as it can be should."
Other preventive measures taken by the C.D.C. Recommended for schools are those who have previously approved it. Universal mask wear and physical distancing are most effective, but the agency also advocated hand washing and hygiene, cleaning, and contact tracing.
The agency noted that schools refer all symptomatic students, teachers, staff and their close contacts for diagnostic testing, and that schools consider routine weekly testing of students and staff, except in communities where transmission is low. The costs and logistics of a comprehensive screening would place a heavy burden on school districts, some experts noted.
The C.D.C. In communities with higher levels of transmission, schools should ensure that individuals are at least two meters physically away from each other. However, in communities with lower transmission rates, the agency said students and staff should only be physically distant "as much as possible".
"We are concerned that if we mandate a physical distance of six feet, people will not be able to fully learn in person again," said Dr. Walensky too.
"Many communities have followed hybrid approaches or, in some cases, simply didn't open because they couldn't figure out this distance problem," said Dr. Nuzzo from the Johns Hopkins Bloomberg School of Public Health. "The whole attempt to bring children back to school doesn't have to collapse over it."
However, Ms. Pringle of the National Education Association, the country's largest teachers' union, said there should be no leeway for physical distancing or other mitigation strategies.
"We need detailed instructions from the C.D.C. that leaves no room for political games, ”she said. “This is an airborne disease. Masks must be mandated, social distance must be maintained, and adequate ventilation is a must. "
As before, the C.D.C. It is recommended that two measures be used to determine the risk of transmission in the community: the total number of new cases per 100,000 people and the percentage of positive test results over the past seven days.
Dr. Helen Jenkins, an infectious disease expert at Boston University, said the percentage of positive tests can depend on how many tests a community is doing. And the highest community spread levels defined by the agency are too conservative. Schools would be safe even if there were more cases in the community, she and other experts said.
Mr. Biden has pledged to open a majority of the K-8 schools within the first 100 days of his administration. But on Wednesday White House press secretary Jen Psaki said the president was referring to in-person tuition "at least one day a week."
Under the agency's new guidelines, many schools now working virtually should consider at least some in-person learning.
For example, if the new recommendations had gone into effect last fall, San Francisco could have opened all of its schools for personal teaching in mid-September. Under the guidelines, San Francisco could open elementary schools in a hybrid mode today, and the city is about to open middle and high schools in a hybrid mode.
Instead, the city's schools have closed since the pandemic began, and the district has agreed with its union on far more restrictive reopening standards. Officials have not set a date to bring young children back to school, and they have said they don't expect most middle and high school students to return in person this year.
The new guidelines recommended states immunize teachers in the early stages of rollout, but said that access to vaccines "should still not be viewed as a condition for schools to be reopened for personal instruction".
Vaccinating teachers is very effective in reducing cases among both teachers and students in a high school transmission model, said Carl Bergstrom, an infectious disease expert at the University of Washington in Seattle. "It should be an absolute priority," he said.
Still, he added, "I can see with certainty why they chose not to make this a requirement as it may not be possible to open schools in time."
Some teacher unions have also asked for strict air quality protection in school buildings, an issue raised by the C.D.C. is not fully covered.
In Boston, for example, air quality was a major issue in the resumption of negotiations between the school district and the teachers' union. Their agreement included air purifiers in classrooms and a system for testing and reporting air quality data.
Ms. Pringle, the union president, said its members remain concerned about aging schools without modern ventilation systems. These buildings were more likely to be in low-income and non-white communities, which were hardest hit by the pandemic.
On Friday, Dr. Walensky, while the new guidelines should allow schools to remain open in most local conditions, if transmission skyrockets – possibly due to the contagious new varieties that are beginning to circulate in the country – "we may need to reconsider. "